Double-orifice mitral valve and an associated malformation: secundum atrial septal defect

The authors report a case of double-orifice mitral valve (DOMV) which showed mitral stenosis and mild insufficiency. An associated anomaly was secundum atrial septal defect. DOMV is an unusual congenital heart defect. The occurrence of this anomaly with or without secundum atrial septal defect is very rare. More often it is associated with other congenital malformations arising from atrioventricular canal defects. There may be no haemodynamic consequences but mitral insufficiency and/or stenosis may complicate this malformation. Treatment can be summarised as abstention, surgical repair or valve replacement

Perioperative Hyperglycemia is a Strong Correlate of Postoperative Infection in Type II Diabetic Patients after Coronary Artery Bypass Grafting

This study was planned to assess the relationship of perioperative glycemic control to the subsequent risk of infectious complications and to compare early clinical outcomes of coronary artery bypass surgery in diabetics with nondiabetics in a single center. A total of 1090 adults who underwent coronary artery surgery in a five year period were included in a retrospective cohort study based on available chart review. Of 1090 patients, 400 had type II diabetes mellitus. Intraoperative and postoperative blood glucose levels in diabetic group were manipulated by means of a continuous insulin infusion. Data of pre- and postoperative blood glucose levels were evaluated with respect to postoperative infection risk for diabetics. Risks of early mortality, cerebrovascular accident, and postoperative infection in diabetic patients were compared with the nondiabetic group. High preoperative mean glucose levels were the main risk factor for the development of postoperative infection (p = 0.012 and p = 0.028 for the mean glucose levels 1 and 2 days before operation, respectively). For diabetic group, of 400 patients 20 (5%) were diagnosed to have postoperative infection (superficial sternal wound in 3 (0.75%), donor site infection in 4 (1%), mediastinitis in 5 (1.25%), urinary tract infection in 6 (1.5%), and lung infection in 2 (0.5%) patients). The diabetic group had significantly higher prevalence of mediastinitis, donor site infection, urinary tract infection and total infection (p values were 0.048, 0.013, 0.009, and 0.044, respectively). Early mortality was higher among diabetics than in nondiabetics (1.73% vs 3%, p = 0.048) but the risk of cerebrovascular accident in diabetics was not greater than in nondiabetics in early period. In patients with diabetes who undergo coronary artery bypass surgery, preoperative hyperglycemia is an independent predictor of short-term infectious complications and total length of stay in hospital.WoSScopu

Right Atrial Myxoma in an Infant

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Saǧ Ventrikül Çikiş Yolundaki Divertiküle Baǧli Ventriküler Taşikardi

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The Interventricular Septal Giant Hydatid Cyst Caused By Biventricular Outflow Tract Obstruction

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The Long-Term Follow Up Results Of Kay-Shiley Heart Valve Prostheses

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The effect of type ii diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease

Objective: The impact of DM on post-operative morbidity and mortality after valve surgery is less well defined and the results of the studies are controversial. This study evaluated the effects of DM on post-operative short-term morbidity after isolated mitral valve replacement. Methods: The study population included 214 consecutive patients undergoing isolated mitral valve replacement (MVR) with mechanical valves under cardiopulmonary bypass (CPB). Patients were divided into two groups; diabetics (group I, n=36) and non-diabetics (group II, n=178). The groups were compared with respect to pre- and post-operative creatinine and blood urea nitrogen (BUN) levels, post-operative cerebrovascular disorders, arrhythmia, post-operative revision due to blood loss, surgical site infection, post-opertive extubation time, intensive care unit (ICU) and in-hospital stay time, CPB and aortic cross-clamp time. Results: In the diabetic group, post-operative rate of cerebrovascular disorders (13.9% vs. 2.8%; p=0.015), intubation time (11.5±7.6 h vs. 10.4±15.9 h; p=0.001 ), length of ICU stay (3.5±2.9 d vs. 2.7±2.1 d; p=0.001 ) and in-hospital stay (14.4±8.9 d vs. 11.1±6.9 d; p=0.023), rate of surgical site infection (19.4% vs. 3.9%; p=0.003), revision requirement rate (16.7% vs. 6.2%; p=0.045) were significantly higher. DM was also identified as an independent risk factor for surgical site infection, cerebrovascular disorder, arrhythmia and requirement of revision. Conclusion: This study showed that DM not only increases short-term morbidity due to its multiple effects but is also an independent risk factor for surgical site infection, cerebrovascular disorder, arrhythmia and requirement of revision after isolated mitral valve replacement procedures. ©Copyright 2011 by Gazi University Medical Faculty