Aortic Root Dissection Due to an Automated Fastener Device

Minimally invasive aortic valve replacement through a right thoracotomy is frequently performed in patients with aortic valve disease. The Cor-Knot Device (LSI Solutions) is an automated fastener that secures valve sutures. This case report is for a patient who developed postcardiotomy shock during a minimally invasive aortic valve surgery. The patient was found to have an aortic root dissection involving 90% of the aortic root circumference, including bilateral coronary ostia. The autopsy revealed that the aortic damage could be explained by a direct aortic intimal tear from the distal tip of the device shaft. The device was most likely not in perfect apposition to the sewing ring because of the restricted angle and space between the ribs

Genetics of immunoglobulin-A vasculitis (Henoch-Schönlein purpura): An updated review

Immunoglobulin-A vasculitis (IgAV) is classically a childhood small-sized blood vessel vasculitis with predominant involvement of the skin. Gastrointestinal and joint manifestations are common in patients diagnosed with this condition. Nephritis, which is more severe in adults, constitutes the most feared complication of this vasculitis. The molecular bases underlying the origin of IgAV have not been completely elucidated. Nevertheless, several pieces of evidence support the claim that genes play a crucial role in the pathogenesis of this disease. The human leukocyte antigen (HLA) region is, until now, the main genetic factor associated with IgAV pathogenesis. Besides a strong association with HLA class II alleles, specifically HLA-DRB1 alleles, HLA class I alleles also seem to influence on the predisposition of this disease. Other gene polymorphisms located outside the HLA region, including those coding cytokines, chemokines, adhesion molecules as well as those related to T-cells, aberrant glycosylation of IgA1, nitric oxide production, neoangiogenesis, renin-angiotensin system and lipid, Pyrin and homocysteine metabolism, may be implicated not only in the predisposition to IgAV but also in its severity. An update of the current knowledge of the genetic component associated with the pathogenesis of IgAV is detailed in this review.Acknowledgements: RL-Mis supported by the Miguel Servet I programme of the Spanish Ministry of Economy and Competitiveness through the grant CP16/ 00033. FG is recipient of a Sara Borrell postdoctoral fellowship from the “Instituto Carlos III de Salud” at the Spanish Ministry of Health (Spain) (CD15/00095). SR-M is supported by funds from the RETICS Program (RIER) (RD16/0012/0009). FDC is supported by the Ramón y Cajal programme of the Spanish Ministry of Economy and Competitiveness through the grant RYC-2014-16458

Surgical Approaches to Symptomatic Arteriovenous Fistula Aneurysms: a Single-Center Experience

Arteriovenous fistulas (AVFs) created for hemodialysis accesses are prone to aneurysmal degeneration. Arteriovenous fistula aneurysms may lead to pain, aesthetic problems, infection, bleeding, and fistula thrombosis. The aim of this study is to report our surgical approaches and outcomes of AVF aneurysms. Medical records of a total of 21 patients (9 males, 12 females) with an AVF aneurysm who underwent surgery at Karabuk Training and Research Hospital, Department of Cardiovascular Surgery between January 2013 and March 2015 were retrospectively analyzed. The mean age was 59.7±13.5 years. Aneurysmectomy was performed on eight patients, while partial aneurysmectomy and polytetrafluoroethylene graft interposition were carried out in four patients. Three patients underwent aneurysmorrhaphy, whereas six patients underwent thrombectomy + aneurysmorrhaphy to the aneurysmatic segment. All patients were discharged without any event at the postoperative second day. They were scheduled for follow-up visits and assessed by Doppler ultrasound. Currently, surgical repair is the gold standard in the treatment of AVF aneurysms. Based on our experience, we recommend surgical interventions for selected patients to maintain AVF continuation. [Med-Science 2016; 5(2.000): 403-10

Primary Myxoma of the Pulmonary Artery

P>Cardiac myxomas are most commonly found within the left atrium. We now report a patient presenting with dyspnea, palpitation, and chest pain who was found to have myxoma arising from the pulmonary valve commissure. Urgent surgical treatment is curative and warranted for these lesions, in order to prevent outflow obstruction and thromboembolic phenomena. (J Card Surg 2011;26:286-287)

Extracardiac Off-Pump Fontan Completion for Single Ventricle With Dextrocardia

Extracardiac off-pump is reported to result in better early hemodynamics and shorter mechanical ventilation periods. We present a case report of extracardiac off-pump Fontan in a 5-year-old girl with single ventricle and dextrocardia

Popliteal artery entrapment syndrome needs an interdisciplinary approach

Background: In this study, we report our long-term experiences of popliteal artery entrapment syndrome and to highlight the importance of an interdisciplinary approach

Selective glucose dehydration over novel metal phthalocyanine catalysts at low temperatures

In this report, promising carbon-based novel metal phthalocyanine catalysts were prepared and tested in glucose dehydration at low temperatures (90-130 degrees C) under atmospheric conditions. Most of the prepared phthalocyanines exhibited high conversions in dimethylsulfoxide (DMSO). A complete conversion of glucose was obtained over Aluminum phthalocyanine (AlPcCl) and Tin phthalocyanine (SnPcCl2) catalysts. AlPcCl also provided the highest HMF yield (53% in 3 h at 130 degrees C). Al3+ cations promoted the glucose conversion and Cl- anions played an active role in 5-Hydroxymethylfurfural (5-HMF) formation. Dimethylsulfoxide (DMSO) as a solvent, was also found effective with phthalocyanines for high 5-HMF yield by stabilizing its structure. Thus, the 5-HMF yield was observed high (53.0% at 130 degrees C for 3 h) over AlPcCl in DMSO. Kinetic studies showed that the optimum reaction temperature was 130 degrees C at 1/5 catalyst/glucose ratio for 3 h. Dehydration reactions, performed in the aqueous phase, exhibited higher fructose selectivities with AlPcCl catalyst.Research Fund of Usak University [2019/DTS005]; Regional Development ProgramThis work was mainly financially supported by the Research Fund of Usak University (2019/DTS005) and the Regional Development Program

A new heart surgery clinic: Open Heart Surgery Outcomes at Karabuk Training and Research Hospital: Assessment of the first year

This study aims to assess the one-year outcomes of open heart surgeries performed at the recently established Cardiovascular Surgery Clinic of Karabuk Training and Research Hospital. A total of 71 consecutive patients (60 males, 11 females; mean age 63.7±9.3 years; range 42 to 84 years) who underwent open heart surgery were evaluated retrospectively from 21 January 2016 to 21 January 2017. The most common comorbidity was hypertension (64.8%), followed by smoking (61.9%), chronic obstructive pulmonary disease (54.9%), and diabetes mellitus (40.6%). Mean length of stay at the intensive care unit was 3.4±2.9 days, and mean length of stay at the hospital was 10.4±6.9 days. In-hospital mortality occurred in a total of seven patients (9.9%). Early mortality (within the first 30 days) was seen in four (5.6%) patients. We believe our mortality and morbidity rates are acceptable despite the disadvantages of being a recently established center and the presence of multiple comorbid factors of patients. Although our clinic is a new center founded in Karabuk province, it is planned to become an important center in the future in terms of heart surgery through the increasing number and variety of surgeries. [Med-Science 2018; 7(1.000): 145-150

Airway management of major blunt tracheal and esophageal injury: A case report

Trans-sectional injuries of trachea are quite rare and can be extremely challenging for anesthesiologists to deal with. About 25% of post-traumatic deaths are due to thoracic traumas in which blunt injuries take a rather small place within and the resultant damage of respiratory tract is quite rare with an incidence of 0.5-2%.A recent review from a single trauma center revealed an incidence of 0.4% for tracheobronchial injury (TBI) due to blunt thoracic injuries. Most of the patients having tracheal transection lose their lives on the field due to loss of airway. Patients mostly present with a large spectrum of clinical features varying from hoarseness to respiratory collapse; though subcutaneous emphysema is the most common presenting sign which should remind possible TBI. Emergent surgery is preferred seldomly; such in cases of partial damage or because of late diagnosis, due to favorable outcome of conservative approach. Herein, we report the management of a case on TBI due to blunt thoracic trauma, experiencing difficult ventilation despite tracheal intubation. Fiber-optic bronchoscope (FOB) seems obligatory to visualize site and severity of injury and to ensure safe airway during procedures such as the neck exploration, primary end-to-end anastomosis of the trachea, tracheostomy, diversion pharyngostomy, and feeding jejunostomy