Coronary Artery and Mitral Valve Surgery in Takayasu's Arteritis: A Case Report

Concomitant coronary artery disease and mitral valve disease are rare in Takayasu's Arteritis. Our patient had Takayasu's Arteritis diagnosed 9 years ago. She had an inferior myocardial infarction and double stent implantation 8 months ago. She was admitted to the hospital for chest pain, and 3 vessel diseases were diagnosed with significant mitral regurgitation due to anterior leaflet prolapse. In this report, we present perioperative management of our patient who underwent coronary artery bypass grafting and mitral valve replacement

A useful cannulation strategy to facilitate re-warming during total arch replacement

"Distal-first" surgical technique with antegrade cerebral perfusion and early re-warming is a secure and comfortable method for aortic arch replacement. By using this technique, we can minimize total circulatory arrest and hypothermic periods. Cerebral morbidities can be reduced by antegrade cerebral perfusion which is achieved via both axillary cannulation and balloon-catheters. Distal organ, cerebral, and renal morbidities can be minimized by early femoral arterial perfusion and early re-warming that is re-started immediately after distal anastomosis is performed

The Reliability of the Use of Serum Neutrophil Gelatinase-Associated Lipocalin Levels in the Assessment of Renal Functions after Coronary Artery Bypass Grafting

Objective. Evaluation of perioperative renal function is very important for early diagnosis and treatment of acute kidney injury after coronary artery bypass grafting. Serum creatinine levels, creatinine clearance, and estimated glomerular filtration rates used in determination of postoperative kidney injury can lead to late detection. Therefore, it is necessary to make a diagnosis earlier in clinical practice and to search for a reliable method. The reliability of the use of serum neutrophil gelatinase-associated lipocalin levels in close follow-up of renal function was evaluated in patients with coronary artery bypass grafting under cardiopulmonary bypass in our study. Patients and Methods. A total of 40 patients who underwent coronary artery bypass grafting under cardiopulmonary bypass between September 2009 and February 2010 were included in the study. The reliability of the postoperative 1st day plasma neutrophil gelatinase-associated lipocalin (Triage (R) NGAL Device; Biosite Inc.) measurements was evaluated in kidney injury developed in the first 5 days after operation that was detected using the Risk-Injury-Failure-Loss-End stage criteria. Results. Ten (25%) women and 30 (75%) male patients were included in the study. The average age is 59 +/- 8.6 years. Kidney injury according to Risk-Injury-Failure-Loss-End stage criteria developed in 8 patients (20%). For 150 ng/mL cutoff value of postoperative plasma neutrophil gelatinase-associated lipocalin levels, the area under the receiver-operating characteristic curve was 0.965. Neutrophil gelatinase-associated lipocalins sensitivity, specificity, and negative and positive predictive values were 100%, 93.8%, 100%, and 80%, respectively. Conclusion. It has been determined that plasma neutrophil gelatinase-associated lipocalin levels can be reliably used for early diagnosis of kidney dysfunction in patients undergoing coronary artery bypass grafting

The reliability of estimated glomerular filtration rate in coronary artery bypass grafting

Background: In this study, we investigated the reliability of the estimated creatinine clearance and glomerular filtration rate in patients undergoing on-pump coronary artery bypass grafting

The dose-related effects of Dexmedetomidine on renal functions and serum neutrophil gelatinase-associated lipocalin values after coronary artery bypass grafting: a randomized, triple-blind, placebo-controlled study

OBJECTIVES: Acute kidney failure after coronary artery bypass grafting (CABG) is a serious complication that increases morbidity and mortality rates. Early detection and prevention of this complication are very important. A novel biomarker named neutrophil gelatinaseassociated lipocalin (NGAL) can play an important role in early diagnosis of acute kidney injury. Recent studies on the favourable effects of Dexmedetomidine on cardiac surgery have been published. The aim of this study is to investigate whether there is a dose-dependent positive effect of Dexmedetomidine on neutrophil gelatinase-associated lipocalin levels and renal functions when used after CABG

Central venous catheter insertion into the false lumen of a complicated aortic dissection

Thoracic endovascular repair is considered the first-line treatment in complicated acute type B dissection. Central venous catheters provide valuable vascular access during endovascular treatments. However, central venous catheters are not without complications. Herein, we report a case of central venous catheter insertion into the false lumen of a complicated acute type B aortic dissection by direct aortic puncture. The tip of the central venous catheter was in the false lumen. The central venous catheter was left in place initially and was removed after graft stent deployment. This case illustrates the importance of image guidance during central venous catheter insertion, which may further complicate an already complicated aortic dissection case