Vascular Calcifications

Calcium-phosphate levels have an effect on the vascular wall. Calcium is a cation in human body. It is has a crucial effect on intracellular and extracellular mechanisms. Extracellular calcium levels are more than intracellular levels. In total serum, the calcium level is approximately 8.8–10.4. Parathormone and vitamin D regulate blood calcium levels. Phosphorus is more common than calcium in the human body. Most of the phosphorus is present in the skeletal system. Phosphorus level is approximately 2.5–4.5 mg/dl in blood. It is often observed calcification in cardiovascular system in some diseases such as chronic renal failure due to increased calcium-phosphate levels. While the calcification seems in tunica intima layer of the vessel in atherosclerotic disease, it seems in tunica media layer of vessel in chronic renal failure with high uremic level. Vascular calcification is due to arterial stiffness, stenosis, and occlusion. Vascular and valvular calcifications are irreversible. Increased arterial stiffness destroys vascular compliance, causes left ventricular hypertrophy, and disrupts coronary perfusion. As a result, increased vascular calcification is associated with cardiovascular mortality

Comparison of the Early Results of Preterm Infants who Underwent the Surgical Ligation of Patent Ductus Arteriosus with two Different Surgical Approaches

INTRODUCTION: Patent ductus arteriosus (PDA) is the most common congenital heart disease in preterm infants. Surgical ligation is still the gold standard technique, especially in low birth weight patients. To reduce surgical trauma and possible complications, the anterior mini-thoracotomy (AMT) technique has been defined. However, conventional lateral thoracotomy (LT) is still the method preferred by many centers today. In our study, we aimed to compare the early results of preterm infants who underwent PDA ligation with two different surgical techniques in a newly established center. METHODS: A total of 26 patients (12 males, 14 females; median gestational age at surgery 32 weeks [IQR: 29-37]) who underwent surgical PDA ligation in preterm infants between January 2018 and February 2020 were retrospectively analyzed. PDA closure was performed through the left anterior mini-thoracotomy approach in 15 of the patients and left lateral thoracotomy in 11 patients. The early outcomes of the two groups were compared. RESULTS: The median weight at operation was 1000 gr. (IQR: 720-1200) in AMT group and 1200 gr. (IQR: 1000 – 2800) in the LT group. The difference between weights at operation was found statistically significant (p: 0.03). The operation time of the AMT group was found to be statistically significantly shorter. (p: 0.03) DISCUSSION AND CONCLUSION: Anterior mini-thoracotomy technique provides an effective surgical closure in the low-weight preterm infant at least lateral thoracotomy technique. Based on the results of our series and our opinion, it should be considered the first choice surgical method, especially in very low and extremely low-weight preterm infants