Demonstration of the histopathological and immunohistochemical effects of a novel hemostatic agent, ankaferd blood stopper, on vascular tissue in a rat aortic bleeding model

Background: Ankaferd Blood Stopper®(ABS) is a folkloric medicinal plant extract used as a hemostatic agent in traditional Turkish medicine. This experimental study investigated the histopathological and immunohistochemical effects of ABS on vascular tissue in a rat model of aortic bleeding.Methods: Four groups of 11 Wistar albino rats were used. The abdominal aortas of the rats were wounded; an ABS-soaked tampon was applied to rats in Groups 1 and 3, and a plain gauze tampon was applied to rats in Groups 2 and 4 until the bleeding stopped. The bleeding time was recorded. Immediately following sacrificing, the arteriotomy sites from Groups 1 and 2 were removed. The abdominal incisions in Groups 3 and 4 were closed following hemostasis. On Day 7 of the study, Group 3 and 4 rats were sacrificed and the abdominal aorta arteriotomy sites were removed for histopathological and immunohistochemical evaluation.Results: The mean bleeding time in 15 animals in Groups 2 and 4 was 4.9 ± 0.6 s, and in 22 animals in Groups 1 and 3 was 3.1 ± 0.6 s. Distal aortic occlusion was not observed on either Day 1 or 7 in any group. Significantly more widespread and dense endothelial nitric oxide synthase (eNOS) staining was observed in Group 1 animals than Group 2. On Days 1 and 7 after application of ABS, histopathological changes, consisting of necrosis, inflammation, and endothelial cell loss, in the rat abdominal aortas did not differ between Groups 1 and 2. The basophilic discoloration in the ABS group on the operation day was a result of a foreign body reaction and hemosiderin-loaded histiocyte accumulation, which occurred on Day 7.Conclusions: In this study, hemostasis was successfully achieved with ABS in rat abdominal aortas. No histopathological change was found in the rat abdominal aortas between the ABS and control groups on Days 1 and 7. Further studies on the long-term effects of foreign body reactions and hemosiderin-loaded histiocyte accumulation are required. © 2010 Kandemir et al; licensee BioMed Central Ltd

Our open heart surgery experience in factor XII deficiency: a case report

WOS: 000385272300025Factor XII deficiency is an important hematological problem which is characterized by isolated prolongation of the activated partial thromboplastin time and presents with thrombosis and thromboembolism tendency rather than expected bleeding diathesis in clinical practice. A 55-year-old male patient who was scheduled for aortic coronary bypass graft surgery had elevated activated partial thromboplastin time (109.4 sec) as a laboratory finding. The patient was diagnosed with factor XII deficiency and operated in our clinic. No thromboembolic event was seen during follow-up. The patient was discharged in the seventh postoperative day uneventfully. Herein, we highlight the importance of this disease due to its rare occurrence and present our treatment strategy applied

Intracardiac Masses in Western Black Sea Region and Our Surgical Experience

WOS: 000386042600004Objective: We aimed to report our surgical experience and outcomes in patients operated for intracardiac mass in our clinic. Materials and Methods: Six patients were operated for an intracardiac mass between May 2006 and March 2015. Five patients were female and 1 was male; the mean age of the study population was 54 (34-82) years. One patient presented with dyspnea and tachycardia secondary to pulmonary thromboembolism (PTE) and one patient with syncope, while the other patients presented with constitutional symptoms such as fatigue and dyspnea. Definitive diagnosis was made by a combination of thoracoabdominal tomography (CT) and echocardiography in one patient, and transthoracic echocardiography (TTE) and/or transesophageal echocardiography (TEE) in the remaining patients. The time from the diagnosis to the operation of masses was 2.5 days (1-4 days) on average. Four patients aged over 45 years underwent coronary angiography, irrespective of gender. The operations were performed via cardiopulmonary bypass, under standard aorta bicaval cannulation, antegrade cold blood cardioplegia, and moderate hypothermia. All defects in the patients with the initial diagnosis of cardiac myxoma were primarily closed. One patient was operated for a right atrial mass (thrombus). None of the patients suffered an intraoperative complication. The patients were discharged after an average of 9.6 days. Results: Histopathological diagnosis was a thrombus secondary to hypercoagulopathy related to antipsychotic drug use in one patient, and myxoma in the other patients. All myxomas were located in the left atrium while thrombi were in the right atrium, extending to the inferior vena cava. None of the patients had a family history for intracardiac mass. All patients enjoyed a clear clinical benefit upon mass removal. No early or late-term mortality was observed. There were no recurrences between 1 to 106 months (17.6 months on average) during early or late follow-up. Conclusion: Intracardiac masses, with myxomas being in the first place, may cause embolism, syncope, palpitations, and dyspnea; they should thus be remembered in the differential diagnosis of other intracardiac pathologies and operated at an early stage as soon as they are diagnosed; the tumor mass should be totally excised with a wide resection

A rare case of coronary thrombectomy

WOS: 000378158900021A 59-year-old male patient was admitted to our clinic with the complaint of chest pain. Coronary angiography revealed acute myocardial infarction due to a thrombosis at the right coronary artery. Herein, we report a case undergoing quadruple coronary bypass grafting and revascularization and coronary thrombectomy on right coronary artery due to atherosclerotic heart disease and inferior myocardial infarction

Giant left atrial myxoma causing mitral valve obstruction and pulmonary hypertension

[No abstract available

Surgicaly Revascularized Type IV Dual LAD

WOS: 000217474100010Double LAD with same origin (type I, II, III) is a rare congenital anomaly, however double LAD arising from right and left main coronary arteries is even more rare (type IV). A 49-year-old male patient was referred to our center with typical angina. Echocardiography revealed depressed left ventricular systolic functions. Coronary angiography showed a terminated LAD in the middle portion of the anterior interventricular sulcus after giving first diagonal and septal branches and a second LAD originating from different ostium in the right coronary sinus and extending to interventricular sulcus distally. The aforementioned findings were compatible with type IV LAD coronary artery anomaly. Herein we aimed to share our revascularization experience in a patient with congenital type IV LAD anomaly

An unusual case of lymphedema tarda

WOS: 000241425300016PubMed: 17006408Background: Lymphedema is the result of the equilibrium between the load to be cleared and the transport capacity of the clearing system. Lymphedema may be classified as primary or secondary, based on the underlying etiology. Primary lymphedema is an unusual disorder characterized by inadequate lymphatic drainage. Lymphedema tarda is a rare form of primary lymphedema. Case Report: The case of lymphedema tarda documented here was chronic, progressive, and resistant to medical therapy and recurred several times after previous operations. Conclusions: We performed two-staged operations and we recommend that the staged excisional procedures offers reliable long-term improvement and minimizes postoperative complications in chronic advanced lymphedema

Thyroid dysfunction coexistence in patients with acute and subacute deep vein thrombosis

Objective: Coagulation anomalies in patients with thyroid dysfunction may vary from subclinical disorders in laboratory tests to life threatening thrombotic events or bleeding. We aimed to determine the effect of thyroid dysfunction on thrombophilia in patients with acute and subacute deep vein thrombosis (DVT). Materials and Methods: A number of 30 patients with the diagnosis of DVT between November 2015 and June 2016 included in this case - control study. The patients divided into two groups as provoked (with known ethiology, n = 13) and unprovoked (with un-known ethiology, n = 17) patients. Provoked patients group divided as the patients with acquired risk factors (predisposition) and/or the patients with genetic risk factors. Results: The difference of the rate of the thyroid dysfunction between the provoked and unprovoked groups was not significant (p=0.844). The PAI – 1 gene mutation was detected in 70% of the study cohort and none of the patients had prothrombin gene mutation. The most provocative factors for DVT were male gender and undergoing a major surgery in the last three months. Conclusions: There was no correlation between acute – subacute DVT and thyroid dysfunction in this study. Therefore, we think that the ‘provocative factors’ may support the relation of thyroid dysfunction and venous thromboembolism (VTE). We think that more studies with larger cohorts and prospective should be conducted about this subject

A preliminary study about the effects of warm priming solution on oxidative stress and postoperative atrial fibrillation in open heart surgery

WOS: 000309233400004PubMed: 22878793An important reason for production of ischemia and reperfusion injury and oxidative stress is the sudden and rapid changes in body temperature during the institution of cardiopulmonary bypass. The aim of this study was to investigate the effects of warm priming solution on oxidative stress and atrial fibrillation. This is a preliminary prospective study on a group of 40 patients who underwent elective coronary artery bypass grafting operation using cardiopulmonary bypass. Patients were randomized into two groups, each consisting of 20 patients; one group was primed with a solution at 20 A degrees C and the other at 36 A degrees C initially for cardiopulmonary bypass. Blood samples from both of the groups were drawn preoperatively and at the 15th and 60th min of aortic cross clamping and 24th h following the surgery. Serum malondialdehyde levels, protein carbonyl content and total antioxidant status were detected. Patients were followed for postoperative atrial fibrillation. Malondialdehyde and protein carbonyl content were found to be significantly higher and total antioxidant status was concordantly lower in the cold priming group at the 15th and 60th min, recovering to the normal range postoperatively at the 24th h. Patients in the cold priming group had developed a significantly higher rate of atrial fibrillation when compared with the patients in the warm priming group during the postoperative period. In conclusion, although this study has its limitation about the sample size it may provide an insight about the probable preventive effects of 36 A degrees C warm priming solution in oxidative stress and postoperative atrial fibrillation

A preliminary study about the effects of warm priming solution on oxidative stress and postoperative atrial fibrillation in open heart surgery

An important reason for production of ischemia and reperfusion injury and oxidative stress is the sudden and rapid changes in body temperature during the institution of cardiopulmonary bypass. The aim of this study was to investigate the effects of warm priming solution on oxidative stress and atrial fibrillation