Mid-term outcomes of thoracic endovascular aortic repair for complicated type B aortic dissection

Objectives: The aim of this study was to evaluate the mid-term outcomes of thoracic endovascular aortic repair (TEVAR) of complicated type B aortic dissection. Patients and methods: This retrospective study included a total of 29 consecutive patients (27 males, 2 females; mean age 61.1±11.8 years; range, 34 to 80 years) who underwent TEVAR due to complicated type B aortic dissection at our center between March 2015 and December 2018. All pre-, intra-, and postoperative data were collected. Surgical and discharge notes were reviewed. Results: Of the patients, 27 had hypertension and seven had coronary artery disease. The mean maximum aortic diameter was 50.5±7.7 mm. Suspicion of impending rupture was the most (n=13) associated complication with type B aortic dissection. Six patients (20.7%) had rupture and 10 patients (34.5%) had uncontrolled hypertension. The procedure was performed under elective conditions in 18 patients (62.1%) and under emergency setting in 11 patients (37.9%). Early mortality was developed in one patient (3.4%) due to low cardiac output syndrome. The mean follow-up was 25±11 months. Late mortality occurred in two patients (6.9%) due to lung cancer and sepsis. The overall survival rate was 86.1±9.8% and freedom from aortic re-intervention was 88.8±7.5% at 50 months. Conclusion: Our study results show that TEVAR is a safe procedure associated with good postoperative outcomes, and outstanding mid-term results in complicated type B aortic dissection

فاعلية تطبيق التحول الرقمي ممارسة للحوكمة الرقمية دراسة استطالعية في المصارف األهلية في محافظة بغداد

هدف المقال تحري فاعلية تطبيق التحول الرقمي في المصارف العراقية، تألف مجتمع الدراسة من )5000( فرد من شاغلي الوظائف اإلدارية، سحبت منه عينة بالطريقة العشوائية الطبقية المتساوية، بمجموع كلي )406( استمارة إال ان االستبانات المعادة والصالحة للتحليل كانت )197( استبانة وتشكل نسبة )%49( من مجموع االستمارات الموزعة، واعتمدت االستبانة أداة رئيسة في جمع البيانات واستخدمت وسائل اإلحصاء الوصفي )الوسط الحسابي، واالنحراف المعياري، واختبار t )في تحليل البيانات . أظهرت نتائج الدراسة ان مستوى التحّول الرقمي جاء متوسطا ًبشكل عام، وهذا ما يشير إلى أن المصارف األهلية العراقية تهتم بجانب فاعلية عمليات التفاعل االجتماعي بمستوى متوسط بحيث أن المصرف يمتلك خبرات قادرة على حماية سرية البيانات في الحوسبة السحابية واستخدام تطبيقات الهواتف في خدمة الزبائن وإعالن الخدمات الجديدة وفي تسوق الزبائن ومعرفة آراء العمالء. وقدمت الدراسة مجموعة من التوصيات أهمها االهتمام بموضوع البيانات الضخمة وتهيئة المتطلبات والموارد الالزمة لالستثمار فيها، االهتمام بموضوع الحوسبة السحابية ووضع آليات استخدامها والتدريب عليها

Further biochemical profiling of Hypholoma fasciculare metabolome reveals its chemo-genetic diversity

Natural products with novel chemistry are urgently needed to battle the continued increase in microbial drug resistance. Mushroom-forming fungi are underutilized as a source of novel antibiotics in the literature due to their challenging culture preparation and genetic intractability. However, modern fungal molecular and synthetic biology tools have renewed interest in exploring mushroom fungi for novel therapeutic agents. The aims of this study were to investigate the secondary metabolites of nine basidiomycetes, screen their biological and chemical properties, and then investigate the genetic pathways associated with their production. Of the nine fungi selected, was revealed to be a highly active antagonistic species, with antimicrobial activity against three different microorganisms: , , and . Genomic comparisons and chromatographic studies were employed to characterize more than 15 biosynthetic gene clusters and resulted in the identification of 3,5-dichloromethoxy benzoic acid as a potential antibacterial compound. The biosynthetic gene cluster for this product is also predicted. This study reinforces the potential of mushroom-forming fungi as an underexplored reservoir of bioactive natural products. Access to genomic data, and chemical-based frameworks, will assist the development and application of novel molecules with applications in both the pharmaceutical and agrochemical industries

Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019.

The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.Funding/Support: The Institute for Health Metrics and Evaluation received funding from the Bill & Melinda Gates Foundation and the American Lebanese Syrian Associated Charities. Dr Aljunid acknowledges the Department of Health Policy and Management of Kuwait University and the International Centre for Casemix and Clinical Coding, National University of Malaysia for the approval and support to participate in this research project. Dr Bhaskar acknowledges institutional support from the NSW Ministry of Health and NSW Health Pathology. Dr Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, which is funded by the German Federal Ministry of Education and Research. Dr Braithwaite acknowledges funding from the National Institutes of Health/ National Cancer Institute. Dr Conde acknowledges financial support from the European Research Council ERC Starting Grant agreement No 848325. Dr Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia, IP under the Norma Transitória grant DL57/2016/CP1334/CT0006. Dr Ghith acknowledges support from a grant from Novo Nordisk Foundation (NNF16OC0021856). Dr Glasbey is supported by a National Institute of Health Research Doctoral Research Fellowship. Dr Vivek Kumar Gupta acknowledges funding support from National Health and Medical Research Council Australia. Dr Haque thanks Jazan University, Saudi Arabia for providing access to the Saudi Digital Library for this research study. Drs Herteliu, Pana, and Ausloos are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. Dr Hugo received support from the Higher Education Improvement Coordination of the Brazilian Ministry of Education for a sabbatical period at the Institute for Health Metrics and Evaluation, between September 2019 and August 2020. Dr Sheikh Mohammed Shariful Islam acknowledges funding by a National Heart Foundation of Australia Fellowship and National Health and Medical Research Council Emerging Leadership Fellowship. Dr Jakovljevic acknowledges support through grant OI 175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. Dr Katikireddi acknowledges funding from a NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_00022/2), and the Scottish Government Chief Scientist Office (SPHSU17). Dr Md Nuruzzaman Khan acknowledges the support of Jatiya Kabi Kazi Nazrul Islam University, Bangladesh. Dr Yun Jin Kim was supported by the Research Management Centre, Xiamen University Malaysia (XMUMRF/2020-C6/ITCM/0004). Dr Koulmane Laxminarayana acknowledges institutional support from Manipal Academy of Higher Education. Dr Landires is a member of the Sistema Nacional de Investigación, which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación. Dr Loureiro was supported by national funds through Fundação para a Ciência e Tecnologia under the Scientific Employment Stimulus–Institutional Call (CEECINST/00049/2018). Dr Molokhia is supported by the National Institute for Health Research Biomedical Research Center at Guy’s and St Thomas’ National Health Service Foundation Trust and King’s College London. Dr Moosavi appreciates NIGEB's support. Dr Pati acknowledges support from the SIAN Institute, Association for Biodiversity Conservation & Research. Dr Rakovac acknowledges a grant from the government of the Russian Federation in the context of World Health Organization Noncommunicable Diseases Office. Dr Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. Dr Sheikh acknowledges support from Health Data Research UK. Drs Adithi Shetty and Unnikrishnan acknowledge support given by Kasturba Medical College, Mangalore, Manipal Academy of Higher Education. Dr Pavanchand H. Shetty acknowledges Manipal Academy of Higher Education for their research support. Dr Diego Augusto Santos Silva was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil Finance Code 001 and is supported in part by CNPq (302028/2018-8). Dr Zhu acknowledges the Cancer Prevention and Research Institute of Texas grant RP210042

Mitral kapak onarımın dayanıklığı: Tek merkez deneyimi

Background: This study aims to present clinical outcomes of mitral valve repair in patients with different etiologies. Methods: Between June 2006 and August 2017, a total of 421 consecutive patients (266 males, 155 females; mean age 53.1±15.6 years; range, 5 to 89 years) who underwent mitral valve repair with or without concomitant cardiac procedures were retrospectively analyzed. All pre-, intra-, and postoperative data were collected. Echocardiographic examinations were performed at discharge and during follow-up. Kaplan-Meier analysis was used to estimate overall survival and from residual severe mitral regurgitation, endocarditis and reoperation-free survival rates. Results: The mean follow-up was 58.9±35.1 months. Of the patients, 12 (2.8%) had previous cardiac operations. The most predominant pathology was degenerative disease in 265 patients (62.9%). Repair techniques included ring annuloplasty (n=366, 86.9%), artificial chordae implantation (n=185, 44%), and commissurotomy (n=38, 9%). Overall in-hospital mortality rate was 1.2% (n=5). Echocardiography before discharge showed no/trivial mitral regurgitation in 64.9% (n=270) and mild mitral regurgitation in 34.85% (n=145) of the patients. At the late postoperative period, transthoracic echocardiography revealed moderate mitral regurgitation in 23 patients (5.7%) and severe in 11 patients (2.7%). The mean late survival and freedom from endocarditis, reoperation, and recurrent severe mitral regurgitation rates were 92±0.03%, 98.5±0.07%, 98.1±0.01%, and 94.7±0.02%, respectively. Conclusion: Our study results suggest that mitral valve repair is a safe and effective procedure associated with favorable longterm outcomes in experienced centers.Amaç: Bu çalışmada farklı etiyolojileri olan hastalarda mitral kapak onarımının klinik sonuçları sunuldu. Ça­lış­ma pla­nı: Haziran 2006 - Ağustos 2017 tarihleri arasında eş zamanlı kardiyak ameliyat ile birlikte veya tek başına mitral kapak onarımı yapılan toplam 421 ardışık hasta (266 erkek, 155 kadın; ort. yaş 53.1±15.6 yıl; dağılım, 5-89 yıl) retrospektif olarak incelendi. Tüm ameliyat öncesi, sırası ve sonrası veriler toplandı. Ekokardiyografik incelemeler taburculukta ve takip sırasında yapıldı. Kaplan-Meier analizi genel sağkalım ve rezidüel ciddi mitral yetmezlik, endokardit ve tekrar ameliyatsız sağkalım oranlarının tahmininde kullanıldı. Bulgular: Ortalama takip süresi 58.9±35.1 ay idi. Hastaların 12’si (%2.8) daha önce kalp ameliyatı geçirmişti. En yaygın patoloji 265 hastada (%62.9) dejeneratif hastalık idi. Onarım teknikleri ring anüloplasti (n=366, %86.9), yapay korda implantasyonu (n=185, %44) ve komissürotomi (n=38, %9) idi. Genel olarak hastane mortalitesi %1.2 (n=5) idi. Taburculuk öncesinde ekokardiyografide hastaların %64.9’unda (n=270) mitral yetmezlik izlenmedi veya önemsiz mitral yetmezlik izlendi ve hastaların %34.85’inde (n=145) hafif mitral yetmezlik izlendi. Ameliyat sonrası geç dönemde, transtorasik ekokardiyografide 23 hastada (%5.7) orta dereceli ve 11 hastada (%2.7) ciddi mitral yetmezlik izlendi. Ortalama geç sağkalım, endokardit, yeniden ameliyat ve tekrarlayan ciddi mitral yetmezlikten bağımsızlık oranı sırasıyla %92±0.03, %98.5±0.07, %98.1±0.01 ve %94.7±0.02 idi. So­nuç: Çalışma sonuçlarımız mitral kapak onarımının deneyimli merkezlerde uzun dönem olumlu sonuçlar ile ilişkili olarak, güvenli ve etkin bir yöntem olduğunu göstermektedi

Açık kalp cerrahisi sonrası sternal yara komplikasyonlarının görülme sıklığı Jackson-Pratt dreni kullanımı ile etkilenir mi?

Background: This study aims to investigate the effect of theJackson-Pratt drain on sternal wound complications in patients witha Body Mass Index of ≥30 kg/m2 undergoing open cardiac surgeryvia median sternotomy.Methods: A total of 174 patients (124 males, 50 females; mean age58.2±10.4 years; range, 33 to 78 years) with a Body Mass Indexof ≥30 kg/m2 undergoing cardiac surgery via median sternotomybetween January 2011 and December 2015 in our institutionwere retrospectively analyzed. Of the patients, 94 were inserteda Jackson-Pratt drain (JP group) following median sternotomy,while 80 patients received no drain (non-JP group). Pre-, intra, andpostoperative outcomes of both groups including type of operation,length of hospital stay, and complications were compared.Results: No significant difference in the age, gender, Body MassIndex, and potential risk factors was found between the groups. Themedian of stay in the intensive care unit was two days and the mediantime from operation to discharge was seven days in both groups. Therewas a statistically significant difference in the rate of sternal woundcomplications between the groups. Sternal wound complicationsoccurred in two patients (2.1%) in the drained group, compared to ninepatients (11.25%) in the non-drained group (p=0.01).Conclusion: Our study results show that Jackson-Pratt draininsertion after median sternotomy in patients with a Body MassIndex of ≥30 kg/m2 undergoing open cardiac surgery is a simpleand reliable method to reduce the risk of postoperative sternalwound complications, compared to the conventional closuretechnique.Amaç: Bu çalışmada median sternotomi ile açık kalp cerrahisi yapılan, Vücut Kütle İndeksi ≥30 kg/m2 olan hastalarda Jackson- Pratt dreninin sternal yara komplikasyonları üzerindeki etkisi incelendi. Çalışma planı: Ocak 2011 - Aralık 2015 tarihleri arasında Vücut Kütle İndeksi ≥30 kg/m2 olan, hastanemizde median sternotomi ile açık kalp cerrahisi yapılan toplam 174 hasta (124 erkek, 50 kadın; ort. yaş 58.2±10.4 yıl; dağılım, 33-78 yıl) retrospektif olarak incelendi. Hastaların 94’üne median sternotomi sonrası Jackson-Pratt dreni takılırken (JP grubu), 80 hastaya dren takılmadı (JP olmayan grup). Her iki grubun ameliyat tipi, hastanede kalış süresi ve komplikasyonlar dahil olmak üzere ameliyat öncesi, sırası ve sonrası sonuçları karşılaştırıldı. Bulgular: Gruplar arasında yaş, cinsiyet, Vücut Kütle İndeksi ve muhtemel risk faktörleri arasında anlamlı bir fark yoktu. Her iki grupta da yoğun bakım ünitesinde median kalış süresi iki gün ve ameliyattan taburculuğa kadar geçen median süre yedi gündü. Gruplar arasında sternal yara komplikasyon oranı açısından istatistiksel olarak anlamlı bir fark bulundu. Dren takılmayan grupta dokuz hastaya (%11.25) kıyasla, dren takılan grupta iki hastada (%2.1) sternal yara komplikasyonu gelişti (p=0.01). Sonuç: Çalışma bulgularımız, median sternotomi sonrasında Jackson-Pratt dren kullanımının vücut kitle indeksi ≥30 kg/m2 olan, açık kalp cerrahisi yapılan hastalarda geleneksel kapatma tekniğine kıyasla, ameliyat sonrası sternal yara komplikasyon riskini azaltmada basit ve güvenli bir yöntem olduğunu göstermektedir

Does using Jackson-Pratt drain affect the incidence of sternal wound complications after open cardiac surgery?

Background: This study aims to investigate the effect of the Jackson-Pratt drain on sternal wound complications in patients with a Body Mass Index of ≥30 kg/m 2 undergoing open cardiac surgery via median sternotomy. Methods: A total of 174 patients (124 males, 50 females; mean age 58.2±10.4 years; range, 33 to 78 years) with a Body Mass Index of ≥30 kg/m 2 undergoing cardiac surgery via median sternotomy between January 2011 and December 2015 in our institution were retrospectively analyzed. Of the patients, 94 were inserted a Jackson-Pratt drain (JP group) following median sternotomy, while 80 patients received no drain (non-JP group). Pre-, intra, and postoperative outcomes of both groups including type of operation, length of hospital stay, and complications were compared. Results: No significant difference in the age, gender, Body Mass Index, and potential risk factors was found between the groups. The median of stay in the intensive care unit was two days and the median time from operation to discharge was seven days in both groups. There was a statistically significant difference in the rate of sternal wound complications between the groups. Sternal wound complications occurred in two patients (2.1%) in the drained group, compared to nine patients (11.25%) in the non-drained group (p=0.01). Conclusion: Our study results show that Jackson-Pratt drain insertion after median sternotomy in patients with a Body Mass Index of ≥30 kg/m 2 undergoing open cardiac surgery is a simple and reliable method to reduce the risk of postoperative sternal wound complications, compared to the conventional closure technique. © 2019 All right reserved by the Turkish Society of Cardiovascular Surgery. Amaç: Bu çalişmada median sternotomi ile açik kalp cerrahisi yapilan, Vücut Kütle I˙ndeksi ≥30 kg/m 2 olan hastalarda Jackson- Pratt dreninin sternal yara komplikasyonlari üzerindeki etkisi incelendi. çalişma plani: Ocak 2011-Aralik 2015 tarihleri arasinda Vücut Kütle I˙ndeksi ≥30 kg/m 2 olan, hastanemizde median sternotomi ile açik kalp cerrahisi yapilan toplam 174 hasta (124 erkek, 50 kadin; ort. yaş 58.2±10.4 yil; dağilim, 33-78 yil) retrospektif olarak incelendi. Hastalarin 94'üne median sternotomi sonrasi Jackson-Pratt dreni takilirken (JP grubu), 80 hastaya dren takilmadi (JP olmayan grup). Her iki grubun ameliyat tipi, hastanede kaliş süresi ve komplikasyonlar dahil olmak üzere ameliyat öncesi, sirasi ve sonrasi sonuçlari karşilaştirildi. Bulgular: Gruplar arasinda yaş, cinsiyet, Vücut Kütle I˙ndeksi ve muhtemel risk faktörleri arasinda anlamli bir fark yoktu. Her iki grupta da yoğun bakim ünitesinde median kaliş süresi iki gün ve ameliyattan taburculuğa kadar geçen median süre yedi gündü. Gruplar arasinda sternal yara komplikasyon orani açisindan istatistiksel olarak anlamli bir fark bulundu. Dren takilmayan grupta dokuz hastaya (%11.25) kiyasla, dren takilan grupta iki hastada (%2.1) sternal yara komplikasyonu gelişti (p=0.01). Sonuç: çalişma bulgularimiz, median sternotomi sonrasinda Jackson-Pratt dren kullaniminin vücut kitle indeksi ≥30 kg/m 2 olan, açik kalp cerrahisi yapilan hastalarda geleneksel kapatma tekniğine kiyasla, ameliyat sonrasi sternal yara komplikasyon riskini azaltmada basit ve güvenli bir yöntem olduğunu göstermektedir

Kompleks mitral kapak patolojilerin onarımı: Uğraşmaya değer mi?

Introduction: Mitral valve (MV) repair is preferred over replacement for its benefits of preservation of ventricular function, lower operative mortality, superior long-term survival, and avoidance of anticoagulation. In this study, we aimed to review the repair techniques of complex MV pathologies and their outcomes. Patients and Methods: We retrospectively analyzed 56 patients (mean age 41.8 ± 16.5 years; 33 males) who underwent repair of complex MV pathologies. 44 patients had pure mitral regurgitation (MR), and 12 (21.4%) had mixed mitral disease (mitral stenosis (MS) + MR). Preoperative and operative characteristics, postoperative MR severity, operative mortality, and midterm survival were examined for each patient. Results: There was only one early death (30-day mortality: 1.8%) due to postoperative low cardiac output syndrome. The procedures were successful in all patients who underwent MV repair. Transthoracic echocardiography examinations revealed no/trivial MR in 74.6% and mild MR in 21.8% of patients at discharge. Late follow-up was obtained in 55 patients. The mean follow-up period of patients was 47.9 ± 23.1 months. Mortality developed in one (1.8%) patient with Marfan syndrome who had acute aortic dissection three years after MV surgery. During follow-up visits, mitral repair procedures were successful in 49 (90.7%) patients. Four (7.4%) patients presented with moderate MR. Only one (1.9%) patient needed reoperation because of severe MR. Conclusion: This study showed that repair of complex MV pathologies provides excellent surgical outcomes. Repair of complex MV pathologies is safe and highly effective, but operations require considerable surgical experience.Giriş: Ventrikül fonksiyonun korunması, daha az cerrahi mortaliteye sahip olması, üstün uzun dönem survey ve antikoagülan kullanımının önlenmesi gibi üstünlükleri nedeniyle mitral kapak onarımı replasmana daha çok tercih edilmektedir. Bu çalışmanın amacı, kompleks mitral kapak patolojilerin onarım teknikleri ve sonuçları sunmaktır. Hastalar ve Yöntem: Retrospektif olarak kompleks mitral kapak patolojilerin onarımı geçiren 56 hasta incelendi (ortalama yaş 41.8 ± 16.5 yıl; 33 erkek). Kırk dört hastada saf mitral yetmezliği varken, 12 (%21.4) hastada miks mitral kapak hastalığı (mitral darlığı + mitral yetmezliği) vardı. Preoperatif ve operatif özellikleri, postoperatif mitral yetmezliği derecesi, cerrahi mortalite ve orta dönem sonuçları her hasta için araştırıldı. Bulgular: Postoperatif düşük kardiyak debi sendromuna bağlı bir hastada erken mortalite (30 gün mortalite: %1.8) görüldü. Mitral kapak onarımı ameliyatı olan bütün hastalarda mitral onarım prosedürleri başarılı olmuştur. Hastalar taburcu olduğunda yapılan ekokardiyografik değerlendirmede %74.6’sında hiç/eser yetersizlik ve %21.8’inde hafif yetersizlik saptandı. 55 hastada geç dönem takibi yapıldı. Hastalarımızın ortalama takip süresi 47.9 ± 23.1 aydı. Geç mortalite mitral kapak onarımından 3 yıl sonra akut aort diseksiyonu nedeniyle ameliyata alınan marfan sendromlu bir hastada gözlendi. Takipler sırasında yapılan ekokardiyografik değerlendirmede hastaların %90.7 (49 hasta)’sinde hiç ya da hafif yetersizlik gözlendi. Orta yetersizlik gözlenen 4 (%7.4) hastada tıbbi tedavi uygulandı. İleri yetersizlik gözlenen 1 (%1.9) hastada reoperasyon uygulandı. Sonuç: Çalışmamız kompleks mitral kapak patolojilerin onarımının sonuçları mükemmel olduğunu gösterdi. Kompleks mitral kapak patolojilerin onarım teknikleri güvenli ve sonuçları son derece etkindir, fakat ameliyatlarda yeterli cerrahi tecrübe gereklidir

Effectiveness of artificial neochordae implantation in tricuspid valve repair

WOS: 000470726100009PubMed ID: 31236073Various techniques for treating tricuspid regurgitation have been described; however, because of scarce data about the long-term outcomes of different repairs, the optimal technique has not been established. We evaluated the effectiveness and durability of artificial neochordae implantation in the treatment of tricuspid regurgitation. From 2009 through 2014, 507 patients underwent tricuspid valve repair at our institution. Of those, 48 patients implanted with artificial neochordae were included in our study. The median age of the participants was 62 years (range, 4-77 yr) and 50% were women. Thirty patients (63%) were in New York Heart Association functional class III, and 11 (23%) were in class II. The cause of tricuspid regurgitation was functional in 33 patients (69%) and rheumatic in 15 (31%). In 46 patients, neochordae implantation was performed in addition to Kay annuloplasty (n= 13) or ring annuloplasty (n= 33). Forty-two patients were discharged from the hospital with absent or mild tricuspid regurgitation. The mean follow-up period was 44.3 +/- 20.2 months. Follow-up echocardiograms revealed that tricuspid regurgitation was absent, minimal, or mild in 38 patients (80.8%), moderate in 7, and severe in 2. Our results indicate that the use of artificial neochordae implantation as an adjunct procedure to annuloplasty leads to effective and durable repair in comparison with conventional techniques for treating tricuspid regurgitation