Endovascular treatment of huge saccular abdominal aortic aneurysm in a young Behcet patient: mid-term result

BACKGROUND: Abdominal aortic aneurysm formation is among the arterial complications of Behcet's disease. Weakness and fragility of aortic walls leads to the development of arterial complications like pseudoaneurysms. CASE PRESENTATION: A case of huge saccular abdominal aortic aneurysm in a young Behcet patient who was successfully treated with endovascular stent graft placement is reported, diagnostic and interventional procedures are discussed, and mid-term follow-up results are presented. CONCLUSIONS: Endovascular treatment of abdominal aortic aneurysm complications of young Behcet patients who are not suitable for open surgery and need intervention could be an alternative treatment modality even without performing preprocedural angiography

Long-term outcomes in patients who underwent surgical correction for atrioventricular septal defect

Objective: The follow-up results of patients operated for atrioventricular septal defect (AVSD) during 1996-2016 at Baskent University are presented. Methods: Data obtained from hospital records consists of preoperative echocardiographic and angiographic details, age and weight at surgery, operative details, Down syndrome presence, postoperative care details, early postoperative and latest echocardiographic findings and hospitalization for reintervention. Results: A total of 496 patient-files were reviewed including 314 patients (63.4%) with complete and 181 (36.6%) with partial AVSD (48.4% of all patients had Down syndrome). Atrioventricular (AV) valve morphology was Rastelli type A in 92.2%, B in 6.5%, and C in 1.3% of patients. The operative technique used was single-patch in 21.6% (108), double-patch in 25.8% (128), and modified single-patch (Wilcox) in 52.5% (260) of patients. The follow-up time was 37.79 +/- 46.70 (range, 0-198) months. A total of 64 patients (12.9%) had a rrhythmias while in the intensive care unit; pacemaker was implanted in 12 patients. A total of 78 patients (15.7%) were treated for pulmonary hypertensive crisis. The early morbidity and mortality in the postoperative first month were calculated as 38% and 10%, and the late morbidity and mortality (>1 month) were calculated as 13.1% and 1.9%, respectively. The rate of reoperation in our cohort was 8.9%. Conclusion: Although the early morbidity and mortality are low in AVSD operations, the rate of reoperations for left AV valve insufficiency are still high. Although Down syndrome is not a risk factor for early mortality, the co-morbid factors, such as longer postoperative mechanical ventilator or inotropic support, lead to higher risk for morbidity. The frequency of pulmonary hypertension and consequent complications are also high

Our experience with single patch repair of complete atrioventricular septal defects

Background: Various surgical methods have been utilized in the management of complete atrioventricular septal defects (CAVSD). Early intervention and achievement of a competent left atrioventricular valve are the key factors for successful treatment. Methods: A total of 66 patients with complete atrioventricular septal defect have been operated in a tertiary care center. Patient group consisted of 28 males and 38 females with an average age of 6.2 ± 3.3 months. Ventricular and atrial defects were repaired generally with single-patch technique using autogenous pericardium. Results: Preoperative catheterization and angiography was performed in 41 patients. Single patch and modified single patch techniques were preferred in 57 and 9 patients respectively. The average duration for respiratory support, intensive care unit stay and discharge from hospital were 36 ± 49.3 hours, 4.1 ± 1.9 days, and 10.1 ± 3.3 days respectively. In the left atrioventricular valve mild, moderate and severe regurgitation were detected in 44 (66.6%), 17 (25.7%) and 2 (3%) patients postoperatively. No regurgitation was determined in 3 patients (4.5%). Two cases ended up with mortality (3%). Conclusion: Single patch repair technique can provide satisfactory surgical outcomes in patients with complete atrioventricular septal defect

Evaluation of Coronary Artery-Saphenous Vein Composite Grafts: The Aortic No-Touch Technique

We retrospectively compared the results of conventional coronary artery bypass grafting (CABG) performed on patients who showed no preoperative evidence of serious atherosclerosis of the ascending aorta with the results of the aortic no-touch technique (using coronary artery-saphenous vein composite grafts) on CABG patients who did show such evidence. From 2003 through 2012, 3,152 consecutive patients underwent isolated primary CABG at our hospital. We chose 360 for the current study. The study group (n=120) comprised patients who had undergone operation via the aortic no-touch technique. Propensity-score-matching (1: 2) was used to select the control group of 240 patients who had undergone conventional CABG. Early and late survival rates, reintervention-free survival rates, and freedom from cardiac death were compared. Early and late mortality rates were similar in the study and control groups (P=0.19 vs P=0.29, respectively), as were cardiac-related death (2.5% vs 2.1%, respectively; P=0.53) and overall death (8.3% vs 7.9%, respectively; P=0.51). Overall survival rates were 91.7% vs 92.1% and freedom-from-cardiac-death rates were 97.4% vs 97.5% (P=0.71 vs P=0.78, respectively; mean follow-up period, 5.27 +/- 2.51 yr). Reintervention-free survival rates were also similar (96.7% vs 98.8%, respectively; P=0.2). As a result of the similar rates of early and late survival, reintervention-free survival, and freedom from cardiac death, we conclude that the aortic no-touch technique with composite grafts might be a reasonable option in patients who have atherosclerotic ascending aorta that cannot be clamped

Günübirlik cerrahi girişim ile patent duktus arteriyozusu bağlanan 20 düşük ağırlıklı erken doğmuş bebekte cerrahi tedavi ve ameliyat sonrası izlem sonuçları

Aim: We aimed to evaluate premature babies who were sent to us for patent ductus arteriosus (PDA) closure and who were then transferred back following the surgical procedure

Surgical and postoperative follow-up results for day case patent ductus arteriosus ligation of 20 low weight premature patients

Aim: We aimed to evaluate premature babies who were sent to us for patent ductus arteriosus (PDA) closure and who were then transferred back following the surgical procedure

Congenital heart surgery in Turkey; today and tomorrow

2APR181-1852