Giant left anterior descending coronary artery aneurysm in a patient with Behçet’s disease

Coronary artery involvement is quite rare in the course of Behçet’s disease. Complications secondary to coronary artery aneurysms, including rupture, dissection, and myocardial ischemia, may be fatal. In young patients without cardiovascular risk factors, systemic inflammatory vasculitis syndromes should be investigated in case of acute coronary syndrome secondary to dilated coronary arteries. In this report, we present our management strategy in a 31-year-old male patient with Bechet’s disease

¿La aplicación de pegamento de fibrina perivascular tiene un efecto preventivo del daño endotelial en el injerto de vena safena? Un modelo experimental

Background. The effect of tissue adhesives on coronary grafts in cardiac surgery is a controversial issue. Objective. The aim of this study is to investigate the effect of fibrin glue (FG) applied around the saphenous vein grafts (SVG) in preventing cellular damage resulting from intraluminal pressure increase. Methods. Twenty volunteer patients were included in this ex vivo study. The SVGs remained after coronary artery bypass grafting were connected to the arterial line of the cardiopulmonary bypass circuit. The grafts were divided into two segments and one segment received perivascular FG applied whereas the other part was used plain. SVGs were kept in circulation at 120 mmHg pressure 250 mL/min flow rate for 60 min. The tissues were sent for histopathological examination to determine the endothelial damage. Results. Endothelial damage was more pronounced in the control group when compared with the FG group. In the FG group, no damage was seen in 13 samples and no Type 3 endothelial damage was observe whereas Type 1 injury was detected in seven specimens, Type 2 injury was observed in seven specimens, and Type 3 injury was detected in two specimens in the control group. Conclusion. Perivascular application of FG on the SVG showed a protective effect against endothelial damage resulting from increased intraluminal pressure.Antecedentes. El efecto de los adhesivos tisulares sobre los injertos coronarios en cirugía cardíaca es un tema controvertido. Objetivo. Investigar el efecto del pegamento de fibrina aplicado alrededor de los injertos de vena safena para prevenir el daño celular resultante del aumento de la presión intraluminal. Método. En este estudio ex vivo fueron incluidos 20 pacientes voluntarios. Los injertos de vena safena que quedaron después del injerto de derivación de la arteria coronaria se conectaron a la línea arterial del circuito de derivación cardiopulmonar. Los injertos se dividieron en dos segmentos y a uno de ellos se le aplicó pegamento de fibrina perivascular, mientras que la otra parte se usó sola. Los injertos de vena safena se mantuvieron en circulación a una presión de 120 mmHg y una velocidad de flujo de 250 ml/min durante 60 minutos. Los tejidos se enviaron para examen histopatológico para determinar el daño endotelial. Resultados. El daño endotelial fue más pronunciado en el grupo de control ue en el grupo de pegamento de fibrina. Se observó lesión de tipo 2 en siete muestras del grupo de pegamento de fibrina y lesión de tipo 3 en dos muestras del grupo de control. Conclusiones. La aplicación perivascular de pegamento de fibrina en los injertos de vena safena mostró un efecto protector contra el daño endotelial resultante del aumento de la presión intraluminal

The effect of renin-angiotensin blockers on COVID-19 related mortality: A tertiary center's experience

Background: The first reports on coronaviruse disease 2019 (COVID-19) revealed an exaggerated mortality rate in hypertensive patients. In this regard, concerns about angiotensin-converting enzyme (ACE) inhibitors’ and angiotensin-receptor blockers’ (ARBs) have been aroused. Our aim in this study was to evaluate the potential bad outcome effect of hypertension and anti-hypertensive therapy on COVID-19. Methods: 183 patients with polymerase-chain-reaction (PCR)-proven COVID-19, who were admitted to our hospital and consulted to cardiology department between 15th of March and 15th of April 2020 were included. Data were recruited from hospital records. Results: Thirty-two out of 183 patients with COVID-19 died in hospital. Hypertension incidence was not statistically different between patients who survived and died (76 [50.3%] vs 19 [59.4%, p = 0.352]). Although the usage rate of ACEI were similar among groups, ARB usage rate was significantly higher in patients who died than survived (11 [34.4%] vs 23 [15.2%], p = 0.011). Binary regression analysis showed an association between ARBs and mortality (OR: 0.032, 95% CI 1.045–2.623, p = 0.032). Conclusion: Our study confirmed previous concerns regarding a potential harmful effects of ARBs on COVID-19 related mortality.Kontext: První zprávy o onemocnění koronavirem v roce 2019 (coronavirus disease 2019, COVID-19) ukazovaly na zvýšenou mortalitu jedinců s hypertenzí, což vyvolalo obavy ohledně užívání inhibitorů angiotenzin konvertujícího enzymu (ACEI) a blokátorů receptoru AT1 pro angiotenzin II (ARB). Cílem naší studie bylo posoudit možnost nepříznivého vlivu onemocnění covid-19 na závažnost hypertenze a účinnost antihypertenzní léčby. Metody: Do studie bylo zařazeno 183 pacientů s onemocněním covid-19 prokázaným PCR testem, kteří byli v období od 15. března do 15. dubna 2020 přijati do naší nemocnice a následně odesláni na kardiologickou kliniku. Údaje byly získány z nemocničních záznamů. Výsledky: Celkem 32 ze 183 pacientů s onemocněním covid-19 zemřelo v nemocnici. Incidence hypertenze se mezi pacienty, kteří přežili a zemřeli, statisticky významně nelišila (76 [50,3 %] vs. 19 [59,4 %]; p = 0,352). I když podíly pacientů užívajících inhibitory ACE byly v obou skupinách podobné, léčiva ze skupiny ARB užívalo statisticky významně více pacientů, kteří zemřeli, než těch, kteří přežili (11 [34,4 %] vs. 23 [15,2 %]; p = 0,011). Binární regresní analýza prokázala souvislost mezi užíváním ARB a mortalitou (OR: 0,032; 95% CI 1,045–2,623; p = 0,032). Závěr: Naše studie potvrdila původní obavy týkající se možných škodlivých účinků lékové skupiny ARB na mortalitu v souvislosti v onemocněním covid-19

Ascending aortic coarctation - an atypical location in a non-takayasu arteritis female patient

Coarctation of the aorta is a well-known congenital cardiovascular disorder that typically occurs within proximity to the ductus arteriosus. The ascending aorta, distal descending aorta, and abdominal aorta are segments which are prone to development of an atypical coarctation. The etiologies of atypical cases are usually associated with various types of vasculitis syndromes or underlying genetic disorders. In this report, we present a 24-year-old female patient with an ascending aortic coarctation which developed secondary to an atherosclerotic process

Treatment of a patient with congenitally corrected transposition of great arteries associated with ascending aortic hypoplasia and type A interrupted aortic arch without aortic cross clamping leading to myocardial ischemia

İnterrupted aortik ark tedavisi karmaşık bir süreçtir. Cerrahi rekonstrüksiyon genellikle myokard iskemisine neden olan aortik kros klempleme, kalbin durdurulması ve hatta kansız operasyon sahası için derin hipotermi gerektirir.Bu yazıda, normotermik şartlarda, kalbi durdurmadan çıkan aort, aortik ark ve proksimal desendan aort replasmanını selektif kanülasyon ve tüm vücut perfüzyonunu sağlayan cerrahi teknik ile tedavi ettiğimiz konjenital düzeltilmiş büyük arter transpozisyonu, tip A kesintili aortik ark ve hipoplazik asendan aortu olan hastamızı sunuyoruz.Treatment of interrupted aortic arch is complex. Surgical reconstruction consists of procedures that cause myocardial ischemia, such as aortic cross clamping, cardioplegia, and hypothermia. In this article, we present a patient with congenitally corrected transposition of great arteries together with Type A interruption as well as hypoplastic ascending aorta and the aortic arch. The replacement of the aorta, aortic arch, and the proximal descending aorta was performed under normothermic conditions without cardioplegia, which was achieved with a technique that preserves the systemic blood supply by using selective cannulation

Low oxygen saturation following total correction in a patient with tetralogy of fallot and persistant left superior caval vein - How did we diagnose and manage?

Association of tetralogy of Fallot (TOF) with the other intracardiac pathologies such as atrial septal defect (ASD), atrioventricular canal defect or persistent left superior vena cava (PLSVC), absent pulmonary valve are well known pathologies. The associated pathologies require specifi c attention during surgical treatment. In this manuscript, we present management of a four-month-old girl who was diagnosed with TOF and PLSVC but the diagnosis of unroofed coronary sinus was missed in her. Association of unroofed coronary sinus with TOF is a very rare variant of TOF pathology.Souvislost mezi Fallotovou tetralogií (tetralogy of Fallot, TOF) a jinými intrakardiálními patologiemi, jako jsou defekt septa síní (atrial septal defect, ASD), defekt síňokomorového kanálu nebo perzistentní levostranná horní dutá žíla (persistent left superior vena cava, PLSVC) i absence plicní chlopně, je dobře známa. Během chirurgického výkonu vyžadují přidružená onemocnění obzvláštní pozornost. V tomto článku popisujeme léčbu čtyřměsíční dívky s diagnózou TOF a PLSVC, u níž však byl přehlédnut nezastřešený koronární sinus. Nezastřešený koronární sinus se vyskytuje současně s TOF velmi vzácně

Atrial fibrillation designation with micro-Raman spectroscopy and scanning acoustic microscope

Atrial fibrillation (AF) is diagnosed with the electrocardiogram, which is the gold standard in clinics. However, sufficient arrhythmia monitoring takes a long time, and many of the tests are made in only a few seconds, which can lead arrhythmia to be missed. Here, we propose a combined method to detect the effects of AF on atrial tissue. We characterize tissues obtained from patients with or without AF by scanning acoustic microscopy (SAM) and by Raman spectroscopy (RS) to construct a mechano-chemical profile. We classify the Raman spectral measurements of the tissue samples with an unsupervised clustering method, k-means and compare their chemical properties. Besides, we utilize scanning acoustic microscopy to compare and determine differences in acoustic impedance maps of the groups. We compared the clinical outcomes with our findings using a neural network classification for Raman measurements and ANOVA for SAM measurements. Consequently, we show that the stiffness profiles of the tissues, corresponding to the patients with chronic AF, without AF or who experienced postoperative AF, are in agreement with the lipid-collagen profiles obtained by the Raman spectral characterization.Turkiye Cumhuriyeti Kalkinma Bakanlig

Giant aneurysm of non-coronary sinus of valsalva in a patient with marfan sendrom

Valsalva sinüslerinin anevrizmaları, aort anulusu ile sinotubüler bileşke arasındaki aort kök bölgesinin dilatasyonu olarak tanımlanır. Valsalva sinüsünün izole anevrizmaları nadir görülen kardiovasküler patolojilerdir. Sinüs valsalva anevrizması, konjenital veya edinsel kökenli olabilir. Konjenital, özellikle bağ dokusu bozukluklarına sekonder ve konjenital kardiyak defektlerle birlikte görülebilir. Edinsel anevrizmalar ise enfeksiyonlara ve travmaya sekonder olarak oluşabilir. Küçük boyutlu rüptüre olmamış anevrizmalar cerrahi müdahalesiz takip edilebilirken bunun dışındaki tüm hastalarda müdahale gerekir ve cerrahi altın standart tedavi yöntemidir. Bu yazıda, aort yetmezliği ile birlikte non-koroner valsalva sinüsünün dev anevrizması olan ve uygun tedavisi yapılan 12 yaşında Marfan sendromlu hasta anlatılacaktır.Aneurysms of the sinuses of Valsalva are defined as dilatation of the aortic root region be-tween the aortic annulus and the sinotubularjunction. Isolated aneurysms of the sinus of Valsalva are rare cardiovascular pathologies. Sinus valsalva aneurysm may be of congenital or acquired origin. It can occur congenital, secondary to connective tissue disorders or in associa-tion with congenital cardiac defects. Acquired aneurysms may occur secondary to infections and trauma. Small-sized unruptured aneurysms may be followed without surgical treatment; however, surgery may be required in all other patients and surgery is the gold standard treat-ment method. In this article, a 12 -year-old patient with Marfan syndrome who had aortic regurgita-tion and giant aneurysm of the non-coronary sinus of valsalva and was treated appropriately will be presented

Internal thoracic artery: A major collateral supply in case of Leriche syndrome

We read with great interest the article by Bosse and colleagues,1 in which they presented a case series of cardiac surgery combined with bypass from the ascending aorta to the bilateral femoral arteries in patients with severe aorta-iliac occlusion