Eşzamanlı Koroner Arter Baypas ve Plonjan Guatr Cerrahisi

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Left atrial myxoma combined with coronary artery disease in an elderly patient

Cardiac myxoma associated with coronary artery disease is a rare pathology in an elderly patient. Herein wepresent an 81-year-old woman undergoing simultaneous surgical treatment for left atrial myxoma combinedwith coronary artery disease. The postoperative course of the patient was uneventful. The initial removal ofmass should be performed to prevent systemic embolization of tumor fragment

Clinical value of neutrophil to lymphocyte ratio in the region of lower extremity deep venous thrombosis

Objectives. Many studies have demonstrated a significant association between cardiovascular disease andneutrophil to lymphocyte ratio (NLR). To our knowledge, no study has been reported in patients with deepvenous thrombosis (DVT) which affecting proximal or distal leg. In this study we analyzed proximal and distalDVT according to the NLR. Methods. This retrospective study was obtained from patients’ records of a tertiaryuniversity hospital between May 2011 to January 2014. A total of 57 patients with the diagnosis of acute primaryDVT and 30 patients as control group included in the study. All of them were confirmed with lower extremityvenous duplex examinations. Of these, 37 examinations with the diagnosis of proximal DVT were comparedto 20 examinations with distal DVT. The groups compared regarding to complete blood counter values. Results.Mean eosinophil level was higher in the distal DVT group (0.28±0.24 vs. 0.12±0.01, p=0.001), whereas medianNLR were higher in the proximal DVT group than the distal DVT group (3.5 [0.5-4.3] vs. 2.3 [1.2-9.7],respectively; p=0.002). In addition, median NLR, leukocyte and neutrophil counts were statistically lower inthe control group than the others (p=0.014, p=0.027 and p=0.004, respectively). Conclusion. NLR, aninexpensive and easily measurable laboratory variable, was independently and significantly associated withthe presence and severity of DVT, especially acute proximal DV

Endarterectomy and saphenous vein ‘Y’ patchplasty technique for severe carotid artery bifurcation lesion

Arteriosclerosis, is mostly affect coronary and carotid arteriesespecially the ostium and bifurcation due to the natureof the flow. Arterial bifurcation lesions cause dilemmafor the treating physician during both surgical and invasiveprocedures because they require a higher clinical experienceand longer processing time. In carotid artery surgery,it is accepted that patchplasty prevents perioperativeand postoperative restenosis, and as a result of this, itreduces the incidence of ipsilateral stroke. In the presenttime synthetic patch materials (PTFE, Dacron) and autologouspatch materials (saphenous and jugular veins) areused. We report a case of carotid endarterectomy and ‘Y’shaped saphenous patchplasty to the carotid bifurcation.According to our research in the literature, we didn’t findany case with ‘Y’ shaped saphenous vein patch. Therewas only one Y shaped carotid patchplasty case by usingPTFE material. Our original technic is advantageous interms of easy preparation and application as well as itssuccessful outcome.Key words: Carotid artery diseases, saphenous vein,patchplast

Administration of perivascular cyanoacrylate for the prevention of cellular damage in saphenous vein grafts: an experimental model

Objective: The saphenous vein is the most commonly used graft in coronary artery bypass surgery, since no suitable arterial graft is available. However, the frequency of late graft failure is a cause for research into graft protection. The objective of this study was to investigate the effect of synthetic adhesive cyanoacrylate administration on the saphenous vein graft for preventing vascular damage due to internal pressure on the graft. Methods: In this study we enrolled 20 volunteer subjects who had undergone coronary artery bypass surgery and who had excess saphenous vein grafts. Perivascular cyanoacrylate was administered to one of two saphenous vein grafts explanted from each patient. The other saphenous vein graft from each patient was not treated and was used as the control. A model of the arterial system was created using a saphenous vein cardiopulmonary bypass system. Circulation was maintained at 120 mmHg for 45 minutes. Afterwards, the grafts were subjected to histopathological examination. Results: The cyanoacrylate group of grafts did not develop severe vascular damage compared with many instances of moderate and severe damage due to compression in the control group of grafts (p = 0.003). Conclusion: Perivascular administration of cyanoacrylate appeared to be successful in the prevention of early saphenous vein graft injury. No in vivo study has been performed to date to assess endothelial damage in the saphenous vein, in order to demonstrate the long-term effect of cyanoacrylate. Further investigations are needed in this regard

Effects of hyperbaric oxygen therapy combined with platelet-rich plasma on diabetic wounds: an experimental rat model

Introduction: Hyperbaric oxygen and platelet-rich plasma are used in the treatment of diabetic wounds. The aim of this study is to evaluate the effects of hyperbaric oxygen therapy and autologous platelet concentrates in healing diabetic wounds. Material and methods: Thirty-six female Wistar albino rats were used in this study. Diabetes mellitus was induced chemically with an intraperitoneal injection of streptozotocin. The rats were divided into a control group, a hyperbaric oxygen group, a platelet-rich plasma group, and a combined therapy group. Platelet-rich plasma was applied just after the creation of the wound; hyperbaric oxygen treatment was carried out daily over 7 days. Wound healing was evaluated according to four parameters: ulcerations, epidermal thickness, density of dermal collagen fibers, and proliferation of dermal blood vessels. Results: The number of active ulcers in the combined therapy group was fewer than in the control group (p = 0.039), and the wound area was greatest in controls (p < 0.001). The epidermal thickness in platelet-rich plasma and combined therapy groups was non-significantly greater than in the control group (p = 0.097 and p = 0.074, respectively). The amount of fibrous collagen in these two groups was greater than in the control group (p = 0.002). Conclusions: Combined hyperbaric oxygen and platelet-rich plasma therapy was found to be successful in diabetic wound healing. The combination therapy had no additive effect in terms of angiogenesis and the development of new collagen fibers

The Comparison of the Effects of Nebivolol and Metoprolol on Erectile Dysfunction in the Cases with Coronary Artery Bypass Surgery

Purpose: Beta-blocker use is common in the cases with coronary artery bypass surgery. According to the literature, beta-blockers have positive effects but may cause erectile dysfunction (ED). The most commonly used beta-blockers in ischemic cardiac disease are nebivolol and metoprolol. In our clinic, we aimed to compare the effects of nebivolol and metoprolol succinate on ED in the sexually active cases with coronary artery bypass surgery. Methods: In our clinic, a total of 119 patients with coronary artery bypass surgery were included in the study. International Index of Erectile Function (IIEF-5) Test was used to evaluate whether the patients had ED and to grade the cases. Results: No significant difference was found in terms of anti-ischemic efficacy between metoprolol succinate and nebivolol in the postoperative period; however, the incidence of any grade ED was % 85.96 in Group 1, % 83.87 in Group 2. This difference was considered as statistically significant (p = 0.036). Conclusion: Beta-blocker use increases the risk of ED in cases with ischemic cardiac disease. We suggest that the complaints of ED could be less frequent with nebivolol use in sexually active cases with ischemic cardiac disease.Namik Kemal UniversityNamik Kemal UniversityNamik Kemal University provided financial support for the study as a scientific research project