Anesthetic approach to the patients with scleroderma at coronary artery surgery: two case reports

Scleroderma is a progressive connective tissue disease characterized by multiple-organ involvement. Altough the lesions are mostly seen in microvascular bed, in rare cases coronary and peripheral arteries are also affected. In this article, we report the problems and management strategies in two scleroderma patients at an intensive care unit after coronary artery bypass surgery

On-pump coronary bypass surgery in a pseudothrombocytopenic patient: a case report

A sixty-year-old female patient was admitted to our cardiovascular surgery department for coronary bypass surgery. Coronar angiograpy revealed three vessel coronary artery disease. The patient's preoperative whole blood count examination was performed by taking whole blood into EDTA tubes. The platelet count was found to be 23x10(3)/mm(3). The patient has no bleeding problem. In the physical examination; no pathologies were detected other than bilateral basal fine crepitations in the lungs and the result of bleeding and coagulation tests were normal. In the peripheral blood smear examination, adequate platelet clusters were found. Since the laboratory findings were normal and the patient had no history of bleeding problems, the patient was diagnosed with EDTA-dependent pseudothrombocytopenia. We presented this case to emphasize the importance of preoperative platelet count and function and remind of the issue of pseudothrombocytopenia

A comparision of the sensitivity and specificity of the euroscore, Cleveland, and CABDEAL risk stratification systems in the Turkish population EuroSCORE, cleveland ve CABDEAL klinik risk sınıflama sistemlerinin Türk toplumu için duyarlılık ve özgüllüklerinin karşılaştırılmasi

Background: In this study, we aimed to compare three risk stratification systems to establish which of them is more suitable for predicting mortality and morbidity rates in the Turkish population. Methods: Our retrospective study included 501 consecutive patients (366 males, 135 females; mean age 63.4±19.4 years; range 44 to 83 years) who underwent coronary artery bypass graft (CABG) surgery between February 2005 and December 2006 in our clinic. The preoperative and intraoperative risk factors of the Cleveland, EuroSCORE, and CABDEAL risk stratification systems were analyzed for each patient, and the sensitivity and specificity of these three systems were compared in terms of mortality and morbidity. Results: In terms of mortality, the sensitivity and the specificity of the Cleveland system was found to be 61.5% and 90.4%, respectively while for the EuroSCORE system, the rates were 92.3% and 82.2%, respectively. For the CABDEAL system, the sensitivity and specificity were 92.3% and 44.9%, respectively. In terms of morbidity, the sensitivity and specificity of Cleveland system were 23.5% and 89.5%, respectively, while they were 41.2% and 81%, respectively for the EuroSCORE. The sensitivity and specificity of the CABDEAL system were 82.4% and 44.8%, respectively. Conclusion: The study results showed that the EuroSCORE system is more suitable for predicting the expected mortality rates while the CABDEAL system followed by the Cleveland system are more appropriate in for predicting the expected morbidity rates in the Turkish population with cardiac disease