In this review we aimed to present the effects of clamp and shunt usage on vascular endothelium in coronary artery surgery under the light of current literature data. Each surgical team or even each surgeon uses diffe...In this review we aimed to present the effects of clamp and shunt usage on vascular endothelium in coronary artery surgery under the light of current literature data. Each surgical team or even each surgeon uses different methods in order to create bloodless surgical site during beating heart surgical procedures. Every method has its own advantages and disadvantages. There is no formed consensus regarding this issue. Surgeons still want to operate on bloodless surgical fields. But, they have concerns about continuity of blood flow and vascular endothelial injury during off-pump coronary surgery. In order to achieve a consensus statement about this issue, multicentric larger studies are needed.展开更多
Postopereative sternal dehiscence is one of the most important complications of median sternotomy which may cause pulmonary dysfunction and mediastinitis. We are reporting a patient with sternal dehiscence after coron...Postopereative sternal dehiscence is one of the most important complications of median sternotomy which may cause pulmonary dysfunction and mediastinitis. We are reporting a patient with sternal dehiscence after coronary artery bypass surgery that underwent application of thermoreactive nitinol clips in addition to Robicsek procedure. Using thermoreactive nitinol clips method together with Robicsek procedure may be a valuable technique for preventing recurrent sternal dehiscence for patients who are candidates of noninfective recurrent sternal dehiscence.展开更多
Background: Surgical method was introduced for enhancement of prosthetic valve insertion and overcoming difficulties ensourcing from prosthesis-patient mismatch. Methods: Twenty-two patients that underwent aortic valv...Background: Surgical method was introduced for enhancement of prosthetic valve insertion and overcoming difficulties ensourcing from prosthesis-patient mismatch. Methods: Twenty-two patients that underwent aortic valve replacement between January 2005 and July 2009 were included in this prospective study. In these patients, the insertion of prosthesis larger than the annulus diameter was attempted after the application of an external pressure that increased the transverse axis diameter of the aortic annulus. The postoperative results and complications were assessed. Results: This surgical method was performed on 22 patients (16 males, 6 females, mean age: 52.2 ± 15.8 years) during the valve replacement. In 12 patients (55%), replacement of proper sized aortic valve compliant to their surface area was accomplished, while the insertion of a proper valve could not be achieved in 10 (45%) of the patients. No perioperative mortality or complications related to the procedure were reported. Conclusion: Increasing the transverse diameter of aortic valve may not only facilitate the insertion of a prosthetic valve but also aid in overcoming prosthesis-patient mismatch. Further studies on larger series are necessary to document the actual effectively and precise selection criteria for application of this method.展开更多
This study is performed to investigate the effect of Fontan operations on cardiac contractility. Investigation of articles about the contractility in Fontan published in PubMed up to now revealed that the measurement ...This study is performed to investigate the effect of Fontan operations on cardiac contractility. Investigation of articles about the contractility in Fontan published in PubMed up to now revealed that the measurement of contractility values did not include the rudimentary ventricle. Connections between right atrium and right ventricle as well as right atrium and pulmonary artery were studied in the same group as well. In our opinion, for the single ventricular physiology, the RA-RV and RA-PA connected patients’ preload and afterload values cannot be calculated in the same group since volume of rudimentary ventricles must be considered from this point of view as well.展开更多
文摘In this review we aimed to present the effects of clamp and shunt usage on vascular endothelium in coronary artery surgery under the light of current literature data. Each surgical team or even each surgeon uses different methods in order to create bloodless surgical site during beating heart surgical procedures. Every method has its own advantages and disadvantages. There is no formed consensus regarding this issue. Surgeons still want to operate on bloodless surgical fields. But, they have concerns about continuity of blood flow and vascular endothelial injury during off-pump coronary surgery. In order to achieve a consensus statement about this issue, multicentric larger studies are needed.
文摘Postopereative sternal dehiscence is one of the most important complications of median sternotomy which may cause pulmonary dysfunction and mediastinitis. We are reporting a patient with sternal dehiscence after coronary artery bypass surgery that underwent application of thermoreactive nitinol clips in addition to Robicsek procedure. Using thermoreactive nitinol clips method together with Robicsek procedure may be a valuable technique for preventing recurrent sternal dehiscence for patients who are candidates of noninfective recurrent sternal dehiscence.
文摘Background: Surgical method was introduced for enhancement of prosthetic valve insertion and overcoming difficulties ensourcing from prosthesis-patient mismatch. Methods: Twenty-two patients that underwent aortic valve replacement between January 2005 and July 2009 were included in this prospective study. In these patients, the insertion of prosthesis larger than the annulus diameter was attempted after the application of an external pressure that increased the transverse axis diameter of the aortic annulus. The postoperative results and complications were assessed. Results: This surgical method was performed on 22 patients (16 males, 6 females, mean age: 52.2 ± 15.8 years) during the valve replacement. In 12 patients (55%), replacement of proper sized aortic valve compliant to their surface area was accomplished, while the insertion of a proper valve could not be achieved in 10 (45%) of the patients. No perioperative mortality or complications related to the procedure were reported. Conclusion: Increasing the transverse diameter of aortic valve may not only facilitate the insertion of a prosthetic valve but also aid in overcoming prosthesis-patient mismatch. Further studies on larger series are necessary to document the actual effectively and precise selection criteria for application of this method.
文摘This study is performed to investigate the effect of Fontan operations on cardiac contractility. Investigation of articles about the contractility in Fontan published in PubMed up to now revealed that the measurement of contractility values did not include the rudimentary ventricle. Connections between right atrium and right ventricle as well as right atrium and pulmonary artery were studied in the same group as well. In our opinion, for the single ventricular physiology, the RA-RV and RA-PA connected patients’ preload and afterload values cannot be calculated in the same group since volume of rudimentary ventricles must be considered from this point of view as well.
