Object. Vascular complications related to lumbar disc operations are rare but extremely fatal conditions. The authors analyzed data retrospectively obtained in 13 patients with vascular complications that occurred during lumbar disc operations performed between January 1990 and January 2002. Methods. One patient underwent an L5—S1 procedure and the remaining underwent L4–5 surgery. Missed injuries, which were found during the late postoperative period, included pseudoaneurysm in four cases and an arteriovenous fistula in one. In all cases except one in which complication occurred early in the postoperative period, the retroperitoneal area was reached via a transperitoneal approach. In eight patients with complications occurring early in the postoperative period, Dacron graft was placed in four with arterial injuries and saphenous vein graft in one. In three cases of arterial injury and five of venous injury, the lesion was repaired using the primer suture technique. The most commonly affected vessels were left common iliac arteries (76.9%) and left common iliac vein (30.8%). In eight early cases, shock or preshock due to hemorrhage developed during the early phase. During the late postoperative period, graft-related infection occurred in two cases in which Dacron graft was placed, and axillofemoral extraanatomical bypass surgery was later performed. There was no surgery-related death. During a mean follow-up period of 5.6 years, none of the patients suffered any problems related to vascular injury. Conclusions. Despite its low incidence, iatrogenic vascular injury related to lumbar disc surgery is a possible complication. During lumbar disc operations early diagnosis of vascular injuries and urgent transperitoneal surgery can save patients' lives.

According to present data, aneurysm formation functionally reduces the VSD size, but it has the potential consequence of promoting tricuspid insufficiency, aortic valve prolapse, right ventricular outflow tract obstruction, rupture and bacterial endocarditis. Therefore, we recommend that AMS should be resected completely and the defect produced closed with a patch in order to prevent further enlargement and consequent complications even if there are no cardiac symptoms.

Gastrointestinal complications, although of low incidence, carry a significantly high mortality, and the clinician must be alert to institute early appropriate treatment.

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This study depicts that coronary tortuosity is associated with impaired left ventricular relaxation.Thus, coronary tortuosity might be an indicator of impaired left ventricular relaxation.

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Severe heart failure represents a major source of morbidity and mortality. Poor right ventricular function is an independent prognostic marker for mortality in patients with chronic heart failure. In this study, levosimendan (L) and dobutamine (D) in patients with severe chronic biventricular failure were compared. Forty consecutive patients, who were judged for inotropic therapy by their primary physicians, with acutely decompensated systolic heart failure and having moderate-to-severe right ventricular dysfunction with right ventricular fractional area change of

We showed that the risk of having non-dipping hypertension, a risk factor for poor cardiovascular outcomes among hypertensive individuals, was tripled (odds ratios) among poor sleepers. We think that evaluating sleeping status and sleep quality among the hypertensive population may help unmask non-dipper hypertension, enabling physicians to treat appropriately.