On-pump coronary artery bypass grafting can be performed in patients with ejection fraction ≤30%, with reasonable mortality and morbidity rates.

SummaryBackgroundCoronary artery bypass (CAB) surgery triggerssystemic inflammatory response syndrome (SIRS) via severalmechanisms. Moreover, age is directly correlated with SIRS.We evaluated the effect of age on SIRS and postoperativeoutcome after CAB surgery.MethodsWe retrospectively reviewed the records of 229 patients who had undergone CAB surgery. The patients were divided into three groups according to age: group 1, < 40 years (n = 61); group 2, 40–75 years (n = 83); and group 3, > 75 years old (n = 85). Pre- and peri-operative data were assessed in all patients. SIRS was diagnosed according to the criteria established by Boehme.ResultsThe average pre-operative EuroSCORE value in group 3 was higher than in the other groups and body surface areas were significantly lower in group 3 than in the other groups (p < 0.05). The postoperative SIRS rates were 68.9% in group 1, 84.3% in group 2 and 91.8% in group 3 (group 1 vs group 3; p < 0.05). Mortality rates were not significantly different between the groups (p > 0.05). The predictive factors for SIRS were age, EuroSCORE rate, on-pump CAB surgery and intra-aortic balloon pump use.ConclusionAge was an important risk factor for SIRS during the postoperative period after CAB.

No abstract

Prompt diagnosis and early surgical intervention is essential for patients with large or expanding left ventricular pseudoaneurysms due to the high propensity of fatal rupture. Associated coronary artery bypass grafting may reduce early mortality of patients with left ventricular pseudoaneurysm by resuscitating the ischemic myocardium.

ÖZAmaç: Bu çalışmada arkus aort anevrizmalarının tedavisinde hibrid işlem ve açık cerrahi sonuçları karşılaştırıldı.Ça lış mapla nı:Ocak 2004 -Ocak 2010 tarihleri arasında arkus aort anevrizması nedeniyle total arkus aort replasmanı yapılan 26 hasta (21 erkek, 5 kadın; ort. yaş 56.6±12.4 yıl; dağılım, 20-83 yıl) retrospektif olarak değerlendirildi. Hastalar açık konvansiyonel cerrahi grubu (grup 1, n=15) ve hibrid işlem (aynı seansta total arkus aort debranching ve endovasküler stent implantasyonu) grubu (grup 2, n=11) olarak iki gruba ayrıldı. Sağkalım oranları ve tekrar ameliyat gereksinimi gruplar arasında karşılaştırıldı. Bul gu lar:Ameliyat sonrası revizyon, ekstübasyon süresi ve drenaj miktarları açısından hibrid işlem daha iyi bulundu. Ancak sağkalım oranları, tekrar ameliyat gereksinimi ve ciddi advers kardiyovasküler olaylar açısından gruplar arasında istatistiksel olarak anlamlı bir fark yoktu.So nuç: Çalışma sonuçlarımız arkus aort anevrizması nedeniyle total arkus aort replasmanı yapılan hastalarda sağkalım ve kısa ila orta dönem sonuçlar açısından açık konvansiyonel cerrahi ve hibrid işlemin benzer olduğunu göstermektedir.Anah tarsöz cük ler: Arkus aort anevrizması; konvansiyonel açık cerrahi; hibrid işlem. ABSTRACTBackground: This study aims to compare the results of hybrid procedure and open surgery for the treatment of aortic arch aneurysms. Methods:Twenty-six patients (21 males, 5 females; mean age 56.6±12.4 years; range, 20 to 83 years) who underwent total aortic arch replacement for aortic arch aneurysm between January 2004 and January 2010 were retrospectively analyzed. The patients were divided into two groups: open conventional surgery group (group 1, n=15) and hybrid procedure (total debranching of the aortic arch and simultaneous endovascular stent) group (group 2, n=11). Survival rates and need for reoperation were compared between the groups.Results:The hybrid procedure was found to be more favorable in terms of postoperative revision, extubation period, and drainage amounts. However, there was no statistically significant difference in the survival rates, need for reoperation, and major adverse cardiovascular events between the groups. Conclusion:Our study results suggest that conventional open surgery and hybrid procedure are similar in terms of survival and short-to-mid-term results in patients undergoing total aortic arch replacement for aortic arch aneurysm.

Patch closure of the ventricular septal rupture with an infarct-exclusion technique provided acceptable results. Concomitant coronary artery bypass grafting might be beneficial to control additional risk of an associated coronary artery lesion. Prompt diagnosis followed by early surgical intervention is essential for patients with ventricular septal rupture.

Extracardiac unruptured sinus of Valsalva aneurysm (SVA) is an infrequent cardiac anomaly. Unruptured SVAs are typically symptom-free until rupture occurs. We describe a case of an unruptured extracardiac SVA originating from noncoronary sinus with left ventricular dysfunction. The patient was asymptomatic. The diagnosis was made by transthoracic echocardiography, computed tomography, and cardiac catheterization. The aneurysm was surgically resected and the sinus was successfully reconstructed with a patch. The patient remained asymptomatic throughout the postoperative follow-up period. Early surgical repair should be the choice of treatment for extracardiac SVAs in order to prevent sudden death.

No abstract