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Bu çalışmada açık kalp cerrahisi sonrası gelişen aortik patolojilerin risk faktörleri değerlendirildi. Ça lış mapla nı:Ocak 2000-Ocak 2009 tarihleri arasında kliniğimizde vücut dışı sirkülasyon ile açık kalp cerrahisi uygulanmış 13.995 hasta retrospektif olarak incelendi. Bu hastalar içinden daha önce açık kalp cerrahisi geçirmiş olan ve sonrasında aortik patoloji tespit edilen 50 hasta (39 erkek, 11 kadın; ort. yaş 52.1±13.9 yıl; dağılım 21-80 yıl) çalışmaya dahil edildi. Her iki ameliyat arasında geçen ortalama süre 8.5±7.4) ay (dağılım 1-31 ay) idi. Bul gu lar: Total mortalite oranı %32 idi (n=15). Acil olarak ameliyata alınan beş hastanın tamamı kaybedildi. İlk ameliyattaki aort çapları 4.1 cm iken, ikinci ameliyatta tespit edilen ortalama aort çapı 5.5 cm idi. Sağ kalan hastalara kıyasla, mortalite grubunda yaş, aortik kros klemp zamanı ve total perfüzyon zamanı daha yüksekti (p<0.05). So nuç: Yaşam beklentisinin artmasına paralel olarak, redo ameliyatların sıklığının artacağı ve bu ameliyatların mortalitesinin yaş ile birlikte arttığı göz önünde bulundurulmalıdır. Bu nedenle ilk ameliyatlarda palyatif yaklaşımlardan ziyade daha radikal cerrahi girişimler uygulanabilir. Anah tar söz cük ler: Aortik anevrizma; aortic diseksiyon; aort kapak replasmanı; koroner arter baypas greftleme; mitral kapak replasmanı. Background:This study aims to assess the risk factors for aortic pathologies developing following open heart surgery. Methods: Between January 2000 and January 2009, 13,995 patients who underwent open heart surgery under extracorporeal circulation in our clinic were retrospectively analyzed. Among these patients, 50 with a previous history of cardiac surgery (39 males, 11 females; mean age 52.1±13.9 years; range 21 to 80 years) followed by an aortic pathology were enrolled. The mean time lapse between two operations was 8.5±7.4 months (range 1-31 months). Results:The rate of total mortality was %32 (n=15). All of the five patients who underwent emergent operations died. The mean aortic diameter during the first operation was 4.1 cm, while it was 5.5 cm during the second operation. Age, aortic cross-clamping time and total perfusion time were higher in the mortality group compared to the survivors (p<0.05). Conclusion:In parallel with the increasing life expectancy, it should be kept in mind that the frequency of redo operations may increase with an increasing mortality rate depending on the age. More radical surgical interventions, thus, may be used in lieu of palliative approaches during the first operation.

In this study, the addition of candesartan to a cardioplegic arrest protocol routinely performed during cardiac surgery did not provide a significant advantage in protection against ischemia-reperfusion injury compared with the administration of cardioplegic solution alone.

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Background: Factor XI deficiency (FXID), is a rare disorder of the coagulation system and the incidence of FXID is estimated to be one in a million. It is claimed to be associated with prominent bleeding in case of trauma and surgery irrelevant to the FXI level. The treatment modality of FXID varies from Fresh frozen plasma (FFP) to the plasma-derived FXI concentrate depending on country and medical center. In this case report, we present a patient with FXID who underwent coronary artery bypass grafting (CABG), and his perioperative management.Case report: A 52-year-old, male patient was admitted to the cardiovascular surgery department and prepared for surgery. He was prepared in accordance with hematologist's recommendation and underwent CABG successfully. He was discharged from hospital on the seventh postoperative day without any complication. Conclusion:The diagnosis of FXID is mainly based upon suspicion in cases of elevated aPTT or unusual bleeding after or during the surgery or trauma, as well as family history like in our case. Suspicion and proper history taking warned us to take precautions and manage the case successfully. In case of cardiovascular surgery of FXID patients, a team-based approach including a cardiologist, surgeon, intensivist and a hematologist with an on-site coagulation laboratory is essential.

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