Although acute aortic dissections with bilateral carotid artery involvement are rare, they have serious morbidity and mortality rates. The most important strategy in cases with carotid involvement is to provide adequate cerebral perfusion during cardiopulmonary bypass. In this case, we presented, aortic dissection with bilateral carotid involvement was detected in the patient who was admitted to the emergency department with severe chest pain, vision loss, and left arm monoplegia, and the decision for surgery was made urgently. Selective cerebral perfusion was provided throughout the operation with direct bilateral carotid cannulation, in terms of being the fastest method and providing adequate cerebral flow. During the discharge period, full recovery was achieved in neurological deficits without any sequelae. We think that the technique we have applied in such a difficult and complicated case is the best strategy because it is fast and effective.

Background: This study aimed to investigate the incidence of postoperative atrial fibrillation (POAF) in patients undergoing off-pump versus on-pump coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB). Methods: A total of 3,197 consecutive patients (1,816 males, 1,381 females; mean age: 60.8 ± 9.8 years) with preoperative sinus rhythm who underwent CABG at a cardiovascular surgery clinic between November 2009 and March 2014 retrospectively were analyzed. Of the patients, 1,680 underwent on-pump and 1,517 underwent off-pump cardiac surgery. Data, including demographic characteristics, preoperative risk factors, preoperative medications, laboratory test results, postoperative data and complications, and mortality and morbidity rates, were recorded. Results: According to the multivariate analysis, the type of operation, number of anastomoses, right coronary artery or right coronary posterior descending artery graft, vasopressor therapy (epinephrine, norepinephrine), operation duration, age >60 years, hypertension, length of hospital stay >4 days, and obstructive sleep apnea syndrome (OSAS) were the independent predictors of POAF after CABG. Our study results suggest that on-pump CABG under CPB is correlated with POAF. Conclusion: We recommend using off-pump CABG in select cases to minimize the risk of POAF.

Objective: In this study, we investigated whether the addition of vitamin B complex to prime solution for cardiopulmonary bypass (CPB) in cobalamin-deficient patients undergoing on-pump coronary artery bypass grafting (CABG) helps prevent the development of postoperative delirium (POD). Materials and Methods: In the present study, 69 of 138 patients with serum vitamin B12 levels <200 pg/mL based on the blood sample taken within 1 week prior to on-pump CABG between January 2013 and December 2017 were enrolled. The control group included 69 patients. Vitamin B complex (25 mg vitamin B1, thiamine hydrochloride, 2.734 mg vitamin B2, riboflavin phosphate ester monosodium, 5 mg vitamin B6, pyridoxine hydrochloride, 15 mcg vitamin B12, 50 mg niacinamide, and 17.2 mg D-panthenol) was added to the prime solution for CPB in the study group. The Intensive Care Delirium Screening Checklist (ICDSC) was used for the diagnosis of POD, and the severity of delirium was assessed by using the Delirium Rating Scale-Revised-98 (DRS-R-98). Results: Twenty-nine patients in the control group (42%) and 18 patients (26%) in the study group developed POD (P = .017), delirium severity scores were higher in the control group (16.5 ± 2.9 versus 15.03 ± 2.48, P = .034). Logistic regression analyses showed vitamin B complex was an independent protective factor for preventing the development of POD in patients undergoing on-pump CABG (odds ratio [OR]: 0.23, 95% confidence interval [95% CI]: 0.06-0.83, P = .025). Conclusion: On the basis of the results of our study, the addition of vitamin B complex to the prime solution for CPB decreases the incidence of POD in cobalamin-deficient patients undergoing on-pump CABG.

How to cite/Atıf için: Atılgan K, Demirdaş E, Er CZ, Çiçekçioğlu F. Evaluation of deep vein thrombosis incidence with respect to age and gender in light of regional factors in central Anatolia: A population-based study.

Introduction: Post-operative atrial fi brillation (POAF) and post-pericardiotomy syndrome (PPS) are common complications of cardiac surgery. Both PPS and POAF are associated with increased morbidity, mortality, costs and length of stay after cardiac surgery. Infl ammation is involved in the pathogenesis of both PPS and POAF; however, the relationship between PPS and POAF remains unclear. The aim of this study was to examine the relationship between early PPS and POAF in patients who underwent cardiac surgery. Patients and Methods:Records of patients who underwent on-pump coronary artery bypass graft (CABG) surgery were retrospectively reviewed. A total of 60 consecutive patients who were diagnosed with POAF were included in the study, while 142 consecutive patients who were not diagnosed with POAF were included as controls.Results: An early PPS development was signifi cantly higher in patients with POAF than in patients without POAF (61.7% vs 45.8%, p= 0.04). Logistic regression analysis demonstrated that patients with POAF had 1.9-times increased risk for developing early PPS (OR, 1.9; 95% CI, 1.03-3.5; p= 0.04). Conclusion:This study showed that POAF was associated with an increased incidence of early PPS in patients who underwent isolated CABG surgery. Therefore, patients with POAF should be closely monitored for the occurrence of early PPS.Key Words: Post-pericardiotomy syndrome; post-operative atrial fi brillation; coronary artery bypass graft surgery Kalp Cerrahisi Yapılan Hastalarda Erken Dönemde Gelişen Postperikardiyotomi Sendromu ve Atriyal Fibrilasyon Arasındaki İlişki ÖZETGiriş: Postoperatif atriyal fi brilasyon (POAF) ve postperikardiyotomi sendromu (PPS) kalp cerrahisinin sık görülen komplikasyonları arasında yer alır. POAF ve PPS uzamış yatış süreleri, yüksek morbidite ve mortalite oranları ve yüksek sağlık bakım maliyetleri ile ilişkili bulunmuştur. Her iki komplikasyonun da patogenezinde infl amasyon suçlanmakla birlikte, PPS ve POAF arasındaki ilişki açıklığa kavuşmamıştır. Bu çalışmanın amacı koroner baypas yapılan hastalarda, erken dönemde gelişen PPS ve POAF arasındaki ilişkiyi incelemektir. Hastalar ve Yöntem:Kliniğimizde kardiyopulmoner baypas altında koroner baypas operasyonu yapılmış olan hastaların kayıtları retrospektif olarak incelendi. Takibinde POAF gelişmiş olan ardışık 60 hasta çalışma-ya dahil edildi. Takiplerinde POAF gelişmeyen koroner baypas cerrahisi yapılmış ardışık 142 hasta kontrol grubuna dahil edildi. Bulgular: POAF gelişen hastalarda, POAF gelişmeyen hastalarla karşılaştırıldığında erken PPS gelişme sıklı-ğı anlamlı olarak daha yüksek bulunmuştur (%61.7 vs %45.8, p= 0.04 ). Lojistik regresyon analizinde, POAF gelişen hastalarda erken PPS gelişme riskinin daha fazla olduğu saptandı (Odds oranı 1.9, %95 güven aralığı 1.03-3.5, p= 0.04).Sonuç: Çalışmamızda, izole koroner baypas ameliyatı yapılmış ve POAF gelişen hastalarda, erken PPS gelişim riskinin POAF gelişmeyen hastalarla karşılaştırıldığında daha fazla olduğu saptandı. POAF gelişen hastalar, erken PPS gelişimi açısın...

Mevcut koroner kalp hastalığı, akciğer rezeksiyonunun cerrahi mortalite ve morbidite oranlarında bir artışa neden olabilir. Akciğer rezeksiyonundan önce miyokard revaskülarizasyonu ile eş zamanlı veya iki aşamalı işlem, ameliyat sonrası morbidite ve mortalite oranlarını azaltabilmektedir. Bu yazıda, eş zamanlı atan kalpte koroner arter baypas greftleme ve sağ üst lobektomi yapılan akciğer adenokarsinomlu 65 yaşında erkek bir olgu sunuldu.

Jugular venous aneurysm (JVA) is a rare venous anomaly that usually presents in children and is infrequently reported in the adult literature. We present a case of an internal jugular vein aneurysm (IJVA) in an adult patient who presented with pulmonary embolism. A 70-yearold female was admitted to the hospital with pulmonary embolism. A left IJVA was found incidentally which was 22 × 18 mm in diameter during the screening for malignancy. Duplex ultrasound revealed residual venous thrombosis. The patient had no other risk factors for pulmonary embolism. Although extremely rare, IJVA may be a causative factor of pulmonary embolism.

10% of the coarctation of the aorta (COA) cases are diagnosed higher than 40-year of age and other cardiac pathologies accompany to 40% of these cases. The cause of mortality in 20% of undiagonised cases is the aortic rupture of ascending aorta. Aneurysm of the ascending aorta (AAA), COA, bicuspid aortic valve (BAV)and subaortic membrane were observed in a young male patient referring to our medical center with dispnea. The patient was operated and all pathologies were repaired in one single session. AAA or aortic dissections (AD) accompanying with other cardiac pathologies like BAV, ventricular septal defect (VSD) can be repaired in one single operation by an accurate surgical approach.