Background Robotic mitral valve surgery continues to become widespread all over the world in direct proportion to the developing technology. In this study, we aimed to compare the postoperative results of robotic mitral valve replacement and conventional mitral valve replacement. Methods A total of consecutive 130 patients who underwent robotic mitral valve replacement and conventional mitral valve replacement with full sternotomy between 2014 and 2020 were included in our study. All patients were divided into two groups: Group I, with 64 patients who underwent robotic mitral valve replacement and Group II, with 66 patients with conventional full sternotomy. General demographic data (age, gender, body weights, etc.), comorbidities (hypertension, diabetes mellitus, chronic obstructive pulmonary disease, peripheral artery disease, hyperlipidemia, etc.), intraoperative variables (cardiopulmonary bypass times, and cross‐clamp times), postoperative ventilation times, drainage amounts, transfusion amount, inotropic need, revision, arrhythmia, intensive care and hospital stay times, and mortality were analyzed retrospectively. Results There was no significant difference between demographic data, such as age, gender, body kit index, and preoperative comorbid factors of both patient groups (p > .05). Cardiopulmonary bypass time (204.12 ± 45.8 min) in Group I was significantly higher than Group II (98.23 ± 17.8 min) (p < .001). Cross‐clamp time in Group I (143 ± 27.4 min) was significantly higher than Group II (69 ± 15.2 min) (p < .001). Drainage amount in Group I (290 ± 129 cc) was significantly lower than Group II (561 ± 136 cc) (p < .001). The erythrocyte suspension transfusion requirement was 0.4 ± 0.3 units in Group I; it was 0.9 ± 1.2 units in Group II, and this requirement was found to be significantly lower in Group I (p = .014). While the mean mechanical ventilation time was 5.3 ± 3.9 h in Group I, it was 9.6 ± 4.2 h in Group II. It was significantly lower in Group I (p = .001). Accordingly, intensive care stay (p = .006) and hospital stay (p = .003) were significantly lower in Group I. In the early postoperative period, three patients in Group I and four patients in Group II were revised due to bleeding. In the postoperative hospitalization period, neurological complications were observed in one patient in Group I and two patients in Group II. Two patients in Group I returned to the sternotomy due to surgical difficulties. Two patients died in both groups postoperatively, and there was no significant difference in mortality (p = .97). Conclusion According to conventional methods, robotic mitral valve replacement is an effective and reliable method since total perfusion and cross‐clamp times are longer, drainage amount and blood transfusion need are less, and ventilation time, intensive care, and hospital stay time are shorter.

Background: Minimally invasive heart surgery continues to spread rapidly around the world. Although coronary artery bypass surgery with median sternotomy continues to be performed intensively in many centers, the results of the new literature continue to contribute to proving the reliability of minimally invasive coronary surgery. In this study, we aimed to contribute to the routine feasibility of minimally invasive coronary bypass with left anterior mini-thoracotomy with our own case series.Methods: From July 2019 to August 2021 a total of 184 nonselected consecutive patients underwent minimally invasive on-pump multivessel coronary artery bypass grafting through the left anterior minithoracotomy in the fourth intercostal space. In the operation decision; regardless of low ejection fraction, morbid obesity, number of diseased vessels, or other comorbid factors, bypass operation was performed routinely via thoracotomy without selecting patients, except redo patients or porcelain aorta. The mean number of grafts was 3.3 ± 0.5. Left internal mammary artery was used in all patients. For other anastomoses; saphenous vein graft was used.Cardiopulmonary bypass (CPB), aortic cross-clamping, and blood cardioplegia were used in all patients. Postoperative results of all patients were analyzed retrospectively. Results:The total CPB time was 144.5 ± 27.3 min, and aortic cross-clamp time 82.1 ± 16.2 min. The mean intensive care stay was 1.2 ± 0.7 days and mean total hospital stay 5.1 ± 1.2 days. Total perioperative mortality was 0.54% (one patient). Myocardial infarction was not observed in any case in the postoperative period. The cause of mortality was delayed tamponade occurring on the fifth postoperative day.Nine patients underwent revision due to bleeding in the early postoperative period.There was no patient who underwent stroke or developed renal failure requiring hemodialysis in the postoperative period. One hundred and eighty-three patients (99.4%) were discharged with good recovery. Conclusion:Minimally invasive multivessel bypass surgery is a surgical method that has just started to become widespread. The fact that the technique is new and more challenging than conventional methods makes it difficult for surgeons to adopt it. In addition, one of the most important issues is that the surgical results should be satisfactory. Our study shows that safe, successful, and satisfactory results can be

Reoperations in cardiac surgery are very difficult and risky operations due to possible complications. A 35‐week pregnant, 27‐year‐old woman patient presented to the cardiology department with palpitations. Control transthoracic echocardiography revealed a mass in the right atrium with dimensions of 24 × 25 mm. The patient had dextrocardia and situs inversus totalis, and had undergone a robotic atrial septal defect repair operation 1 year ago. Operation was planned for the patient with the joint decision of cardiology, obstetrics, pediatrics, anesthesia, and cardiovascular surgery departments. Redo robotic heart surgery was performed in beating heart after the operation of the cesarean, and the mass in the right atrium was successfully removed. In conclusion, as it is seen in our case, robotic cardiac surgery can be safely and successfully performed, and can minimize morbidity and mortality even in very complex clinical conditions such as pregnancy, dextrocardia, and reoperation.

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.

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Pneumomediastinum is a rare entity that is defined as free air in the mediastinal space. A 26-year-old male patient was admitted with pneumomediastinum as an unexpected complication of robotic surgery. Diffuse subcutanous emphysema was observed suddenly on Postoperative Day 3 without respiratory distress. Air trapping into the mediastinum was seen on chest X-ray and computed tomography. The patient was followed in the intensive care unit for 7 days and managed conservatively. Subcutaneous emphysema reduced gradually. In conclusion, although it is a rare condition, pneumomediastinum should be kept in mind as a complication of robotic cardiac surgery.

N-acetylcysteine (NAC) is an antioxidant which works as a free radical scavenger and antiapoptotic agent. N-acetylcysteine-amide (NACA) is a modified form of NAC containing an amide group instead of a carboxyl group of NAC. Our study aims to investigate the effectiveness of these two substances on erythrocyte deformability and oxidative stress in muscle tissue. Materials and Methods. A total of 24 Wistar albino rats were used in our study. The animals were randomly divided into five groups as control (n: 6), ischemia (n: 6), NAC (n: 6), and NACA (n: 6). In the ischemia, NAC, and NACA groups, 120 min of ischemia and 120 min of reperfusion were achieved by placing nontraumatic vascular clamps across the abdominal aorta. The NAC and NACA groups were administered an injection 30 min before ischemia (100 mg/kg NAC; 100 mg/kg NACA; intravenous). Blood samples were taken from the animals at the end of the ischemic period. The lower extremity gastrocnemius muscle was isolated and stored at −80 degrees to assess the total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) values and was analyzed. Results. The erythrocyte deformability index was found to be statistically significantly lower in rats treated with NAC and NACA before ischemia-reperfusion compared to the groups that received only ischemia-reperfusion. In addition, no statistically significant difference was found between the control group and the NAC and NACA groups. The groups receiving NAC and NACA before ischemia exhibited higher total antioxidative status and lower total oxidative status while the oxidative stress index was also lower. Conclusion. The results of our study demonstrated the protective effects of NAC and NACA on erythrocyte deformability and oxidative damage in skeletal muscle in lower extremity ischemia-reperfusion. NAC and NACA exhibited similar protective effects on oxidative damage and erythrocyte deformability.

In pediatric cases with supracondylar humerus fractures, one of the serious complications that may occur after closed reduction is vascular injuries. Since it can cause serious complications like extremity loss, is an important issue to be considered. There are different opinions in terms of conservative and surgical approach in the event of a pulse failure after reduction. It should be kept in mind that if there are conditions requiring surgical intervention such as coldness, paleness and pulse failure in the extremity, the repair of the damaged vessel segment may be insufficient and it may be necessary to change the entire damaged vessel segment to eliminate endothelial damage caused by traction. In this case report, a surgical approach to iatrogenic brachial artery injury is presented in a 5 years old child who has no radial and ulnar pulse after supracondylar humerus fracture.