Objective: Cardiac myxoma usually presents during early adulthood. There is generally a tendency for prompt surgical resection. However, advanced age of patients presenting with this disease may increase the operative risk due to other cardiac and non-cardiac problems. Therefore, we evaluated elderly patients who underwent surgery for myxoma to review the management of treatment. Methods:Between September 1985 and March 2012, a total of 17 consecutive patients over 65 years of age (5 male, 12 female; mean age: 69.3±3.5 years) who had undergone surgical resection for cardiac myxoma were analyzed retrospectively. Echocardiography had been performed in all patients to diagnose the myxoma and evaluate other cardiac pathologies. Coronary angiography had been performed in all patients except in two cases who underwent emergency surgery.Results: Thirteen patients (76.4%) survived the operation. Two patients who underwent emergency operation died early and four patients died during the follow-up time. Concomitant procedures included coronary artery bypass grafting in two, radiofrequency ablation in one, mitral valve reconstruction in one and femoral embolectomy in one patient. Conclusions:In an era of aging population, myxoma tends to be diagnosed more frequently in elderly and high-risk patients. Complete preoperative assessment of these patients is a more appropriate approach in stable patients than the traditional emergency surgery applied to all cases.Keywords: Coronary angiography, echocardiography, myxoma, older age ÖZET İleri yaş hastalarda kardiyak miksomanın cerrahi tedavisiAmaç: Kardiyak miksoma genellikle erken erişkinlikte ortaya çıkar ve tanı sonrası hızlı bir şekilde cerrahi rezeksiyon yapılmaya eğilim vardır. Bununla beraber, daha ileri yaşlarda bu hastalığa maruz kalan hastalarda, cerrahi risk eşlik eden diğer kardiyak ve non-kardiyak rahatsızlıklardan dolayı daha yüksek olabilir.Bu nedenle, kardiyak miksoma nedeniyle cerrahi rezeksiyon yapılan yaşlı hastalarımızı, tedavi yönetimle-rini gözden geçirmek için değerlendirdik.Yöntemler: Eylül 1985-Mart 2012 arasında kardiyak miksoma nedeniyle ameliyat edilen 65 yaş üzerindeki ardışık 17 hasta (5 erkek, 12 kadın; ortalama yaş, 69.3±3.5 yıl) retrospektif olarak analiz edildi. Tüm hastalara miksoma tanısı ve diğer kardiyak defektlerin saptanması için ekokardiyografi yapıldı. Acil olarak opere edilen iki hasta dışında tüm hastalara koroner anjiyografi yapıldı. En çok gözlenen semptom dispneydi (%70.5), atriyal fibrilasyon 5 hastada gözlendi (%29.4). Sistemik embolizasyon 7 hastada vardı (%41.1). Tüm tümörler sol atriyumdan köken almışlardı. Bulgular:Operasyon sonrası hayatta kalan hasta sayısı 13 (%76.4) idi. Acil olarak operasyona alınan iki hasta da erken dönemde kaybedildi. Takip esnasında 4 hasta kaybedildi. Eş zamanlı olarak iki hastaya koroner arter baypas cerrahisi, 1 hastaya radyofrekans ablasyon, 1 hastaya mitral kapak onarımı ve 1 hastaya da femoral embolektomi yapıldı.Sonuç: Yaşlanan toplumda, miksomanın daha yaşlı ve yüksek riskli hastalarda ...
Purpose: The present study investigated the correlation between extend aortic cross-clamping time and peripheral nerve injury on rats. Methods: 24 male, Sprague Dawley rats were divided into 3 groups; (a) control group: abdomen was directly closed after reached aorta, and followed by 72 hours, (b) shortterm ischaemia-reperfusion group: peripheral nerve ischemia was induced in rats by supraceliac aortic occlusion for 20 min followed by 72 h of reperfusion, (c) long-term ischaemia-reperfusion group: peripheral nerve ischemia was induced for 30 min followed by 72 h of reperfusion. Preoperative and postoperative, electromyography (EMG) recordings were done. End of 72 h, the sciatic nerves were harvested from each animal for histopathological and biochemical analysis. Results: The mean compound muscle action potential (CMAP) amplitude of long-term ischaemia-reperfusion group was statically significant reduced when compared to the control group (p <0.01). However, the mean distal latency value of long-term ischaemia-reperfusion group was statically significant increased (p <0.01). On the other hand, there were statically significant differences between the results of malondialdehyde, edema and ischemia fiber degeneration grades on control and long-term ischaemia-reperfusion group (p <0.001). Conclusion: This study demonstrated that the extending cross clamping time directly harms the peripheral nerve of rats.
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