Today, mitral valve replacement is performed under cardioplegic arrest with cross-clamping of the ascending aorta. In the case reported here, mitral valve replacement was performed with an on-pump beating heart technique without cross-clamping the aorta because of diffuse adhesion around the tube graft. A 36-year-old man had undergone a Bentall operation (aortic root replacement+coronary reimplantation) via median sternotomy because of type I aortic dissection 4 years previously in our cardiac center. He was admitted to the hospital complaining of palpitation and dyspnea on mild exertion. Transthoracic echocardiography study revealed third-degree mitral insufficiency. Mitral valve replacement was carried out through re-median sternotomy with an on-pump beating heart technique without crossclamping the aorta. On-pump beating heart mitral valve replacement without a cross-clamp offers a safe approach when excessive dissection is required to place a crossclamp on the ascending aorta.

IntroductionIn this retrospective study, we aimed to determine the risk factors for coronary artery bypass surgery in patients under 45 years of age, and evaluate the early postoperative results and the effect of gender.MethodsA total of 324 patients under 45 years of age who undergone on-pump coronary artery bypass surgery between April 12, 2004 and January 10, 2012 were included to the study. Patients divided into groups as follows: Group 1 consisted of 269 males (mean age 41.3), Group 2 consisted of 55 females (mean age 41.6). Preoperative risk factors, intraoperative and postoperative data and early mortality rates of the groups were compared.ResultsSmoking rate was significantly higher in Group 1. Diabetes mellitus incidence and body mass index were significantly higher in Group 2 (P values P=0.01; P=0.0001; P=0.04 respectively). The aortic cross-clamping and cardiopulmonary bypass time and number of grafts per patient were significantly higher in Group 1 (P values P=0.04; P=0.04; P=0.002 respectively). There were no deaths in either group.ConclusionWe found that gender has no effect on early mortality rates of the coronary bypass surgery patients under 45 years.

Open heart surgery in hemodialysis patients is associated with a higher incidence of risks, but can be performed with acceptable operative complications and mortality with an effective hemodialysis program.

The treatment options for aberrant right subclavian artery vary depending on the presence of Kommerell’s diverticulum. Because there is a tendency not to report mortalities of these rare cases in the literature, it is hard to reach a conclusion on treatments from the limited data on post-interventional results in these patients. We report our experience with a 67-year old patient with an aberrant right subclavian aneurysm with Kommerell’s diverticulum, diagnosed by chance.

Moyamoya disease is a rare, idiopathic, progressive, occlusive disease of the internal carotid artery characterized by the development of collateral vasculature in the brain base. In patients with accompanying coronary artery disease, cardiopulmonary bypass posses a potential risk for perioperative cerebral ischemic complication. Herein, we report a 53-year-old male case of Moyamoya disease and coronary artery disease who was treated with off-pump coronary artery bypass grafting.

Inflammation and oxidative stress markers were lower in the group of patients who underwent beating-heart valve surgery with low-volume ventilation. These results reflect less of an ischemic insult and lower inflammation compared with the results for the patients who underwent conventional operations.

Introduction: The importance of preoperative risk scoring in open-heart surgery has risen in the last decades. Many scoring systems for mortality prediction before coronary artery bypass grafting surgery (CABG) have been described in all over the world. We aimed to compare the efficacy of three different well-known and commonly used mortality risk-scoring systems and to provide a more suitable scoring system for our patient population.Material-Method:  A total of 2120 patients who had undergone a CABG operation in Türkiye Yüksek İhtisas Hospital Cardiovascular Surgery Clinic between January 2003 – December 2004 included in this study. The patients who had concomitant surgery with CABG operation were excluded. The in-hospital deaths and the deaths in postoperative 30 days were accepted as mortality. The patients were divided into low, moderate and high-risk groups as the risk scoring systems prerequisites. The predicted mortality rates by the risk scoring systems and the observed mortality rates were compared. Results: The observed mortality rates and the predicted mortality rates by the European System for Cardiac Operative Risk Evaluation (EuroSCORE) were similar between the groups (p>0.05). The observed mortality rates of low and moderate risk groups were significantly lower than the predicted mortality rates with Parsonnet risk scoring system (p<0.001). In the high-risk group, the observed mortality rates were not significantly different from the predicted mortality rates with the same risk scoring system (p>0.05). The predicted mortality rates with Ontario Province Risk (OPR) scoring system and observed mortality rates in the low risk group were significantly different (p<0.001). But in the moderate and high risk groups, the observed mortality rates and predicted mortality rates with the OPR were not significantly different (p>0.05). In the receiver operating characteristic curve (ROC) analysis, the area under the curve (AUC) = 0.801 for EuroSCORE, AUC = 0.737 for Parsonnet and AUC = 0.677 for OPR risk scoring systems. According to these values, the accuracy of EuroSCORE was accepted as high, Parsonnet was accepted as moderate and OPR was accepted as non-significant. Conclusion: The EuroSCORE risk scoring system results were similar to the results in the literature. It is a reliable way of risk prediction for the patients undergoing CABG surgery in our region.

Traditionally, reoperations for mitral valve replacement are carried out under cardioplegic arrest with cross-clamping of the ascending aorta via a median sternotomy. In this case, the mitral valve replacement operation was performed with an on-pump beating heart technique without cross-clamping the aorta and via a right thoracotomy because of diffuse adhesions around the ascending aortic tube graft. A 44-year-old male patient had undergone a Bentall operation via a median sternotomy for annulo-aortic ectasia 3 years ago. He was admitted to the hospital complaining of palpitation and dyspnea. Transthoracic echocardiography revealed 4th degree mitral insufficiency. Mitral valve replacement was carried out through a right thoracotomy using an on-pump beating heart technique without cross clamping the aorta. In conclusion, mitral valve replacement with an on-pump beating heart technique via a right thoracotomy offers a safe approach when excessive dissection is required to place a cross-clamp to the ascending aorta.