Visceral artery aneurysm (VAA) is a relatively uncommon disorder and it shows some vague symptoms. Therefore, the clinical diagnosis is difficult and these aneurysms are discovered and diagnosed only after rupture in many cases. This case report describes the history of a woman who had a superior mesenteric artery (SMA) branch aneurysm. A 62-year-old woman presented with fatigue and moderate to severe epigastric and mid-back pain. A computed tomography of the abdomen and pelvis demonstrated a partially thrombosed aneurysm (38×40 mm) rising from the jejunal branch of the SMA. The aneurysm which contains mural thrombus is resected, and a saphenous vein graft interposition is performed between the ends of the same jejuno-jejunal artery. The patient's recovery was unremarkable, and she was discharged on postoperative day 7. Rapid diagnosis, localization, and surgical or endovascular interventions are necessary to avoid devastating consequences in VAAs. Saphenous vein graft interposition is a good choice for surgical intervention for patients not suitable for endovascular treatment.
ardiac failure has a prevalence of 1% in people aged in their 50 s and 10% in their 80 s. The presence of cardiac failure symptoms in the preoperative period is known to increase the surgical risk and the postoperative mortality and morbidity. In recent years the introduction of new drugs and the increased use of coronary angioplasty and stent methods have enabled coronary heart operations to be performed in older patients and patients with late-stage disease. Thus determination of patient risk prior to operation has acquired importance.The plasma B-type natriuretic peptide (BNP) level varies according to the grade of heart failure; that is, it progressively increases from Grade I to Grade IV of the New York Heart Association classification and this increase in the secretion of natriuretic peptides is closely associated with left ventricular (LV) wall tension and ventricular filling pressure. 1 BNP, which is secreted because of increased LV wall tension, and its aminoterminal fraction N-terminal (NT)-proBNP, have gained a high value with respect to predicting LV function and its prognosis. 2,3 Of the natriuretic peptides, NT-proBNP particularly is accepted as a specific marker of cardiac failure 4 and in cases where the NT-proBNP level has increased above approximately 200 pg/ml, a diagnosis of cardiac failure may be made if there are also concomitant signs of cardiac failure. 5 Studies of the relationship between the severity of the heart failure after cardiac surgery and the requirement for inotropic agent, as related to the predictive use of NT-proBNP, are limited in the literature. Circulation Journal Vol.71, January 2007In the present study, the association between the preoperative NT-proBNP level and the prevalance and level of cardiac failure in the early postoperative period in patients undergoing coronary artery bypass grafting (CABG) was investigated. MethodsWe enrolled 52 adult patients undergoing elective CABG. In all patients the NT-proBNP level was measured via Elecys ProBNP sandwich immunoassay method on the day before surgery, and the normal value was accepted as <220 pg/ml. 6 Based on this we divided the patients into 2 groups: NT-proBNP level <220 pg/ml (Group A, n=26) or >220 pg/ml (Group B, n=26). Patients with renal failure (because a preoperative creatinine level >1.6 would cause an increase in the NT-proBNP level), acute myocardial infarction, or combined valvular disease and severe obstructive pulmonary disease were excluded.All the patients underwent CABG with standard cardiopulmonary bypass (CPB) techniques. The left internal mammary artery was used for revascularizing the left anterior descending coronary artery or a saphenous vein graft was used for the other coronary arteries. Arterial pressure was monitored via a radial artery cannula and cardiac rhythm was followed by the bedside monitor. The values for cardiac output (CO) and cardiac index (CI), pulmonary capillary wedge pressure (PCWP), pulmonary artery pressure (PAP), central venous pressure (CVP) were measured preoperatively an...
Cardiac surgery affects a patient's sleep characteristics. Patients with elevated S100B values have more sleep disturbances after cardiac surgery than patients with normal S100B values.
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