Özet Amaç SummaryObjectives: The aim of this study was to compare the sharp and blunt needles in order to determine the incidence of complications during transforaminal anterior epidural steroid injections. Methods: In this retrospective study, 185 cases that undergo transforaminal epidural steroid injection with sharp or blunt needles were evaluated between June 2004 and December 2008. Patients age, sex, diagnosis, needle type (sharp or blunt), volume of local anesthetic and steroid injected, complications (paresthesia, dural puncture, bleeding, paralysis, intravascular penetration, headache, local back pain, temporary motor loss in lower extremities) was recorded. Results: 3 cases in blunt needle group and 8 cases in sharp needle group showed paresthesia during the procedure. The difference was not found to be significant among the groups. Vascular penetration was observed in 2 cases in blunt and 13 cases in sharp needle group and the difference between groups was statistically significant (p<0.001). Dural puncture and headache incidence were not significant when the two groups are compared. The local back pain at the injection site had a higher incidence in the blunt needle group. Conclusion: When using the blunt needles, vascular penetration and paresthesia were less during transforaminal epidural steroid injections. Therefore blunt needles seem to be more advantageous.

Bu çalışmada Türk Kalp ve Damar Cerrahisi Derneği'nin en geniş katılımlı ulusal kongrelerinde sunulan sözlü bildirilerin literatüre katkısı araştırıldı. Ça lış ma pla nı: Mayıs 2018 tarihinde iki yılda bir düzenlenen 12, 13. ve 14. kongrelerde sözlü olarak sunulan toplam 675 bildiri PubMed ve Google Akademik veri tabanlarında tarandı. Bildiriler gönderildikleri kurum, bilimsel dergilerde yayımlanma durumu, hakemli derginin türü ve yayımlanma yılı açısından incelendi. Bul gu lar: 675 sözlü bildirinin, %69.1'i klinik çalışma, %18.8'i olgu sunumu ve %12.1'i deneysel araştırma idi. Kabul edilen bildirilerin %47.3'ü üniversite hastanelerinden, %36.1'i eğitim ve araştırma hastanelerinden ve %16.6'sı diğer karma kurumlardan gönderildi. Bildirilerin toplam 279'u (%41.3) makale olarak bilimsel bir dergide yayımlandı. Yayımlanma oranı açısından kurumlar arasında anlamlı bir fark olmakla birlikte (p= 0.04), üniversite hastaneleri en yüksek orana sahipti. Bildirilerin bilimsel bir dergide yayımlanma süresi ortalama 16.7±9.1 (dağılım, 4-60) ay idi. So nuç: Türk Kalp ve Damar Cerrahisi Derneği'nin son üç kongresinde sunulan bildirilerin yayına dönüşme oranı, diğer uzmanlık alanlarına ait ulusal kongrelerinde bildirilen literatür sonuçlarına göre daha yüksek, ancak uluslararası kongrelere kıyasla daha düşüktür. Uluslararası bildiriler ile aynı düzeye ulaşmak için bu oranın artırılması ve araştırmacıları yayına teşvik edici yöntemlerin geliştirilmesi gerektiğine inanmaktayız.

Thermoreactive nitinol clips allow the surgeon to perform a rapid and less challenging technique for sternal reoperations, without additional complications. Using this technique in an identical group with a finite sample size, we accomplished similar early results to those of the classic Robicsek technique.

Surgical treatments for heart failure patients are being increasingly performed every year. While experiences in this field are increasing, transition to alternative surgical approaches to minimize incisions is gaining popularity. However, there are clinics that still avoid performing these techniques. In the current study, we aim to present our experiences in transitioning to a minimally invasive technique by comparing two groups. One group was operated with a minimally invasive technique that has been performed in the learning curve period, while the second was operated with a familiar and standard technique. One hundred twenty patients who were implanted with left ventricular assist devices (LVADs) from April 2015 to January 2019 were retrospectively analyzed. The first 30 LVAD-implanted patients via less invasive approach (since April 2017) were included in group 1, and the last 30 isolated LVAD implanted patients via standard full sternotomy were included in group 2. Early clinical outcomes were compared between these two groups. There were no significant differences between two groups in terms of demographic features and preoperative statuses. Group 1 had significantly lesser mortality rates, cardiopulmonary bypass times, drainages, and blood products. Hospital stays had no significant difference between the groups, while extubation times and ICU stays were significantly lesser in group 1. Left ventricular assist device implantation through thoracotomy and ministernotomy is as feasible as that done through the conventional full sternotomy technique. In this group of patients with a high risk of bleeding, besides providing less hemorrhage, we believe that the surgical procedure was not more difficult than the conventional method.

Severe enlargement of the atrium usually happens within the left atrium and is rarely seen in the right atrium. Giant right atrium is a rare condition that can be seen in tricuspid valve pathologies. Pulmonary hypertension, which could develop after tricuspid valve stenosis or insufficiency, may lead to giant right atrium in adults. A 45-year-old female patient was operated for tricuspid valve insufficiency related to a giant right atrium. Key Words: Pulmonary hypertension, right atrial dilatation Dev Sağ Atrium ÖZETAtriumun ileri derecede genişlemesi genelde sol atriumda görülür. Nadiren sağ atriumda da gelişebilir. Dev sağ atrium triküspit kapak patolojilerinde nadir görülen bir durumdur. Erişkinlerde triküspit kapak stenozu ve yetmezliği sonucunda oluşabilen pulmoner hipertansiyona sekonder gelişebilir. Kırk beş yaşında kadın hasta triküspit yetmezliğine bağlı gelişen dev sağ atrium sebebiyle opere edildi.

No abstract

In this study, a rare kind of injury due to smoke bomb capsule impaction to midface and under the cranial base is presented, and maneuvers to reduce mortality are discussed. Three male patients were presented with impacted smoke bomb capsules into the midface and under the cranial base structures. Midface structures, anterior cranial base, and, in 2 patients, unilateral eye were severely damaged. Two patients died after the initial emergency operations because their lung disease progressed to acute respiratory distress syndrome. One of the patients lived, and soft tissue reconstruction was achieved by using temporal transposition and cheek advancement skin flaps with split-thickness skin graft from donor site. However, craniofacial destruction is important in these patients; a multidisciplinary approach is needed for the treatment of direct smoke bomb injuries because the patients experienced chemical burn and acute trauma. The timing of maxillofacial reconstruction is also a question in these specific patients.

Mitral regurgitation (MR) is an important consequence of heart failure (HF) patients, which increases hospitalization and mortality rates. The MitraClip procedure is increasingly preferred for HF patients with obvious MR to improve MR and related symptoms. In some cases, patients may need further intervention such as left ventricular assist device implantation with the aim of improving progressive clinical deterioration caused by the progression of HF or mitral clip associated complications (i.e., detachment or mitral stenosis). This case study summarizes our two patients who received concomitant mitral clip removal and left ventricular assist device implantation with clinically successful results.