BackgroundSurgical drainage is a rapid and effective treatment for pericardial tamponade in cancer patients. We aimed to investigate the effectiveness of pericardial window formation via mini-thoracotomy for treating pericardial tamponade in cancer patients, and to evaluate clinical factors affecting long-term survival.MethodsRecords of 53 cancer patients with pericardial tamponade treated by pericardial window formation between 2002 and 2008 were examined. Five patients were excluded due to insufficient data. Kaplan-Meier and Cox regression analysis were used for analysis.ResultsForty-eight patients (64.7% male), with a mean age of 55.20 ± 12.97 years were included. Patients were followed up until the last control visit or death. There was no surgery-related mortality and the 30-day mortality rate was 8.33%; all died during postoperative hospitalization. Morbidity rate was 18.75%. Symptomatic recurrence rate was 2.08%. Cancer type and nature of the pericardial effusion were the major factors determining long-term survival (P <0.001 and P <0.004, respectively).Overall median survival was 10.41 ± 1.79 months. One- and 2-year survival rates were 45 ± 7% and 18 ± 5%, respectively.ConclusionPericardial window creation via minithoracotomy was proven to be a safe and effective approach in surgical treatment of pericardial tamponade in cancer patients. Cancer type and nature of pericardial effusion were the main factors affecting long-term survival.

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Patient: Male, 36Final Diagnosis: Aspergillus flavus endocarditisSymptoms: Malaise • fatigue and dyspneaMedication: —Clinical Procedure: Mitral vale replacemnetSpecialty: CardiologyObjective:Rare diseaseBackground:Infective endocarditis due to Aspergillus species is an uncommon infection with a high mortality rate. It mostly occurs after the implantation of prosthetic heart valves. Parenteral nutrition, immunosuppression, broad-spectrum antibiotic regimens, and illegal intravenous drug use are the risk factors for developing infection.Case Report:We report a case of Aspergillus flavus native mitral valve endocarditis in a patient who had allogeneic stem cell transplantation in the past due to myelodysplastic syndrome.Conclusions:Although it is rare and there is limited experience available with the diagnosis and treatment, early recognition and therapeutic intervention with systemic antifungal therapy and aggressive surgical intervention are critical to prevent further complications that may eventually lead to death. In addition, better novel diagnostic tools are needed to facilitate more accurate identification of patients with invasive Aspergillus and to permit earlier initiation of antifungal treatment.

Purpose: Different surgical procedures were defined due to degree of Ebstein anomaly. In this study, we are reporting our surgical experience of adult patients with Ebstein anomaly.Methods: We analyzed the patients, who had operated with the diagnosis of Ebstein anomaly from March 2011 through February 2018, retrospectively. We evaluated patients in two groups: patients with cone type surgical repair were in Group 1 and patients with other surgical (Danielson, Carpentier) procedures were in Group 2.Results: There were 23 patients in the study; 9 (39%) were in Group 1 and 14 (61%) were in Group 2. In the comparison of preoperative data, groups were statistically similar. Aortic cross clamp and cardiopulmonary bypass (CPB) times, need for inotropic agents, intubation time, postoperative >2 tricuspid regurgitation incidence, intensive care unit, and hospital staying times were statistically significantly higher in Group 2. There was one mortality (4.3%) in Group 2 due to sepsis.Conclusion: Cone type repair can safely be performed in the repair of Ebstein anomaly with acceptable results. Our results are encouraging to prefer this technique as one of the first-line treatment of Ebstein anomaly. However, further randomized controlled studies are recommended to evaluate the efficacy of this surgical procedure.

This study demonstrates that methylprednisolone is effective for ensuring better myocardial protection during cardiac surgery by suppressing the inflammatory response via decreasing the levels of IL-6 and by increasing anti-inflammatory activity through IL-10.

Background: End-stage renal disease is considered an independent risk factor for early and late survival after coronary artery bypass grafting. Methods: We retrospectively analysed patients with dialysisdependent renal insufficiency who had undergone coronary artery bypass surgery between 2010 and 2017. Patients who were operated with the assistance of cardiopulmonary bypass (ONCAB) were in group 1 and those operated with off-pump coronary artery bypass surgery (OPCAB) were in group 2. We compared peri-operative morbidity and mortality rates and short-term results of the two groups. Results: There were 74 patients in group 1 and 36 in group 2. Blood transfusion requirement, drainage, need for intraaortic balloon pump and duration of stay in intensive care unit was statistically significantly higher in group 1 (p < 0.05). Also, postoperative creatine kinase (CK) and creatine kinasemuscle/brain (CKMB) values were statistically significantly higher in group 1 (p = 0.003). Conclusion: Coronary artery bypass grafting under ONCAB was a potential risk for morbidity and mortality in patients with end-stage renal disease. Performing OPCAB surgery may improve postoperative outcomes and should be kept in mind as a surgical option.

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CABG with open stent endarterectomy is a valuable alternative option for patients with "full-metal jacket" diseased LAD that are not graftable using standard surgical techniques.