True radial artery aneurysms are uncommon pathologies and have an organic cause, unlike trauma-induced false aneurysms. A 52-year-old man presented with a pulsatile mass at the anatomical snuff box area of his left hand. The aneurysm was repaired with reconstructive procedure. Although many posttraumatic and iatrogenic cases of false aneurysm of the radial artery have been reported; there are a few reported cases of a true idiopathic aneurysm. A case of reconstructive surgery for true idiopathic radial artery aneurysm is reported in this paper.

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Introduction Aging is a natural process for every living organism. The trouble here is increased health problems as a result of aging. Aging is a dominant risk factor for cardiovascular diseases and is associated with progressive vascular dysfunction (Herrera et al., 2010; Laurent, 2012). Many studies reported a sex difference in age-associated vascular changes (Sarabi et al., 1999; Sader and Celermajer, 2002; Okumura et al., 2011). Celermajer et al. (1994) showed that age-related impairment in endothelial function appeared to occur earlier in males than in females. Different regulation of endothelial function is one of the main mechanisms underlying the variation in age-associated vascular changes in females and males (Sarabi et al., 1999). However, the underlying mechanisms of sex-dependent alterations in endothelial function remain to be investigated. Endothelium-derived NO plays a key role in the regulation of vascular homeostasis (Moncada et al., 1991). The capacity of NO release is considered to be a major indicator of endothelial function. Vascular aging characterized by endothelial dysfunction is associated with reduced NO bioavailability and increased generation of reactive oxygen species (ROS). ROS combine with NO and produce deleterious free radicals, leading to endothelial dysfunction (Heitzer et al., 2001; Tsimakis, 2006; El Assar et al., 2013; Rochette et al., 2013). ADMA is an endogenous competitive inhibitor of NO synthase and an increase in ADMA is associated with impairment of NO synthesis (Bouras et al., 2013; Sverdlov et al., 2014). It has been reported that plasma concentrations of ADMA increase in elderly people and in postmenopausal women (Schulze et al., 2005). H 2 S is acknowledged as an important gaseous signaling molecule (Kolluru et al., 2013). It has been revealed that H 2 S is an endogenous regulator of oxidative damage and aging in C. elegans (Qabazard et al., 2014). However, the relationship between these molecules and endothelial function in the aging process is still largely unknown. Recent studies have focused on epigenetic changes that occur as a hallmark of aging (Brunet and Berger, 2014).

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Objectives While clinical experience in transcatheter mitral valve interventions is rapidly increasing, there is still a lack of evidence regarding surgical treatment options for the management of recurrent mitral regurgitation (MR). This study provides guidance for a minimally invasive surgical approach following failed transcatheter mitral valve repair (TMVr), which is based on the underlying mitral valve (MV) pathology and the type of intervention. Methods A total of 46 patients who underwent minimally invasive MV surgery due to recurrent or residual MR after transcatheter edge-to-edge repair or direct interventional annuloplasty between October 2014 and March 2021 were included. Results Median age of the patients was 78 [Interquartile range (IQR), 71–82] years and EuroSCORE II was 4.41 [IQR, 2.66–6.55]. At the index procedure, edge-to-edge repair had been performed in 45 (97.8%) patients and direct annuloplasty in one patient. All patients with functional MR at the index procedure (n = 36) underwent MV replacement. Of the patients with degenerative MR (n = 10), 5 patients were eligible for MV repair after Clip removal. One-year survival following surgical treatment was 81.3% and 75.0% in patients with functional and degenerative MR, respectively. No residual MR more than mild during follow-up was observed in patients who underwent MV repair. Conclusions Minimally invasive surgery following failed TMVr is feasible and safe, with promising mid-term survival. The surgical management should be tailored according to the underlying valve pathology at the index procedure, the extent of damage of MV leaflets and the type of previous intervention.

Bu çalışmada kalp kitlelerinin cerrahi eksizyonuna ilişkin deneyimimiz sunuldu ve bu hastaların sağkalım özellikleri incelendi. Ça lış ma pla nı: Ocak 2004-Aralık 2015 tarihleri arasında merkezimizde primer kardiyak tümör ile ameliyat edilen toplam 131 hasta (88 kadın, 43 erkek; ort. yaş 49.4±16.2 yıl; dağılım 1.2 ay-81 yıl) bu çalışmaya alındı. Demografik ve hastalara ilişkin diğer veriler, merkezimizin tıbbi kayıtlarından retrospektif olarak incelendi. Bul gu lar: Tüm benign tümörler tamamen rezeke edilirken, malign tümörler için yalnızca palyatif yöntemler uygulandı. Patoloji sonuçlarında tümörlerin %88.5'inin (n=116) benign ve %11.5'inin (n=15) malign olduğu görüldü. Tümörler en sık sol atriyum (%76.3, n=100) yerleşimliyken, bunu sağ atriyum (%11.5, n=15) ve sağ ventrikül (%5.3, n=7) izledi. Hastaların 116'sı (%88.5) hayatta kalırken, 15 hastada (%11.5) geç mortalite görüldü. Ortalama sağkalım 130.6±4.5 ay idi. Son ölüm 124. ayda gözlenirken, kümülatif sağkalım oranı %79.2 idi. Mortalite ve tümörün patolojik özellikleri arasında istatistiksel olarak anlamlı bir ilişki vardı ve malign tümörlerde mortalite oranları daha yüksekti (p= 0.002). So nuç: Primer kardiyak tümörlerin cerrahi rezeksiyonu düşük morbidite ve mortalite oranları ile yapılabilir. Benign tümörlerde sağkalım oranı tatmin edici iken, malign tümörleri olan hastaların prognozu kötüdür. Uzun dönem mortalitenin başlıca klinik öngördürücüleri tümörün histolojisi ve yeridir.

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Objectives Analyses of fast-track processes demonstrated that low-risk cardiac surgical patients require minimal intensive care, with a low incidence of mortality or morbidity. We investigated perioperative factors and their association with fast-track failure in a retrospective cohort study of patients undergoing minimally invasive mitral valve surgery. Methods Patients undergoing minimally invasive surgical mitral valve repair for Carpentier type I or type II mitral regurgitation between 2014 and 2020 were included in the study. The definition of fast-track failure consisted of > 10 hours mechanical ventilation, >24 hours intensive care unit stay, re-intubation after extubation and re-admission to the intensive care unit. Multivariable logistic regression analysis enabled the identification of factors associated with fast-track failure. Results In total, 491 patients were included in the study and were analysed. Two-hundred and thirty-seven patients (48.3%) failed the fast-track protocol. Multivariable logistic regression analysis showed that a New York Heart Association classification ≥3 (OR 2.05; CI 1.38-3.08; p < 0.001, pre-existing chronic kidney disease (OR 2.03; CI 1.14-3.70; p = 0.018), coronary artery disease (OR 1.90; CI 1.13-3.23; p = 0.016), postoperative bleeding requiring surgical revision (OR 8.36; CI 2.81-36.01; p < 0.001) and procedure time (OR 1.01; CI 1.01-1.01; p < 0.001) were independently associated with fast-track failure. Conclusions Factors associated with fast-track failure in patients with Carpentier type I and II pathologies undergoing minimally invasive mitral valve repair are a New York Heart Association classification III-IV at baseline, pre-existing chronic kidney disease and coronary artery disease. Postoperative bleeding requiring rethoracotomy and procedure time were also identified as important factors associated with failed fast-track. Clinical registration number The corresponding local ethics committee (Charité Medical School, Berlin, Germany) approved the present study which complies with the Declaration of Helsinki (ethics approval number: EA2/175/20).