Background. Red cell distribution width (RDW) is an important marker which reflects inflammatory activity in many chronic diseases. The objective of this study is to investigate the impact of RDW on morbidity and mortality before and after pediatric congenital heart surgery. Methods. 107 patients with congenital heart disease, cardiac case group, and 70 patients, control group, without heart disease were retrospectively analyzed. Pre-, and postoperative and at discharge RDW of the cardiac patients were determined. Lengths of hospital and intensive care unit (ICU) stay and exited patients were determined. Results. Mean lengths of ICU and hospital stay were 3.3 ± 2.7 and 7.3 ± 2.9 days. In control group, mean preoperative RDW was 12.6 ± 1.4, while in cardiac case group it was significantly higher (15.1 ± 3.5). In cardiac case group, postoperative RDW were significantly higher than preoperative period, while RDW at discharge were significantly lower than postoperative estimates. A significant and a positive correlation was detected between lengths of ICU and hospital stay and RDW. RDW of the exited patients were significantly higher than the survivors. Conclusions. This study demonstrates that RDW can be used as an important indicator in the prediction of morbidity and mortality during pre-, and postoperative period of the pediatric congenital heart disease surgery.

The etiology of deep vein thrombosis disease is multifactorial, and currently, it is seen as a public health problem. Simple, cheap and useful tests that can be used for diagnosis, treatment, and follow-up is increasingly needed day by day because of the increasing number of patients. For this purpose, the changes of platelet indices in routine hemogram tests during DVT follow-up were examined retrospectively. Method: This study is a retrospective analysis of patients who diagnosed with deep venous thrombosis in Sivas Cumhuriyet University School of Medicine between 01.01.2017-31.12.2018 years. The investigation started after the decision of Sivas Cumhuriyet University Local Ethics Committee No. 2019-02/67. The acute, subacute, and chronic phase parameters of patients with deep venous thrombosis were evaluated. The study included 72 patients who developed DVT. Platelet indexes and other hemogram parameters were analyzed statistically according to the phases of deep vein thrombosis. Results: 55.6% of the patients were female, and 44.4% were male. DVT was found most commonly in the left femoral region (48.6%). PDW and MPV tended to increase rapidly in the acute phase of deep vein thrombosis and managed to fall in the subacute and chronic phases. However, there was no statistically significant change in platelet count and platelet crit. Conclusions: PDW and MPV appear to be useful markers in the follow-up of all stages of deep vein thrombosis. It is evident that with the developing technology, more sensitive and specific parameters of platelet indices will be obtained.

AimTo compare systemic right ventricular function by isovolumic myocardial acceleration before and 6 months after the percutaneous closure of atrial septal defects (ASD).Material and methodsPatients admitted to our tertiary center for the percutaneous closure of atrial septal defects between January 2010 and August 2012 constituted the study group. Right ventricular function of patients was assessed by tissue Doppler echocardiography before and after surgery. Echocardiographic data in patients were compared to age-matched controls without any cardiac pathology and studied in identical fashion mentioned below.ResultsA total of 44 patients (24 males, 20 females) and 44 age-matched controls (25 males, 19 females) met the eligibility criteria for the study. Right ventricular end-diastolic and end-systolic volume, right ventricular end-diastolic diameter measurements on echocardiogram, and pulmonary artery pressures in both pre- and post-ASD groups were significantly higher than in controls. Tricuspid annular plane systolic excursion and isovolumic myocardial acceleration measurements significantly increased after the percutaneous closure of the defect; however, post-ASD measurements were still significantly lower than the controls.ConclusionsAtrial septal defect device closure resulted in a significant increase of isovolumic myocardial acceleration measurements. Tissue Doppler analysis of regional myocardial function offers new insight into myocardial compensatory mechanisms for acute and chronic volume overload of both ventricles.

SummaryBackgroundTo investigate the usefulness of popliteal artery spectral doppler findings as a complimentary approach to isolated calf vein thrombosis (DVT).Material/MethodsWe included consecutive patients presenting with symptomatic and sonographically proven acute isolated calf DVT. Patients with thrombosis of any other vein were excluded. We classified calf vein into into four main types. We investigated how many of these four vessels had DVT and compared them with respect to the pulsatility index (PI) value of the popliteal artery.ResultsWe evaluated spectral doppler characteristics of the popliteal artery on the same side as the isolated calf vein thrombosis as well as on the opposite side. The relationship between PI values of the popliteal artery and the number of thrombosed calf veins was investigated. In patients with 1 and/or 2 thrombosed veins, the mean PI was 6.03±0.54 on the side of cDVT and 5.68±0.39 on the opposite side (p=0.008), respectively. Inpatients with 3 and/or 4 thrombosed veins, the mean PI was 8.05±0.61 on the side of cDVT and 6.34±0.47 on the opposite side (p=0.001), respectively.ConclusionsVenous doppler sonography for the evaluation of calf DVT may be limited by patient characteristics such as obesity, edema, and tenderness., Arterial PI can be used as a complimentary technique for the detection of venous thrombosis in such of cases.

Atrial fibrillation (AF) is seen as very common after cardiac surgery. Postoperative AF occurrence increases mortality and morbidity. Deterioration of clinical condition of the patients results prolongation of hospital stay and increases economic burden. Many risk factors that have an impact on the development of postoperative AF are known. Low vitamin D level has been added to these factors in recent years. Blood serum levels of vitamin D is varied seasonally. Therefore, these factors can be expected to have a seasonal effect on development of postoperative AF. The aim of this study is to investigate the presence of annual features of postoperative AF. Method: This study is a retrospective analysis of patients who developed atrial fibrillation after coronary artery bypass graft surgery in the

Introduction One of the most important problems for patients undergoing hemodialysis due to chronic renal failure is the need for a long-lasting vascular access. The patency of vascular access is affected by many factors. Factors related to surgery are also among these factors. No-touch techniques theoretically and practically prevent endothelial damage due to minimal contact on vascular structures. It is a well-known fact that surgeries performed with these methods also increase long-term survival. Methods Patients who underwent distal radiocephalic arteriovenous fistula (AVF) surgery for the first time between 2017 and 2021 were included in our study. The groups, whose cephalic veins were inflated conventionally and not inflated, were compared in a prospective randomized manner. Results There was a significant difference between both groups in terms of failure and patency rates, which is one of the study endpoints ( p = 0.012). The fact that the patency period is long, and the failure rate is low stands out as the superiority of the fully no-touch technique in AVF surgery. On the other hand, no significant difference was observed in terms of failure to maturation and fistula maturation time. Conclusions Fully no-touch technique in AVF surgery should be considered primarily in suitable patients due to its long patency time and low failure rate.

Objectives Atherosclerosis is the most common etiologic factor for extracranial carotid artery aneurysm in adults, while in childhood, connective tissue diseases, peritonsillar abscess and infections are the most common. Congenital carotid artery aneurysms are rarely reported in the literature. Methods We present a 10-year-old girl with congenital extracranial left internal carotid artery aneurysm and the treatment management. Results Computed tomography angiography at six months showed that internal carotid artery segments were normal. There was no obstruction or aneurysm recurrence. Conclusions Although extracranial carotid artery aneurysms are rare, they can cause complications such as rupture and thromboembolism with high mortality and morbidity. Therefore, the treatment of extracranial carotid artery aneurysms is recommended.

Objective: In this study, the relationship between the duration of intensive care unit stay, hospital stay, and intubation times between nonventilated and continuously ventilated groups of patients who underwent surgery with a cardiopulmonary bypass (CPB) device was investigated. Methods: In the study, we divided patients into two groups. Continuously ventilated during CPB group and non-ventilated group. In the continuously ventilated group, respiratory rate was 6 per minute, tidal volume was 6 ml/kg and FiO2 was 50%. In the non-ventilated group, the lungs were completely removed from the ventilator after the cross-clamp was placed. Results: Although the duration of intensive care unit stays, length of hospital stay, and intubation times were relatively short in the continuously ventilated group, there was no statistically significant difference between the two groups. Conclusion: There is a need for new studies on continuous ventilation during CPB to be designed based on subgroups and larger volumes.