Background: Aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT) frequently is used in the diagnosis and prognosis of liver diseases, however it is also used in the diagnosis and prognosis of many other diseases, such as myocardial infarction, acute ischemic stroke, and peripheral artery disease. Acute kidney injury (AKI) is one of the most important complications after cardiac surgery and is one of the main causes of morbidity and mortality. The purpose of the study was to analyze the relationship between AST to ALT and AKI after isolated coronary artery bypass graft surgery (CABG). Methods: We retrospectively reviewed the prospectively collected data of 253 adult patients, who underwent isolated CABG surgery with normal renal function (baseline serum creatinine value <1.4 mg/dL). Preoperative (T0) and postoperative day 1 and day 3 (T1 and T2) serum AST and ALT levels were analyzed, and AST/ALT was calculated. A preoperative AST/ALT of 1.22 was found to be the best cutoff point for predicting postoperative AKI. Kidney injury was interpreted, according to RIFLE classification. The effect of AST to ALT ratio on AKI after CABG was determined using logistic regression analysis, and the results were expressed as odds ratio (OR) with a 95% confidence interval (CI). A P value < .05 was considered statistically significant. Results: Postoperative AKI occurred in 40 patients (15.8%). On logistic regression analysis, higher AST/ALT both preoperatively and postoperatively were associated with an increased incidence of postoperative AKI (T0: OR, 3.983; 95% CI, 1.940-8.180, P < .001, T1: OR, 2.760; 95% CI, 1.381-5.515, P = .004, T2: OR, 2.515; 95% CI, 1.195-5.294, P = .015). Conclusion: Preoperative and postoperative elevated AST to ALT ratio seems to be associated with an increased incidence of AKI after elective isolated CABG surgery.
Aim:The aim of this study is to evaluate the effectiveness of internal compression therapy (ICT), a new technique used in the treatment of chronic venous insufficiency (CVI), and to share the early results. Material and Method: Between September 2018 and June 2019, 27 patients with superficial venous insufficiency due to saphenofemoral junction (SFJ) insufficiency and who underwent ICT were included in the study. Demographic data, venous color doppler ultrasonography (RDUS) results, CEAP (clinical etiology, anatomy, pathophysiology) classification, venous clinical severity score (VCSS) and visual analog scale (VAS) results were retrospectively analyzed from the files of the patients. Results: It was determined that 14 of the 27 patients were female and 13 were male in the study. While the mean CEAP classification scores were 3.9±0.5 before the procedure, it was 2.3±0.7 at the 3rd month after the procedure (p<0.001). While the mean duration of venous reflux before the procedure was 4.7±0.3 seconds, pathological reflux was detected in 2 patients at the 3rd month after the procedure (p<0.001). While the mean VCSS score was 11.2±3.3 before the procedure, it was 5.4±1.2 at 3 months (p<0.001). While the mean VAS score was 6.5±1.3 preoperatively, the mean VAS score was 2.7±1.4 at 3 months after the procedure (p<0.001). No complications were observed in any of the patients. Conclusion:We think that ICT can be used as an alternative treatment method in the treatment of superficial venous insufficiency due to valve dysfunction in SFJ.
Amaç: Çalışmanın amacı, kliniğimizde yapılan ilk 200 açık kalp ameliyatının sonuçlarını değerlendirmektir. Gereç ve Yöntemler: Yapılan 200 kalp ameliyatı hastane kayıt sistemi taranarak geriye dönük olarak incelendi. Hastaların yaş, cinsiyet, komorbiditeleri, ameliyat tipleri, hastane ve yoğun bakımda yatış süreleri, morbidite ve mortalite oranları değerlendirildi. Bulgular: Hastaların 128'i kadın,72'si erkekti. Yaşları 38-90 yıl arasında olup, ortalama 68±5 yıldı. Komorbit faktörleri olarak, kronik obstrüktif akciğer hastalığı, hipertansiyon, diabetes mellitus, hiperlipidemi, serebro-vasküler hastalık, periferik arter hastalığı ve kronik böbrek yetmezliği ve miyokart enfarktüsü görüldü. Toplam 162 koroner arter bypass grefti (KABG) yapıldı. Bunlardan 24 tanesi çalışan kalpte gerçekleştirildi. Eş zamanlı olarak 5 karotis endarterektomi ve 15 koroner endarterektomi yapıldı. Dört KABG ve mitral kapak replasmanı (MVR), 2 KABG ve aort kapak replasmanı (AVR), 6 AVR, 12 MVR, 4 AVR ve MVR, 3 MVR ve tricuspit anuloplasti yapıldı. İki hastaya aort diseksiyonu nedeniyle asenden aort replasmanı ve 3 hastanın asenden aort anevrizmasına supra koroner aort replasmanı yapıldı. İki hastaya kardiyak yaralanma nedeniyle sağ ventrikül tamiri yapıldı. Düşük kardiyak debi nedeniyle 10 hastaya intra-aortik balon pompası takıldı. Komplikasyon olarak 38 hastada atrial fibrilasyon, 4 hastada akut böbrek yetmezliği, 3 hastada serebrovaskuler olay gelişti. Hastaların 4'ünde postoperatif kanama ve 3'ünde sternal dehisens nedeniyle revizyon yapıldı. Bir hastada mediastinit görüldü. Yoğun bakımda kalış süresi ortalama 2,2±1,7 gün olup, hastanede kalış süresi 7,5±4 gündü. Hastane mortalitesi 8 hastada (%4) görüldü. Sonuç: Kırıkkale Üniversitesi Tıp Fakültesi Araştırma ve Uygulama Hastanesi kalp ve damar cerrahisi kliniği, açık kalp ameliyatlarının literatüre uygun morbidite ve mortalite oranları ile yapıldığı bir merkez olmuştur. Objective:The aim of the study is to evaluate the results of the first 200 open heart surgeries performed in our clinic. Material and Methods: Two hundred heart surgeries performed were analyzed retrospectively by scanning the hospital registry system. Patients' age, gender, comorbidities, types of surgery, hospital stay and intensive care unit stay, morbidity and mortality rates were evaluated. Results: One hundred and twenty-eight of the patients were women and 72 were men. Their age was between 38-90 years and the mean age was 68±5 years. Comorbid factors included, chronic obstructive pulmonary disease, hypertension, diabetes mellitus, hyperlipidemia, cerebro-vascular disease, peripheral artery disease, chronic renal failure, and myocardial infarction. A total of 162 coronary artery bypass graft (CABG) surgeries were performed and 24 of them were off-pump. Five carotid endarterectomies and 15 coronary endarterectomies were performed simultaneously. Four CABG and mitral valve replacement (MVR), 2 CABG surgery and aortic valve replacement (AVR), 6 AVR, 12 MVR, 4 AVR and MVR, 3 MVR and tricuspid annuloplasty were perf...
Aim: This study aimed to investigate the combined effects of magnesium (Mg) and high dose ascorbic acid on cardiac ischemia-reperfusion (IR) injury. Material and Method: This study was performed on 45 patients that were scheduled for coronary artery bypass graft (CABG) operations. The patients were divided into three equal groups. Group C received 50 mg/kg ascorbic acid; Group CM received the same dose of ascorbic acid plus 30 mg/kg Mg; Group K received neither ascorbic acid nor Mg. At various times during the operation, the blood levels of malondialdehyde (MDA), serum creatine kinase MB (CK-MB), and lactate dehydrogenase (LDH) levels were analyzed. Results: There were statistically significant decreases in arrhythmia requiring intervention in Group CM compared to Group K (P=0.026). MDA levels increased in all groups but MDA 2 and MDA 3 levels were found to be statistically significantly lower in Group C and Group CM than in Group K (P=0.009, P=0.012, P=0.009 and P=0.006 respectively). However, inhibition of lipid peroxidation in both Group C and Group CM was not parallel to cardiac enzymes and hemodynamic measurements. There was no significant statistical difference in the cardiac enzyme levels between Group K, Group C, and Group CM (p>0.05). Conclusion: To reduce the IR, Mg with a high dose of ascorbic acid may be efficacious in patients undergoing cardiac surgery. A larger population group is needed to prove the results of this study.
Amaç: Bu çalışmanın amacı açık kalp cerrahisi öncesi 72 saatlik trimetazidin (TMZ) uygulamasının miyokard iskemisi üzerine etkilerini göstermektir.Results: When the TnI values were measured just before the patients were anesthesized, immediately after the cross-clamp was removed, and at the 6th, 12th and 24th hours, there was no statistically significant difference between the groups (p=0. 7734, p=0.3390, p=0.5624, p=0.1296, p=0.1796, respectively). Conclusion:It was found that preoperative short-term TMZ treatment had no effect on myocardial protection in open heart surgery.
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