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Aim: To compare del Nido cardioplegia (DNC) with conventional blood cardioplegia (BC) in aortic root surgery. Methods: Subjects who underwent aortic root surgery during a 3-year period were included. A DNC group was compared with a matched BC group. Results: A total of 72 subjects were included, 36 who underwent DNC compared with 36 propensity-matched subjects who underwent BC. Fifty-one (70.8%) were male, and 21 (29.2%) were female, with a mean age of 66.19 ± 7.02 years (range 51 to 81). No significant differences in baseline characteristics, preoperative echocardiogram parameters, or intraoperative parameters were found between the groups. For DNC versus BC, cardiopulmonary bypass time, aortic clamp time, cardioplegia volume (all P = .001), and defibrillation (P = .007) were significantly lower. For postoperative biochemical parameters, creatinine levels at hour 24, potassium levels at hours 1 and 24, and glucose levels at hours 6 and 24 did not differ between the groups (P > .05). Creatine kinase-MB and troponin T levels at hours 1 and 24 were significantly lower in DNC versus BC (all P = .001). Hematocrit levels at hours 6 and 24 were significantly higher in DNC (P = .001). The groups did not differ in terms of postoperative inotropic support, postoperative complications, intubation period, or duration of intensive care unit stay (P > .05). Although the need for thrombocyte transfusion did not differ between groups (P > .05), DNC resulted in less use of erythrocyte and fresh frozen plasma transfusions (both P = .001). Postoperative ejection fraction was significantly better in the DNC group than in the BC group (P = .006). Conclusion: The results indicate better intraoperative parameters and better ejection fraction rates with DNC than with BC. DNC is an effective and safe alternative to blood cardioplegia for aortic root surgery.

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IntroductionNeointimal hyperplasia due to smooth muscle cell migration and proliferation, as well as extracellular matrix accumulation, plays an important role in stenosis and restenosis that develop after reconstructive vascular interventions. Various agents are being tested to reduce neointimal hyperplasia and to prevent lumen stenosis. In the present study, the effect of N-acetylcysteine (NAC) on intimal hyperplasia and endothelial hyperplasia after carotid anastomosis was investigated in a rabbit model.Material and methodsIn the course of the study, rabbits were divided into two groups. The control group (n = 7) underwent right carotid artery anastomosis and received no medication. The NAC group (n = 7) underwent right carotid artery anastomosis and received NAC for 21 days following surgery. NAC was administered at a dose of 150 mg/kg/day just after the surgery. The carotid artery underwent anastomosis, and the histological examination findings of anastomosed and opposite non-anastomosed carotid arteries were compared in two experimental groups that either received NAC or did not.ResultsCompared with the control group, the reduction in the lumen area and diameter after anastomosis was significantly recovered in the NAC group (p = 0.018; p = 0.612). Increases in the intima and media areas and the intima/media ratio were smaller in the NAC group after anastomosis than in the control group, but the differences were not significant.ConclusionsWe believe that vascular anastomosis and post-intervention NAC administration will prolong vascular patency by reducing intimal hyperplasia and providing vascular remodeling.

Bu çalışmanın amacı, pulsatil ve pulsatil olmayan perfüzyonun hemoliz parametreleri ve kan komponentlerinin korunması üzerindeki etkilerini araştırmaktır. Ça lış mapla nı:Randomize kontrollü ve prospektif olarak tasarlanmış bu çalışmaya, açık kalp ameliyatı yapılan 27 pulsatil olmayan (NP) ve 24 pulsatil (P) olgudan oluşan iki bağımsız grup dahil edildi. Demografik ve hemodinamik veriler kaydedildi. Perfüzyon türlerinin etkisi serbest hemoglobin (serbest Hb), haptoglobin (Hp), laktat dehidrogenaz (LDH), potasyum (K +), trombosit sayısı (plt) ve idrarda Hb açısından değerlendirildi. Bu düzeyler ameliyat öncesinde, kardiyopulmoner baypas (KPB) başlatıldıktan sonra 30. ve 60. dakikalarda ve ameliyat sonrasında iki ve 24. saatte ölçüldü. Ayrıca total göğüs drenajı ve transfüzyon gerekliliği de değerlendirildi. Bul gu lar: Demografik ve hemodinamik ölçümler gruplar arasında farklı değildi. NP grubunun ortalama arteriyel basıncı, 30. dakikada istatistiksel olarak yüksekti. Serbest Hb, Hp, LDH ve K + düzeyleri tüm zaman noktalarında iki grup arasında da farklı değildi. İdrar Hb düzeyleri, 30. dakikada P grubunda anlamlı düzeyde yüksekti. Total göğüs drenaj miktarları ve transfüze edilen eritrosit hücre paketlerinin sayısı açısından bir farka rastlanmadı. So nuç: Laboratuvar esaslı ölçümlerde yalnızca idrarda Hb ölçümü açısından fark olsa da, pulsatil perfüzyonun klinik açıdan anlamlı olmayan hemolitik etkisinden söz edilebilir. Anah tar söz cük ler: Kardiyopulmoner baypas; hemoliz; pulsatilite. Background:The aim of this study was to investigate the effects of pulsatile and nonpulsatile perfusion on hemolysis parameters and protection of blood components. Methods: This randomized, controlled and prospectively designed study included two independent groups, consisting of 27 nonpulsatile (NP) and 24 pulsatile (P) cases who had undergone open heart surgical procedures. Demographic and hemodynamic data were recorded. The effects of perfusion types were evaluated in terms of free hemoglobin (free Hb), haptoglobin (Hp), lactate dehydrogenase (LDH), potassium (K +), platelet number (plt) and urine Hb. These levels were measured in preoperative period, 30 and 60 minutes after initiation of cardiopulmonary bypass (CPB), two and 24 hours postoperatively. Also, total chest drainage and transfusion requirement were assessed. Results: Demographic and hemodynamic measurements did not differ between the groups. The mean arterial pressure of the NP group was statistically higher at the 30 th minute. Free Hb, Hp, LDH and K + levels did not differ in both groups in all time points. The urine Hb levels were significantly higher in the P group in the 30 th minute. There was no difference regarding total chest drainage amounts and number of transfused erythrocyte cell packages. Conclusion: A clinically nonsignificant hemolytic effect of pulsatile perfusion can be outlined, although it is mentioned only in the urine Hb measurements on the laboratory basis.