Turk Gogus Kalp达玛树脂Cerrahisi Dergisi-turkish乔urnal of Thoracic and Cardiovascular Surgery

Abstract:Background This study aims to investigate the dilation of sinus valsalva in patients who underwent aortic repair due to type A aortic dissection and to evaluate its progression. Methods Between January 2004 and December 2019, a total of 68 patients (50 males, 18 females; mean age: 54.2±10.1 years; range, 30 to 82 years) who underwent root-preserving surgery and followed for at least one year in the outpatient setting were retrospectively analyzed. The patients were divided into two groups according to dilatation during follow-up. Group 1 (n=32) included patients with dilatation and Group 2 (n=36) included patients without dilatation. The sinus of Valsalva diameters were measured using pre- and postoperative computed tomography angiography. Results The mean follow-up was 4.9±3.1 (range, 1 to 4) years. Sinus of Valsalva dilatation was observed in 47% of the patients during follow-up. Preoperative sinus of Valsalva diameter was a risk factor for aneurysmatic dilatation. A diameter of ≥4.05 cm was calculated as a cut-off value for developing dilatation requiring reoperation. Conclusion Follow-up using postoperative echocardiography or computed tomography angiography is of utmost importance for the assessment of development of sinus of Valsalva dilatation which requires reoperation in patients without intervention to the aortic root.

Abstract:Background This study aims to examine the relationship between the development of coronary collateral circulation and serum elabela levels. Methods Between January 2020 and December 2021, a total of 50 control individuals (29 males, 21 females; mean age: 63.2±10.0 years; range, 52 to 73 years) with no significant coronary artery disease as confirmed by angiography (Group 1) and 100 patients (55 males, 45 females; mean age: 66.6±9.6 years; range, 56 to 75 years) with coronary artery disease were included. The patients were further divided into two equal groups according to the Rentrop classification as poor (Group 2) and good coronary collateral circulation (Group 3). All groups were compared in terms of several parameters, particularly serum elabela levels. Results Serum elabela levels were found to be statistically higher in the group with good collateral than the other groups (p<0.05). Low serum elabela levels increased the risk of developing weak collaterals by 2.43 times. Conclusion The elabela protein is directly related to good collateral development and can be considered a potential agent for treatment.

Abstract:本研究旨在探讨风险背景factors and surgical outcomes of conversion to median sternotomy in minimally invasive direct coronary artery bypass grafting. Methods Between January 2017 and July 2022, a total of 274 patients (246 males, 28 females; mean age: 57.0±9.6 years; range, 33 to 81 years) who underwent conventional (n=116) or robot-assisted (n=158) minimally invasive direct coronary artery bypass grafting were retrospectively analyzed. The primary outcome measure of the study was conversion to median sternotomy, and the secondary outcome measures were operative mortality, length of intensive care unit and hospital stay. Results Conversion to median sternotomy was required in 26 (9.5%) patients. The most common cause of conversion was intramyocardial left anterior descending artery (27.0%). Among preoperative and operative characteristics, only age was statistically significant risk factor for conversion to sternotomy (odds ratio=1.06, p=0.01). Operative mortality occurred in one patient (0.36%) patient in the entire cohort. The length of intensive care unit and hospital stay was significantly longer in patients requiring conversion to median sternotomy (p=0.002 and p<0.001, respectively). There was no significant difference in other postoperative outcomes between the two groups (p>0.05). Conclusion Intramyocardial left anterior descending artery is the most common reason for conversion to sternotomy, and older age increases the risk of conversion. Minimally invasive coronary artery bypass grafting can be performed with satisfactory results, even if it requires conversion to sternotomy.