Turkish Journal of Thoracic and Cardiovascular Surgery, 2014
Bu calismada atriyal septumun sol tarafindan koken alan ender gorulen kardiyak fibroelastom olgus... more Bu calismada atriyal septumun sol tarafindan koken alan ender gorulen kardiyak fibroelastom olgusu sunuldu. Bu kitle her atriyal sistolde mitral kapaktan sol ventrikule dogru hareketliydi. Ancak, hastada herhangi kardiyak veya serebral semptom yoktu. Ekokardiyografik bulgulara gore kitle sol atriyal miksoma olarak kabul edildi ve hastaya oncelikli olarak ameliyat planlandi. Sol atriyal septuma yapisik olan kitle, septum ile birlikte eksize edildi. Cerrahi olarak olusan septal defekt, otolog perikardiyal yama ile kapatildi. Ameliyat sirasi cekilen transozofageal ekokardiyografide artik kitle saptanmadi ve mitral kapak fonksiyonu normaldi. Kesin tani histopatolojik inceleme ile kondu. Septumdan koken alan papiller fibroelastomalar oldukca nadir gorulur, ancak yerlesim yeri nedeniyle serebrovaskuler emboli acisindan yuksek risklidir. Histopatolojik olarak benign karakterde olmasina ragmen, fatal komplikasyon risklerinden dolayi erken tani ve tedavi cok onemlidir. Anah tar soz cuk ler: Atriyal septum; kardiyak tumor, papiller fibroelastom. In this article, we report an uncommon case of cardiac fibroelastoma originating from the left atrial septum. The mass moved from the mitral valve through the left ventricle in each atrial systole. However, the patient was free of any cardiac or cerebral symptom. Based on the echocardiographic findings, the mass was considered the left atrial myxoma and the patient was primarily scheduled for surgery. The mass which adhered to the left atrial septum was excised with the septum. Surgical septal defect was closed with an autologous pericardial patch. Intraoperative transesophageal echocardiography revealed no residual mass with a normal mitral valve function. The definitive diagnosis is made by histopathological examination. Papillary fibroelastomas originating from septum are extremely rare, but have high-risk for cerebrovascular embolism due to their location. Despite histopathologically benign nature, early diagnosis and treatment is of utmost importance due to fatal complication risks.
Warfarin-induced skin necrosis is the rare but potentially devastating complication of anticoagul... more Warfarin-induced skin necrosis is the rare but potentially devastating complication of anticoagulant therapy and commonly occurs in previously undetected C- and S-protein deficient patients. Because routine preoperative examination does not include protein C and S level measurement, detection of these patients preoperatively is generally not possible, which increases the risk of occurrence of this important complication. In this report we present and discuss such a patient, who died from warfarin-induced skin necrosis after coronary artery bypass surgery.
Background: Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of car... more Background: Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of cardiovascular disease. Acute aortic dissection (AD) is an uncommon but fatal cardiovascular disease. In this study, we investigated both prognostic factors in patients with AD and whether NLR can be a predictor for mortality. Methods: We analyzed retrospectively the data of 57 patients with AD who had undergone emergent surgery in our hospital and included 128 consecutive patients with chest pain admitted to the emergency room as a control group. Also, patients who were operated on due to aortic dissection as another subgroup were compared to NLR values. Baseline clinical features, cardiovascular risk factors, and surgical and laboratory parameters were obtained from the hospital database. Results: Patients with AD had higher NLR than the control group (1.7 ± 0.5 versus 7.6 ± 3.3, P < .001). In the AD group, 15 deaths occurred and non-survivors had significantly higher NLR, compared to ...
Optimal surgical approach for patients with hemodynamically significant carotid and coronary dise... more Optimal surgical approach for patients with hemodynamically significant carotid and coronary disease remains controversial. We analyzed our 5-year experience and compared early and long-term outcome following staged and combined carotid and coronary artery bypass. 312 consecutive patients undergoing carotid endarterectomy and coronary artery bypass between 2008 and 2013 were prospectively enrolled in the study. Patients were scheduled for a staged (carotid endarterectomy followed by coronary artery bypass within 1 week) procedure (Group S) unless they were unstable in terms of cardiac status (were deemed to a combined procedure; Group C). All patient data including demographics, risk factors, immediate perioperative events, 30-day, and long-term outcome were prospectively recorded and then analyzed. Groups S and C were compared for pre- and perioperative data as well as immediate, 30-day, and long-term survival. A P value less than .05 was considered significant. Survival analysis w...
Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of cardiovascular ... more Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of cardiovascular disease. Acute aortic dissection (AD) is an uncommon but fatal cardiovascular disease. In this study, we investigated both prognostic factors in patients with AD and whether NLR can be a predictor for mortality. Methods: We analyzed retrospectively the data of 57 patients with AD who had undergone emergent surgery in our hospital and included 128 consecutive patients with chest pain admitted to the emergency room as a control group. Also, patients who were operated on due to aortic dissection as another subgroup were compared to NLR values. Baseline clinical features, cardiovascular risk factors, and surgical and laboratory parameters were obtained from the hospital database. Results: Patients with AD had higher NLR than the control group (1.7 ± 0.5 versus 7.6 ± 3.3, P < .001). In the AD group, 15 deaths occurred and non-survivors had significantly higher NLR, compared to survivors (1...
Turkish Journal of Thoracic and Cardiovascular Surgery, 2014
Bu calismada atriyal septumun sol tarafindan koken alan ender gorulen kardiyak fibroelastom olgus... more Bu calismada atriyal septumun sol tarafindan koken alan ender gorulen kardiyak fibroelastom olgusu sunuldu. Bu kitle her atriyal sistolde mitral kapaktan sol ventrikule dogru hareketliydi. Ancak, hastada herhangi kardiyak veya serebral semptom yoktu. Ekokardiyografik bulgulara gore kitle sol atriyal miksoma olarak kabul edildi ve hastaya oncelikli olarak ameliyat planlandi. Sol atriyal septuma yapisik olan kitle, septum ile birlikte eksize edildi. Cerrahi olarak olusan septal defekt, otolog perikardiyal yama ile kapatildi. Ameliyat sirasi cekilen transozofageal ekokardiyografide artik kitle saptanmadi ve mitral kapak fonksiyonu normaldi. Kesin tani histopatolojik inceleme ile kondu. Septumdan koken alan papiller fibroelastomalar oldukca nadir gorulur, ancak yerlesim yeri nedeniyle serebrovaskuler emboli acisindan yuksek risklidir. Histopatolojik olarak benign karakterde olmasina ragmen, fatal komplikasyon risklerinden dolayi erken tani ve tedavi cok onemlidir. Anah tar soz cuk ler: Atriyal septum; kardiyak tumor, papiller fibroelastom. In this article, we report an uncommon case of cardiac fibroelastoma originating from the left atrial septum. The mass moved from the mitral valve through the left ventricle in each atrial systole. However, the patient was free of any cardiac or cerebral symptom. Based on the echocardiographic findings, the mass was considered the left atrial myxoma and the patient was primarily scheduled for surgery. The mass which adhered to the left atrial septum was excised with the septum. Surgical septal defect was closed with an autologous pericardial patch. Intraoperative transesophageal echocardiography revealed no residual mass with a normal mitral valve function. The definitive diagnosis is made by histopathological examination. Papillary fibroelastomas originating from septum are extremely rare, but have high-risk for cerebrovascular embolism due to their location. Despite histopathologically benign nature, early diagnosis and treatment is of utmost importance due to fatal complication risks.
Warfarin-induced skin necrosis is the rare but potentially devastating complication of anticoagul... more Warfarin-induced skin necrosis is the rare but potentially devastating complication of anticoagulant therapy and commonly occurs in previously undetected C- and S-protein deficient patients. Because routine preoperative examination does not include protein C and S level measurement, detection of these patients preoperatively is generally not possible, which increases the risk of occurrence of this important complication. In this report we present and discuss such a patient, who died from warfarin-induced skin necrosis after coronary artery bypass surgery.
Background: Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of car... more Background: Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of cardiovascular disease. Acute aortic dissection (AD) is an uncommon but fatal cardiovascular disease. In this study, we investigated both prognostic factors in patients with AD and whether NLR can be a predictor for mortality. Methods: We analyzed retrospectively the data of 57 patients with AD who had undergone emergent surgery in our hospital and included 128 consecutive patients with chest pain admitted to the emergency room as a control group. Also, patients who were operated on due to aortic dissection as another subgroup were compared to NLR values. Baseline clinical features, cardiovascular risk factors, and surgical and laboratory parameters were obtained from the hospital database. Results: Patients with AD had higher NLR than the control group (1.7 ± 0.5 versus 7.6 ± 3.3, P < .001). In the AD group, 15 deaths occurred and non-survivors had significantly higher NLR, compared to ...
Optimal surgical approach for patients with hemodynamically significant carotid and coronary dise... more Optimal surgical approach for patients with hemodynamically significant carotid and coronary disease remains controversial. We analyzed our 5-year experience and compared early and long-term outcome following staged and combined carotid and coronary artery bypass. 312 consecutive patients undergoing carotid endarterectomy and coronary artery bypass between 2008 and 2013 were prospectively enrolled in the study. Patients were scheduled for a staged (carotid endarterectomy followed by coronary artery bypass within 1 week) procedure (Group S) unless they were unstable in terms of cardiac status (were deemed to a combined procedure; Group C). All patient data including demographics, risk factors, immediate perioperative events, 30-day, and long-term outcome were prospectively recorded and then analyzed. Groups S and C were compared for pre- and perioperative data as well as immediate, 30-day, and long-term survival. A P value less than .05 was considered significant. Survival analysis w...
Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of cardiovascular ... more Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of cardiovascular disease. Acute aortic dissection (AD) is an uncommon but fatal cardiovascular disease. In this study, we investigated both prognostic factors in patients with AD and whether NLR can be a predictor for mortality. Methods: We analyzed retrospectively the data of 57 patients with AD who had undergone emergent surgery in our hospital and included 128 consecutive patients with chest pain admitted to the emergency room as a control group. Also, patients who were operated on due to aortic dissection as another subgroup were compared to NLR values. Baseline clinical features, cardiovascular risk factors, and surgical and laboratory parameters were obtained from the hospital database. Results: Patients with AD had higher NLR than the control group (1.7 ± 0.5 versus 7.6 ± 3.3, P < .001). In the AD group, 15 deaths occurred and non-survivors had significantly higher NLR, compared to survivors (1...
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