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Surgical Method for Facilitation of Aortic Valve Replacement:Intraoperative Application of External Pressure for Increasing the Transverse Axis of Aortic Annulus

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World Journal of Cardiovascular Surgery 2015年第10期5卷 108-113页

作者： Sahin Bozok Mert Kestelli Aykut Sahin hakan kara Tevfik Günes Berkan Ozpak Gokhan Ilhan Serdar Bayrak Department of Cardiovascular Surgery Recep Tayyip Erdogan University Faculty of MedicineTraining and Research HospitalRizeTurkey Department of Cardiovascular Surgery Izmir Katip Celebi University Faculty of MedicineAtatürk Training and Research HospitalIzmirTurkey Department of Cardiovascular Surgery Osmangazi University Faculty of MedicineEskisehirTurkey Department of Cardiovascular Surgery Ada HospitalGiresunTurkey Department of Cardiovascular Surgery Pamukkale University Faculty of MedicineDenizliTurkey

Background: Surgical method was introduced for enhancement of prosthetic valve insertion and overcoming difficulties ensourcing from prosthesis-patient mismatch. Methods: Twenty-two patients that underwent aortic valve replacement between January 2005 and July 2009 were included in this prospective study. In these patients, the insertion of prosthesis larger than the annulus diameter was attempted after the application of an external pressure that increased the transverse axis diameter of the aortic annulus. The postoperative results and complications were assessed. Results: This surgical method was performed on 22 patients (16 males, 6 females, mean age: 52.2 ± 15.8 years) during the valve replacement. In 12 patients (55%), replacement of proper sized aortic valve compliant to their surface area was accomplished, while the insertion of a proper valve could not be achieved in 10 (45%) of the patients. No perioperative mortality or complications related to the procedure were reported. Conclusion: Increasing the transverse diameter of aortic valve may not only facilitate the insertion of a prosthetic valve but also aid in overcoming prosthesis-patient mismatch. Further studies on larger series are necessary to document the actual effectively and precise selection criteria for application of this method.

关键词： Aortic Valve Replacement Prosthesis Mismatch Aortic Annulus

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Renal Outcomes and Myocardial Performance after On-Pump Beating Heart versus Conventional On-Pump Surgery in Patients with Preoperative Low Glomerular Filtration Rate

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World Journal of Cardiovascular Diseases 2016年第11期6卷 433-445页

作者： Salih Colak Davut Azboy Zeki Temizturk hakan Atalay Omer Faruk Dogan Dilek Dogan Emjed Khalil Kenan Abdurrahman kara Department of Cardiology The Health and Science University Adana Numune Education and Training Hospital Adana Turkey Department of Cardiovascular Surgery The Health and Science University Elazig Education and Training Hospital Elazig Turkey Department of Cardiovascular Surgery Mersin Private Middle-East Hospital Mersin Turkey Department of Cardiovascular Surgery The Health and Science University Adana Numune Education and Training Hospital Adana Turkey Department of Dietetic and Parenteral Nutrition The Health and Science University Adana Numune Education and Training Hospital Adana Turkey Department of Cardiovascular Surgery The Private Medicana ?aml?ca Hospital Istanbul Turkey

Objective: Acute kidney disease develops 16% - 30% of patients with preoperative impaired renal functions. Our aim of this study was to compare postoperative renal outcomes using two open heart surgery techniques, on-pump beating heart (OPBH) and conventional on-pump (COP), in patients who have preoperative low glomerular filtration rate (eGFR) as an indicator of creatinine clearance. Methods: From 2004 to 2015, 341 patients with preoperative creatinine clearance were lower than 90 ml/min/1.73m2 were selected for this study. On-Pump beating heart was performed in 111 patients (Group I). Conventional on-pump technique was used in 200 patients. In the remaining patients, we measured postoperative Tumor Necrosis Factor Alpha (TNF-alpha), cardiac troponin I (cTn-I), Brain natriuretic peptid (NT-Pro- BNP), creati-nine (Cr), blood urea nitrogen (BUN) and postoperative eGFR daily until day four after surgery. Results: There were no differences in baseline levels of TNF-alpha, NT-Pro-BNP, BUN, cTn-I, Cr levels between the groups. Cardiopulmonary bypass (CPB) time were much longer and cumulative inotrope use was significantly higher in patients underwent COP (P Conclusion: Our study showed that on-pump beating heart CABG technique provides a morbidity benefit and is associated with a lower risk of peroperative LOS in patients with mild renal disfunction. Our study results suggest that OPBH is superior to the COP in terms of postoperative renal injury and cardiac mediators.

关键词： Open Heart Surgery Beating Heart Postoperative Renal Failure

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Recurrent anterior shoulder instability: Review of the literature and current concepts

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World Journal of Clinical Cases 2014年第11期2卷 676-682页

作者： hakan Sofu Sarper Gürsu Nizamettin Ko?kara Ali ?ner Ahmet Issιn Yalkιn ?amurcu Department of Orthopedics and Traumatology Erzincan University Faculty of Medicine 24030 Erzincan Turkey Department of Orthopedicsand Traumatology Baltaliman? Bone and Joint Diseases Hospital 34470 Istanbul Turkey Department of Orthopedics and Traumatology Mengücekgazi Education and Research Hospital 24030 Erzincan Turkey

The purpose of this review article is to discuss the clinical spectrum of recurrent traumatic anterior shoulder instability with the current concepts and controversies at the scientific level. Because of increasing participation of people from any age group of the population in sports activities, health care professionals dealing with the care of trauma patients must have a thorough understanding of the anatomy, patho-physiology, risk factors, and management of anterior shoulder instability. The risk factors for recurrent shoulder dislocation are young age, participation in high demand contact sports activities, presence of Hill-Sachs or osseous Bankart lesion, previous history of ipsilateral traumatic dislocation, ipsilateral rotator cuff or deltoid muscle insufficiency, and underlying ligamentous laxity. Achieving the best result for any particular patient depends onthe procedure that allows observation of the joint surfaces, provides the anatomical repair, maintains range of motion, and also can be applied with low rates of complications and recurrence. Although various surgical techniques have been described, a consensus does not exist and thus, orthopedic surgeons should follow and try to improve the current evidence-based treatment modalities for the patients.

关键词： Recurrent instability Glenohumeral joint Dislocation Shoulder Review

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