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Is trans-apical off-pump neochord implantation a safe and effective procedure for mitral valve repair? Objective: Trans-apical off-pump mitral valve repair is a new minimally invasive surgical technique for the correction of mitral regurgitation caused by mitral leaflet prolapse. The purpose of this study is to evaluate, using clinical and echocardiographic follow-up data, the mid-term results of patients undergoing this procedure. Methods: A total of 26 patients diagnosed with severe mitral regurgitation underwent mitral valve repair with trans-apical off-pump neochord implantation using the NeoChord device at our hospital from July 2015 to July 2017. All patients were examined by transthoracic and transesophageal echocardiography. Eighteen (69.2%) patients had type A anatomy, 4 (15.4%) had type B anatomy, and 4 (15.4%) had type C anatomy. Preoperative, intraoperative, and postoperative demographic, echocardiographic, and clinical data were collected. Results: The patients' age ranged from 33 to 76 years (mean: 56±10.1 years). The average preoperative EuroSCORE II was 1.04%±0.7%. Acute procedural success was achieved in 25 (96.15%) patients. There was only 1 early death (30-day mortality rate: 3.8%) due to postoperative low cardiac output syndrome. Transthoracic echocardiography examinations revealed trivial/mild mitral regurgitation in 87.5% of the patients and moderate regurgitation in 12.5% of the patients. During the follow-up period, transthoracic echocardiography examinations revealed trivial/mild mitral regurgitation (MR) in 14 (58.3%) patients. Six (25%) patients presented with moderate MR and 4 (16.7%) patients had severe MR. At the 30-month follow-up, freedom from residual severe MR was 78.8%±10.3% and freedom from reoperation was 87.5%±6.8%. Conclusion: Trans-apical off-pump mitral valve repair with neochord implantation may be a suitable treatment option in patients with isolated posterior mitral valve leaflet prolapse.

Objective: The effects of coronary artery bypass grafting (CABG) on mortality have not been evaluated in patients with well-developed coronary collaterals. We investigated functional capacity, presence of angina, the occurrence of acute myocardial infarction, survival and mortality in patients with well-developed coronary collaterals both undergoing and refusing CABG. Methods: The study was designed as a retrospective observational case-controlled study. Seventy-eight patients undergoing coronary angiography were included in this study. They had critical occlusion in the proximal left anterior descending artery (LAD) with Rentrop-3 collateral circulation towards LAD, and to proceed with CABG has been suggested. The patients were divided in two groups; first group proceeding with CABG (n=40) and the second, rejecting the surgery (medical treatment group; n=38). The rates of survival, the incidence of angina pectoris and acute myocardial infarction as well as the functional capacities were evaluated in all patients. Survival rates were evaluated using Kaplan-Meier survival analysis. Results: No statistically significant difference was observed between the two groups regarding the baseline characteristics of patients, the presence of angina pectoris, the severity of angina pectoris according to CCS, the occurrence of acute myocardial infarction or stroke, and the functional capacity according to NYHA (p>0.05). Death due to cardiovascular reasons was observed in eight patients of CABG group and in five patients of medical treatment group (p=0.710). The 5-year survival rate was observed to be 80% in CABG group while it was observed to be 84% in the medical treatment group (p=0.730). Conclusion: There was no significant difference regarding the survival rates in patients with well-developed coronary collaterals proceeding with CABG or medical treatment. (Anadolu Kardiyol Derg 2012; 12: 97-101) Key words: Coronary collateral circulation, coronary bypass surgery, survival analysis, prognosis 97 ÖZET Amaç: Bugüne kadar, iyi gelişmiş koroner kolaterali olan hastalarda baypas cerrahisinin mortalite üzerine etkisi değerlendirilmedi. Biz iyi geliş-miş kolaterali olan, baypas olmuş ve baypas'ı reddeden hastalar arasında sağkalım, mortalite, fonksiyonel kapasite, angina varlığı ve akut miyokart enfarktüs gelişimini araştırdık. Yöntemler: Çalışma retrospektif, vaka-kontrollü gözlemsel bir çalışma olarak dizayn edildi. Koroner anjiyografi uygulanan, sol ön inen arter proksimalinden tam tıkalı olup, Rentrop-3 kolaterali olan ve baypas ameliyatı önerilen 78 hasta retrospektif olarak çalışmaya alındı. Hastalar baypas'ı kabul eden (Grup1, n=40) ve reddeden (Grup 2, n=38) hastalar olmak üzere iki gruba bölündü. Tüm hastalarda sağkalım, fonksiyonel kapasite, angina varlığı ve akut miyokart enfarktüs gelişimi araştırıldı. Sağkalım oranları Kaplan-Meier sağkalım analizi ile değerlendirildi. Bulgular: İki grup arasında hastaların temel özellikleri, angina varlığı ve şiddeti, fonksiyonel kapasite, akut miyokart enfarktüsü veya inm...

Objectives Coronavirus disease 2019 (COVID-19) can lead to systemic coagulation activation and thrombotic complications including venous thromboembolism. This study compares the development of pulmonary embolism, post-thrombotic syndrome, and clinical outcomes of COVID-19 and non-COVID-19 patients with deep vein thrombosis (DVT). Methods One hundred and eight patients diagnosed with acute deep vein thrombosis (DVT) between June 2020 and February 2021 in our institution were included in this retrospective study. Thirty-nine patients had been previously diagnosed with COVID-19 and specified as the COVID-19 group. Sixty-nine patients did not have COVID-19 and specified as the non-COVID-19 group. Mean ages of both groups were 64.3 ± 15.8 and 60.1 ± 19.7 years, respectively ( p = .37). Results The median duration from the onset of the COVID-19 to diagnosis of DVT was 22 (2–120) days in the COVID-19 group. The patients of two groups were mostly treated outpatient at rates of 94.9% vs 94.2%, respectively ( p = .88). Pulmonary embolism was seen in six patients (15.4%) in the COVID-19 group and in three patients (4.3%) in the non-COVID-19 group ( p = .04). Kaplan–Meir curves showed that patients with COVİD-19 had significantly higher pulmonary embolism than those without COVID-19 ( p = .015). The recurrence rate of DVT was 2.6% in the COVID-19 group ( n = 1), and 4.3% in the non-COVID-19 group ( n = 3), indicating no statistically significant difference ( p = .63). Mortality was seen in six patients (15.4%) in the COVİD-19 group, and in seven patients (10.1%) in the non-COVID-19 group. According to the Kaplan–Meir method, 10 months survival rates were 73.9 ± 10% in the COVID-19 group, and 66.3 ± 12.8% in the non-COVID-19 group with no statistical significance ( p = .218). Conclusions Our data draw attention to the fact that deep vein thrombosis should not be considered a safe and self-limited condition. Efficient preventive measures such as mobilization and prophylactic drug use should be considered to prevent DVT during the management of COVID-19.