Background: The aim of this study was to assess the effect of timing and techniques of tracheostomy on mortality and morbidity in cardiovascular surgery patients. Methods: Between January 2000 and October 2007, a total of 19,559 cardiac and vascular operations were performed in our hospital, and 205 of these patients (1.04%) who underwent a tracheostomy procedure were included in this retrospective study. Results: Surgical tracheostomy (ST) was employed in 134 (65.4%) and percutaneous tracheostomy (PT) in 71 (34.6%) of the cases. There were 17 complications related to all tracheostomy procedures in 15 (7.3%) patients. Bleeding, requiring surgical intervention, occurred in five (3.7%) ST patients and in one (1.4%) PT patient. Cardiac arrest related to the procedure occurred in two (1.5%) ST patients. Pneumothorax occurred in three (2.2%) ST patients and in one (1.4%) PT patient, subcutaneous emphysema in three (2.2%) ST patients and in one (1.4%) PT patient, and tracheoesophageal fistula in one (0.7%) ST patient (p > 0.05). The postoperative infection rate was significantly lower, and cooperation of the patients, postoperative patient mobilization, and oral feeding rates were higher in the early tracheostomy group. The multifactorial mortality rates of early (

Bu çalışmada, farklı antikolagülan rejimlerinin protez kapak ile ilişkili komplikasyonlar ve feto-maternal mortalite ve morbidite üzerindeki etkileri araştırıldı ve en ideal antikolagülan tedavi rejimi belirlendi. Ça lış ma pla nı: Ocak 1990-Aralık 2015 tarihleri arasında mekanik kalp kapak replasmanı yapılan gebe kadınlarda antikoagülan tedavi rejimleri, retrospektif olarak incelendi. Mekanik kalp kapak replasmanı sonrası 57 hastada 72 gebelik gözden geçirildi ve dört farklı rejim belirlendi ve gebeliğin farklı trimesterlerinde değerlendirildi. Bul gu lar: Yetmiş iki gebeliğin, 40'ı sağlıklı yeni doğanla, 35'i (%48.6) sağlıklı yenidoğan, dördü (%5.6) prematüre doğum ve biri (%1.4) düşük doğum ağırlığı ile sonuçlandı. On sekiz (%25) terapötik ve 12 (%16.7) spontan düşüğün yanı sıra, iki (%2.8) ölü doğum izlendi. Gebelik süresince veya post-partum dönemde, yedi gebede kapak trombozu gelişti. Altı hastada (%10.5) kanama ve yine altı (%10.5) hastada periferik emboli meydana geldi. Maternal mortalite görülmedi. So nuç:Gebelik sırasında en ideal antikoagülasyon rejimine ilişkin tam bir fikir birliği olmamasına rağmen, birinci trimesterde varfarinin teratojenisite ve artmış düşük riskini önlemek için doz ayarlamalı fraksiyone olmayan heparin veya düşük molekül ağırlıklı heparin ile değiştirilmesi uygundur. Düşük molekül ağırlıklı heparinin uygulaması kolaydır ve güvenilir bir şekilde izlenebilir ve başarılı gebelik sonuçlarına da vesile olabilir. Ancak, gebeliğin tüm trimesterleri süresince, günde ≤5 mg varfarini geçmemek kaydıyla kullanılacak varfarin, embriyopati riskinin gebe tarafından kabul edildiği durumlarda, alternatif bir seçenek olabilir. Anah tarsöz cük ler: Antikoagülasyon; mekanik kalp kapağı; gebelik.

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Objective: As aneurysm-related events and rupture is not eliminated, postoperative lifelong surveillance is mandatory after endovascular aneurysm repair (EVAR). For surveillance colored Doppler ultrasound (CDUS) is a standard method of noninvasive evaluation having the advantages of availability, cost-effectiveness, and lack of nephrotoxicity and radiation. We evaluated CDUS for primary surveillance tool after elective EVAR by comparing with computerized tomography. Methods: Between January 2018 and March 2020, 84 consecutive post-EVAR patients were evaluated. First, CDUS was performed by two Doppler operators from the Radiology Department and then computed tomographic angiography (CTA) was performed. The operators were blind to CTA reports. A reporting protocol was organized for endoleak detection and largest aneurysm diameter. Results: Among 84 patients, there were 11 detected endoleaks (13.1%) with CTA and seven of them was detected with CDUS (r = .884, p < .001). All Type I and III endoleaks were detected perfectly. There is an insufficiency in detecting low flow by CDUS. Eliminating this frailty, there was a strong correlation of aneurysm sac diameter measurement between CTA and CDUS (r = .777, p < .001). The sensitivity and specificity of CDUS was 63.6% and 100%, respectively. The accuracy was 95.2%. Positive and negative predictive values were 100% and 94.8%. Bland-Altman analysis and linear regression analysis showed no proportional bias (mean difference of 1.5 ± 2.2 mm, p = .233). Conclusions: For surveillance, CDUS promises accurate results without missing any potential complication requiring intervention as Type I or III endoleak. Lack of detecting Type II endoleaks may be negligible as sac enlargement was the key for reintervention in this situation and CDUS has a remarkably high correlation with CTA in sac diameter measurement. CDUS may be a primary surveillance tool for EVAR and CTA will be reserved in case of aneurysm sac enlargement, detection of an endoleak, inadequate CDUS, or in case of unexplained abdominal

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