IntroductionThe aim of the study was to assess whether a cardiac troponin T (cTnT) level 1 ng/ml or below threshold is safe and to evaluate mid-term follow-up results in stable patients with non-ST-segment elevation after acute myocardial infarction.Material and methodsAmong cTnT positive patients who presented to the emergency unit with chest pain and received coronary angiography, 100 patients who underwent isolated coronary artery bypass grafting (CABG) constituted the study group (group 1). The same number of patients (n = 100) who were cTnT negative and underwent an isolated CABG operation under elective conditions were selected as the control group (group 2).ResultsAmong preoperative criteria, group 1 had significantly higher smoking rates (74% vs. 41%, p = 0.0001), and significantly lower ejection fraction values (47.1 ±8.25, 54.69 ±8.73, p = 0.0001). There were no significant differences between the groups with respect to operative parameters. Postoperative follow-up periods were significantly longer in group 1 (23.25 ±14 vs. 17.55 ±7.95 months, p = 0.001). Average waiting time for cTnT to drop below the 1 ng/ml threshold value was 5.73 ±2.95 (1–12) days. Intra-aortic balloon pump use in Groups 1 and 2 was 3% and 1%, respectively. There were no hospital mortalities in either group. Mortality rates at mid term were 6% in both groups.ConclusionsThis study compared two groups positive and negative for preoperative cTnT. The findings show that it is safe to wait until cTnT levels decrease to the 1 ng/ml threshold value in cTnT positive patients having a stable course. This waiting period is not very long, which is significant with respect to potential complications.
Superior vena kava (SVK) sendromu baş, boyun ve üst ekstremitelerde ödem ve konjesyonla karakterize, genellikle intratorasik malign hastalıklara sekonder gelişen bir tablodur. Son yıllarda hemodiyaliz hastalarında uzun süreli subklaviyan veya juguler ven kateterlerinin kullanımındaki artışa paralel olarak, SVK tromboz ve fibrozisine bağlı SVK sendromu olguları görülmektedir. On bir yıldır diyaliz hastası olan ve beş ay önce böbrek nakli yapılan 21 yaşındaki kadın hasta, SVK sendromu bulguları ile kliniğimize başvurdu. Toraks bilgisayarlı tomografisinde SVK sağ atriyum bileşkesinde total oklüzyon saptandı. Ameliyata alınan hastada sağ atriyum ile SVK arasına kardiyopulmoner baypas kurmadan, Dacron greft interpozisyonu yapılarak, venöz drenaj sağlandı. Ameliyat sonrası erken ve 24 aylık geç takip süresince hastada herhangi bir komplikasyon görülmedi ve renal allogreft fonksiyonları normal seyretti. Böbrek nakli yapılan hastalarda cerrahi stratejide kardiyopulmoner baypastan kaçınılması renal allogreft fonksiyonlarının korunmasında önemli bir faktördür. Anah tar söz cük ler: Santral venöz kateter; böbrek nakli; superior vena kava sendromu.
A 41-year-old woman presented with high fever, vomiting, urticaria-like skin rash, myalgia, and fatigue. Cardiac magnetic resonance imaging demonstrated an intramural posterolaterally located left ventricular ruptured germinative membrane with a diameter of 63 mm, consistent with hydatid cyst (Figure 1), which was surgically removed (Figure 2 and 3).
A b s t r a c t Introduction:The aim of the study was to assess whether a cardiac troponin T (cTnT) level 1 ng/ml or below threshold is safe and to evaluate mid-term follow-up results in stable patients with non-ST-segment elevation after acute myocardial infarction. Material and methods: Among cTnT positive patients who presented to the emergency unit with chest pain and received coronary angiography, 100 patients who underwent isolated coronary artery bypass grafting (CABG) constituted the study group (group 1). The same number of patients (n = 100) who were cTnT negative and underwent an isolated CABG operation under elective conditions were selected as the control group (group 2). Results: Among preoperative criteria, group 1 had significantly higher smoking rates (74% vs. 41%, p = 0.0001), and significantly lower ejection fraction values (47.1 ±8.25, 54.69 ±8.73, p = 0.0001). There were no significant differences between the groups with respect to operative parameters. Postoperative follow-up periods were significantly longer in group 1 (23.25 ±14 vs. 17.55 ±7.95 months, p = 0.001). Average waiting time for cTnT to drop below the 1 ng/ml threshold value was 5.73 ±2.95 (1-12) days. Intra-aortic balloon pump use in Groups 1 and 2 was 3% and 1%, respectively. There were no hospital mortalities in either group. Mortality rates at mid term were 6% in both groups. Conclusions: This study compared two groups positive and negative for preoperative cTnT. The findings show that it is safe to wait until cTnT levels decrease to the 1 ng/ml threshold value in cTnT positive patients having a stable course. This waiting period is not very long, which is significant with respect to potential complications.
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