Heartmate III sol ventrikül destek cihazı ile outflow greft bükülmesi, nadir görülen bir cihaz komplikasyonu olup, nakil merkezlerinden son zamanlarda yapılan bildirimler nedeniyle, firma ve Amerika Birleşik Devletleri Gıda ve İlaç İdaresi önlem amaçlı açıklamalarda bulundu. Outflow greft bükülmesi gerçekleştiğinde, cihaz debisinde ciddi düşüş ve hemodinaminin bozulmasına bağlı olarak, tanı ve tedavisi zaman kaybetmeden yapılmalıdır. Bu yazıda Türkiye'de ilk kez görülen bir outflow greft bükülme olgusu sunuldu.Anah tar söz cük ler: Greft, Heartmate III sol ventrikül destek cihazı, outflow, bükülme.

Background Patch augmentation of the aortic arch as well as construction of an unobstructed pulmonary blood supply are two important surgical targets in patients with hypoplastic left heart syndrome. In this report, we aimed to present our preliminary results with a combination of two relatively new approaches in Norwood‐Sano procedure. Methods A retrospective analysis was performed in 10 newborns with the diagnosis of hypoplastic left heart syndrome. Our surgical approach incorporated the interposition of a 6.0‐mm ring‐reinforced tube graft with the “dunked technique” between the right ventricle and the pulmonary artery; and reconstruction of the aortic arch using a curved porcine pericardial patch which is specifically designed for the Norwood procedure. Results Mean age and body weight at the time of the Sano‐Norwood operation were 7.3 ± 2.4 days and 3164 ± 406 g, respectively. We encountered 1 (10%) early and 1 (10%) late mortality. All of the patients were discharged without any residual gradients at the aortic arch. Four out of eight patients underwent stage 2 bidirectional cavopulmonary anastomosis at a median age of 5 months (range, 4‐6 months). Pericardial patch augmentation of the left pulmonary artery was deemed mandatory in one of our patients. Conclusions The dunked technique of interposing a ring‐reinforced conduit between the right ventricle and pulmonary artery along with the utilization of a curved porcine pericardial patch specifically designed for aortic arch reconstruction are promising modifications of the Sano‐Norwood procedure in newborns with hypoplastic left heart syndrome.

BACKGROUND Aortic valve stenosis is the most common valve disease in the elderly. Sutureless aortic valve replacement has been introduced as an alternative to conventional AVR in elderly high-risk patients. The aim of this study is reporting our single-center experience regarding early outcomes. METHODS Between December 2014 and December 2019, 91 patients (45 Women, 46 Males) were undergone aortic valve replacement in our clinic (49 Sutureless, 42 conventional). Perioperative clinical and echocardiographic outcomes were assessed in all patients. RESULTS The average age was 73.08±7.53 and 66.26±8.63 for sutureless and conventional groups. The mean cross-clamp time and the cardio-pulmonary bypass (CPB) time were 72.86 and 91.88 min, and 104.96 and 119.81 min, respectively. In sutureless group, 30 (61.2%) patients underwent additional procedures. These were CABG, mitral interventions, tricuspid repair, ascending aortic surgery and myxoma. Preoperative peak and mean pressure gradients decreased from 78.16 and 48.95 mmHg to 17.47 and 10.06 mmHg postoperatively for sutureless group. It was 71.53 and 43.89 to 29.16 and 15.14 for conventional group. Paravalvular leak and permanent pace-maker requirement due to AV-block rates were 6.1%. The mean ICU stay were 3.69 and 2.31 days, mean hospital stay were 10.08 and 8.62, 30-day overall mortality rates were 8.2% and 4.8% for sutureless and conventional groups. CONCLUSION The evaluation of our experience suggests that sutureless aortic valve replacement has advantages in terms of shorter cross-clamp and CPB duration, and postoperative aortic gradients. Its benefits could be more prominent in complex cases or minimally invasive surgery

Objective: To compare the results of sutureless aortic valve replacement (AVR) with the conventional method.

No abstract