There is no reduction of AF rate in myocardial revascularization without cardiopulmonary bypass. However, prophylactic beta-blocker usage decreases the incidence of AF after both on-pump and off-pump myocardial revascularization.

BackgroundWe aimed at assessing the efficacy of the patch plasty technique without endarterectomy in patients with diffuse coronary artery. Long anastomosis of the left internal mammary artery graft (LIMA) to the left anterior descending (LAD) artery was performed and examined using transthoracic Doppler echocardiography to detect coronary flow reserve (CFR) and epicardial stenosis.MethodsForty-one patients (6 women; mean age, 58 ± 9 years) who underwent coronary artery bypass surgery using the patch plasty technique without endarterectomy were included in the study. Presence of CFR was examined in each patient by transthoracic Doppler echocardiography.ResultsOne of the patients (2.4%) died on the first postoperative day. The remaining patients were divided into 2 groups: those with normal CFR (CFR ≥ 2) (n = 35, 88%) and those with low CFR (CFR < 2) (n = 5, 12.0%). The length of patch plasty (3.6 ± 0.82 cm) in the low CFR group was significantly longer than that in the normal CFR group (2.69 ± 0.75 cm). Coronary angiography was performed for the 3 patients with CFR < 2: Two patients showed normal grafts and anastomoses, but the third patient’s distal LAD-LIMA anastomosis was almost 90% occluded.ConclusionWe elucidated the reliability of the patch plasty without endarterectomy method and transthoracic Doppler echocardiography for detecting the severity of coronary artery disease.

Bu çalışmada Pediatrik Mortalite İndeksi (PIM) 1, PIM 2 ve modifiye Ardışık Organ Yetersizlik Değerlendirme (m-SOFA) skorlarının pediatrik kalp cerrahisinde mortalite tahminindeki geçerliliği değerlendirildi. Ça lış ma pla nı: 2003 Haziran-2009 Ocak yılları arasında, 12 yataklı ameliyat sonrası kalp cerrahisi yoğun bakım ünitesinde kalp cerrahisi sonrasında izlenen 456 pediatrik hastanın tıbbi dosyası retrospektif olarak incelendi. Bu dosyalardan 373'ü çalışmaya dahil edildi. Hastaların yaş, cinsiyet, tanı, yoğun bakımda ve hastanede kalış süreleri, sağkalım oranları, PIM 1, PIM 2 skorları ve başlangıçtaki, 24. ve 48. saatlerdeki m-SOFA skorları ile zirve m-SOFA skorları kaydedildi. Normal dağılım gösteren veriler Student t testi, nonparametrik veriler Mann-Whitney-U testi ile karşılaştırıldı. Skorların kalibrasyonu Hosmer ve Lemeshow Uyum İyiliği testi ile yapıldı. Skorların ayırım gücü, Alıcı işletim karakteristikleri (ROC) eğrisi kullanılarak analiz edildi. Bul gu lar: Ameliyat sırası dönemde 50 hasta (13.4%) kaybedildi. Zirve ve başlangıç m-SOFA skorları, ölen hastalarda (sırasıyla 9.8±2 ve 9.2±2), sağ kalanlara (sırasıyla 5±2.5 ve 4.6±2.5; p<0.01) kıyasla, anlamlı düzeyde yüksekti. Hosmer-Lemeshow Uyum İyiliği testi ile kalibrasyon PIM 1 için ki-kare df (8)=30.4, p= 0.0002 ve PIM 2 için ki-kare df (9)=13.5, p= 0.13 bulundu. PIM 2'nin ayrım ve kalibrasyon gücü iyi iken (ROC 0.82), PIM 1'in daha iyi bir ayrım (ROC 0.87), ancak zayıf bir kalibrasyon gücü olduğu görüldü. Zirve ve başlangıç m-SOFA skoru ROC değerlerinin iyi bir ayrım gücü olduğu gözlendi (sırasıyla 0.93 ve 0.92). So nuç:Çalışma bulgularımız, pediatrik kalp cerrahisinde zirve ve başlangıç m-SOFA skorlarının mortaliteyi belirleme gücünün, PIM 1 ve PIM 2 skorlarına kıyasla, gelişmiş olduğunu göstermektedir. Anah tar söz cük ler: Mortalite belirleme; m-SOFA skoru; pediyatrik kalp cerrahisi; PIM 1 skoru; PIM 2 skoru. Background: This study aims to evaluate the validity of Pediatric Index of Mortality (PIM) 1, PIM 2, and modified Sequential Organ Failure Assessment (m-SOFA) scores for predicting mortality in pediatric heart surgery. Methods: Between June 2003 and January 2009, medical files of 456 pediatric patients who were monitored in a 12-bed postoperative cardiac surgery care unit following heart surgery were retrospectively analyzed. A total of 373 files were included in the study. Age, gender, diagnosis, the length of stay in the intensive care unit and hospital, survival rates, PIM 1, PIM 2 scores and m-SOFA scores on admission, at 24 and 48 hours and peak m-SOFA scores were recorded. Student's t test was used to compare the normally distributed data, whereas Mann-Whitney-U test was used to compare non-parametric data. Calibration of the scores was performed using the Hosmer and Lemeshow Goodness of Fit test. Discrimination power of the scores was analyzed using the receiver operating characteristic (ROC) curves. Results: Fifty patients (13.4%) died perioperatively. Peak and m-SOFA scores on admission were significantly higher in nonsurvivors (...

Introduction: Atherosclerosis is a chronic inflammatory event characterized by stiffness and thickening of the vascular walls. In our daily practice, we assume the atherosclerotic potential of the patient by following the total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglyceride levels (lipid panel). We aimed to understand the relation between the HDL, LDL, cholesterol levels and the atherosclerosis in large vascular structures such as the ascending aorta. Material and methods: We have searched for atherosclerosis in the aortic tissue samples from 48 patients. It is a study in which we examine the correlation of preoperative cholesterol values (HDL, LDL, triglyceride, total cholesterol) by dividing the patients into two groups according to the presence of plaque. Results: Forty-three (89.6%) male and 5 (10.4%) female patients between 39 and 81 years of age were included in the study. There was no statistically significant difference between the patients' preoperative cardiovascular risk assessments. The free T3 values were within the normal range in all patients, but there was a difference that patients in the non-atherosclerosis group had lower values. There was no statistically significant difference between the two groups' HDL, LDL, total cholesterol, or triglyceride parameters. Conclusions: As a result, in our study, no significant difference was found between HDL-C, LDL-C, triglyceride, total cholesterol values and the pathological process of aortic atherosclerosis. As a result of this study, we believe that it was necessary to correct the error margins of these parameters. In addition, it required the need for a clearer laboratory parameter to demonstrate atherosclerosis.

Objective: The prevalence of Streptococcus mutans serotype k, which was speculated that might be associated with the development of cardiovascular diseases, has been reported in adult cardiovascular surgery patients. There is no information about presence of serotype k in children with cardiac disease. The aim of this study was to determine the salivary prevalence of S.mutans serotype k in children with congenital heart disease. Study Design: Salivary samples of 25 patients undergoing elective surgery for congenital heart defects with cardiopulmonary bypass and an age and gender matched control group of 25 healthy children were enrolled in the study. Species-specific 16SrRNA gene sequences were used for S. mutans and serotype-specific rgpF gene sequences were used for S.mutans serotype k determination in stimulated saliva samples. Results: S.mutans was detected in 19 (76%) of the study and 15 (60%) of the control children. The difference was not shown to be statistically significant. Serotype k was determined from 3 (12%) of the study group, while it was not determined from the samples of the control group. Conclusions: Our results indicate that those children with congenital heart disease may possess S.mutans serotype k in oral cavity at a higher frequency as similar with the adult cardiac surgery patients.