Gunshot injuries are one of the penetrating traumas of the heart and that require urgent intervention. Localization of the cardiac injury is important in terms of appropriate treatment approach. For this reason, rapid diagnosis and surgical intervention is life-saving in such patients. In our study, we present a surgical intervention of a patient with lesion on the right coronary artery that doesn’t allow blood flow in coronary angiography due to cardiac injury with gunshot injury.

Radial artery is one of the intervention cites for coronary angiography and has an increased tendency according to the successful results in the literature. However, some undesirable clinical situations may occur by using this route as with every invasive intervention. In this study, we presented a patient who had left upper limb ischemia following transradial angiography. An intimal flap with an approximate length of 15 cm was removed during embolectomy from the brachial artery. After multiple embolectomy procedures, axillo-brachial bypass was performed using the saphenous vein. However, ischemia in the forearm did not improve and limb loss occurred.

Background: Serious coronary artery diseases including left main coronary artery disease, proximal left anterior descending artery disease, and three-vessel coronary artery disease with carotid artery stenosis are required simultaneous operations. By using complete arterial revascularization technique for coronary artery bypass graft operation, radial artery can be used safely as a patch material for carotid endarterectomy in combined surgery. Methods: Between 2016 and 2018, 14 patients who had serious coronary artery disease with the stenosis of unilateral carotid artery equal/over 70% were included in the study. Complete arterial revascularization was performed in all patients and radial artery was used as a patch material in carotid endarterectomy. Results: All patients were discharged without any complication and carotid artery colored Doppler ultrasound was performed to the patients in the 3rd months, 6th months, and first year of the operation. There was no restenosis detected. Conclusion: In conclusion, radial artery is useable for carotid patch angioplasty in patients who underwent simultaneous carotid endarterectomy and coronary artery bypass graft operation with complete arterial revascularization. Further studies including a large number of patients are needed to examine the long-term patency of this graft.

Background: Cardioplegia solutions are used to protect the myocardium from ischemic injury caused by cardiopulmonary bypass and various types of cardioplegia solutions have been introduced for cardiac surgery. In this study, we aimed to compare the effects of del Nido cardioplegia and microplegia, which were mostly used in our clinic for intraoperative and postoperative processes among patients who underwent elective mitral valve replacement. As a result, the comparison could be performed in a specific patient group without additional valvular or coronary disease, and cardioplegia distribution could be achieved more efficiently. Methods: Between 2018 and 2023, a total of 120 patients who underwent elective mitral valve replacement via sternotomy with del Nido cardioplegia or microplegia were included in the study. Patients were divided into two groups; group 1 (del Nido, n = 64) and group 2 (microplegia, n = 56). Preoperative characteristics, intraoperative and postoperative early clinical data as primary outcomes, and postoperative mortality rates and intensive care costs as secondary outcomes were compared statistically. Results: There were no statistically significant differences in terms of preoperative characteristics between the two groups. Duration of cross clamp differences between group 1 versus group 2 (45 ± 16 vs. 57 ± 19 min), cardiopulmonary bypass (56 ± 17 vs. 65 ± 21 min), intensive care length of stay (18.04 ± 7.41 vs. 22.37 ± 6.86 h), requirement of intraoperative defibrillation (n = 5 vs. n = 13), and intensive care costs were found to be statistically significantly lower in del Nido group. Conclusion: Either del Nido or microplegia solutions can be used safely in mitral valve replacement operations, however, del Nido cardioplegia has some advantages over intraoperative processes, such as lowering the cross clamp and cardiopulmonary bypass time. Furthermore, patients who received del Nido cardioplegia had shorter intensive care stay and required less intraoperative defibrillation compared with the microplegia group. Therefore, less exposure to anesthesia, the prevention of infection due to shortened operation duration, and greater cost-effectiveness can be achieved by using del Nido cardioplegia instead of microplegia.