Background/Objectives: The Charlson Comorbidity Index (CCI) is designed for evaluating comorbidities and mortality risks, with the age-adjusted CCI (ACCI) combining age and comorbidity assessments. Despite its long-standing use, research on CCI’s application in cardiac surgery patients is limited. This study assessed the effectiveness of CCI and ACCI in predicting in-hospital mortality and post-surgery outcomes for patients undergoing isolated coronary artery bypass grafting (CABG). Methods: CCI and ACCI scores were derived from medical records between 2016 and 2022. Patient demographics, surgical techniques, and postoperative complications were documented. Results: Totally 393 patients [297 (75.6%) males, 96 (24.4%) females] with an average age of 65 years were included. Median CCI and ACCI scores were 1 (1–2) and 4 (3–5), respectively. In-hospital mortality occurred in 5.9% (n = 23) of cases, with CCI being an independent predictor (OR 1.865, 95% CI 1.117–3.116; p = 0.017). Both CCI and ACCI scores negatively correlated with preoperative EF (%) and positively correlated with ICU and total hospital stay, cardiopulmonary bypass time, and cross-clamp time. ACCI score also positively correlated with extubation time. Patients categorized by CCI comorbidity severity (no comorbidity, mild, moderate, severe) showed a significant increase in postoperative complications with increasing severity, including postoperative VT (p = 0.000), acute renal failure (p = 0.009), pneumonia (p = 0.007), and in-hospital mortality (p = 0.001). Conclusions: Both CCI and ACCI are prognostic indicators for in-hospital mortality in isolated CABG surgery patients, effectively predicting postoperative complications, extended ICU stays, and prolonged hospital stays. Implementing these scoring systems could enhance patient care and improve surgical decision-making.

Background: The lactate dehydrogenase to albumin ratio (LAR) is a novel inflammatory marker and a potential predictor of mortality in various conditions. No research has yet examined LAR’s impact on mortality in cardiac surgery patients. This study evaluated LAR’s role in predicting mortality and complications in isolated coronary artery bypass grafting (CABG) patients. Methods: A retrospective analysis of 377 CABG patients (93 women, 24.7%; 284 men, 75.3%; mean age 65.9 years) from 2020 to 2024 was conducted. Data included demographics, preoperative characteristics, surgical details, and postoperative outcomes, along with ICU and hospital length of stay (LOS). Results: In-hospital mortality was 6.1% (n = 23). Independent predictors were low preoperative ejection fraction (EF) (OR: 0.96, p = 0.024), baseline LAR (OR: 1.08, p = 0.000), LOS-ICU (OR: 1.1, p = 0.000), postoperative ventricular tachycardia (OR: 37.9, p = 0.006), and acute renal failure (OR: 12.1, p = 0.000). Mortality cases had a higher median LAR than survivors (8.6 vs. 5.2, p = 0.000). Elevated LAR correlated with lower preoperative EF (r = −0.227, p = 0.000), longer LOS-ICU (r = 0.17, p = 0.001), and longer LOS-hospital (r = 0.208, p = 0.000). A LAR cut-off of 7.097 predicted mortality (AUC: 0.823, sensitivity 78.3%, specificity 77.1%). Elevated LAR values were observed in all groups with postoperative complications (p < 0.05), indicating its consistent association with negative outcomes. Conclusions: LAR is a valuable predictor of in-hospital mortality and postoperative complications in CABG patients. Elevated LAR is associated with longer ICU/hospital stays and poorer outcomes. Preoperative LAR assessment can guide risk stratification, forecast mortality, and inform surgical planning and treatment strategies.

Here we present a 47-year-old male diagnosed with a pseudocoarctation of the aorta and a funnel-like subclavian artery aneurysm with a large orifice and severe aortic valve insufficiency. The patient underwent a two-stage repair for both pathologies. After an aortic valve replacement, postcardiotomy pericardial effusion occurred and was medically managed. Six months later, the patient underwent a distal arcus aorta and subclavian artery replacement with a left posterolateral thoracotomy as the second stage. Due to the strict adhesions, pulmonary veins were not cannulated and an extracorporeal bypass between the pulmonary artery and femoral artery was used for distal body perfusion. The coincidence of subclavian aneurysms and a pseudocoarctation of the aorta is rare and a literature review was performed to identify treatment options for this pathology.

Background/Objectives: Previous studies have reported that inflammatory biomarkers have prognostic value in various fields, including vascular surgery. Biomarkers such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) help identify patients at higher risk for cerebrovascular events, as well as in the treatment and follow-up of patients. There are studies investigating the usefulness of these biomarkers for carotid artery disease. However, data on whether they help predict neurological complications after carotid artery surgery are limited. This study examined the correlation between preoperative carotid arterial stenosis severity, symptomatic presentation, and PLR and NLR levels as potential biomarkers for predicting postoperative neurological complications. Methods: We retrospectively analyzed the preoperative and postoperative demographics, physical examination, and laboratory results of patients who underwent carotid endarterectomy for carotid artery stenosis in our clinic between January 2019 and January 2023. Results: While our findings did not demonstrate a statistically significant correlation between NLR and PLR levels and postoperative neurological complications, elevated platelet counts were associated with such complications, underscoring the importance of antiplatelet therapy in managing carotid artery disease. Conclusions: The study linked high platelet counts to postoperative complications and highlights the importance of antiplatelet therapy in managing carotid artery disease. The differences in findings highlight the complexity of stroke prediction and the need for a multifactorial approach.

Knitted Dacron grafts are often preferred as they are easy to process, soft, and flexible; they also tend to expand due to their high porosity. Bleeding and pseudoaneurysm formation at the anastomotic site are common complications of vascular surgery, but nonanastomotic bleeding due to degeneration of Dacron graft's textile structure is rare. Here, we present a 70-year-old male diagnosed with a giant pseudoaneurysm that continues from the femoral artery to the popliteal artery formed due to the degeneration of the previous seven-year-old prosthetic graft. The pseudoaneurysm continued to be the source of arterial flow with its capsule, and the arterial flow into it was able to provide blood supply to the lower extremity without causing ischemia. The patient underwent surgery to excise the giant pseudoaneurysm and create a new bypass between the femoral and popliteal arteries. Today, the durability of prostheses is becoming increasingly important, and modifications in the manufacturing process have made Dacron grafts more resistant to cyclic pulsatile stretching and facilitated the adaptation of the prosthetic material to the host tissue. Despite all the remarkable innovations over the last 50 years, complications of prosthetic grafts can result in fatal bleeding. This situation emphasizes the importance of close follow-up and detailed clinical and radiological evaluation of patients.