Background: Abdominal aortic aneurysms (AAAs) are life-threatening conditions that require timely intervention to prevent rupture. Endovascular aneurysm repair (EVAR) is preferred due to faster recovery and lower perioperative risk; however, intraoperative failure and long-term complications highlight the continued significance of open surgical repair (OSR) and the need for improved risk assessment. Methods: This retrospective study analyzed data from 210 patients who underwent EVAR (n = 163) or OSR (n = 47) at a single center. Clinical characteristics, complications, reintervention rates, and 30-day mortality were recorded. EVAR-to-OSR conversion and mortality predictors in AAA treatments were identified. Results: The overall mortality rate was 9.5% (20/210 patients), with 12 patients (7.3%) in the EVAR group and 8 patients (17%) in the OSR group (p = 0.085). Five patients required early and six required late conversion to open surgery. In follow-ups beyond 30 days, the reintervention rate for EVAR was higher (HR: 1.2, 95% CI: 0.4–3.6; p = 0.754). According to the multivariable analysis, rupture (p = 0.045), female sex (p = 0.018), body weight (p = 0.003), and aortic size index (p = 0.019) were significant predictors of mortality, whereas OSR was not (p = 0.212). Conclusions: Treatment optimization requires a balanced approach, integrating both EVAR and OSR based on patient-specific factors. Maintaining expertise in both techniques is essential to ensure the best possible outcomes, and OSR should remain a viable option when clinically indicated.

Blood transfusion; is considered an organ transplant. In coronary bypass surgery, large volumes of homologous blood transfusion may be required due to excessive bleeding. The large number of use of homologous blood transfusion in open heart surgery and the awareness of its various harmful effects have prompted researchers to conduct research on the use of autologous blood. With autologous transfusion, blood diseases, incompatibility, immunosuppression and organ damage can be prevented and the patient can be extubated earlier in the postoperative period. Between January 2020 and January 2016, a total of 176 patients, 56 in the treatment group (with autologous blood transfusion) and 120 in the control group, whose information could be reached from hospital records were investigated retrospectively. No statistical difference was found between the mean intubation SO2 and PO2 values of the groups. On the contrary, considering the mean intubation times in the intensive care unit of both groups, the patients who underwent autologous blood transfusion were extubated at a statistically significant earlier time. Autologous blood transfusion is a safe method in selected patients as well. Thanks to this method, patients are protected from complications associated with homologous blood transfusion. It is believed that performing autologous blood transfusion in selected patients undergoing open-heart surgery can decrease the number of postoperative transfusions, frequency of transfusion-related complications (especially in the lungs), and mean intubation times.

Background and Objectives: Valvular heart disease (VHD) is a major cause of morbidity and mortality worldwide, and valve replacement surgery performed under cardiopulmonary bypass (CPB) with full sternotomy remains an important treatment modality. Colchicine has well-established anti-inflammatory effects in ischemic heart disease and pericardial disease, but its association with postoperative morbidity in patients undergoing valvular heart surgery has not been well studied. This study aimed to investigate the association of perioperative colchicine use with clinical morbidity and inflammatory parameters in patients undergoing valvular heart surgery with CPB. Materials and Methods: In this retrospective study, 82 patients who underwent elective on-pump valvular heart surgery through full sternotomy were divided into a control group (n = 42) who did not receive colchicine and a colchicine group (n = 40) who received oral colchicine (0.5 mg once daily) for three days before and ten days after surgery. Demographic, clinical, and laboratory data, including length of hospital and intensive care unit (ICU) stay, transfusion requirements, sternal wound complication, surgical re-exploration, and inflammatory parameters on postoperative day 5 (C-reactive protein [CRP], white blood cell count, albumin, platelet-to-lymphocyte ratio [PLR], and neutrophil-to-lymphocyte ratio [NLR]), were compared between the groups. Results: Length of ICU stay was significantly shorter in the colchicine group than in the control group (4.1 ± 1.6 vs. 5.3 ± 2.4 days; p = 0.009), and fresh frozen plasma transfusion requirement was significantly lower in the colchicine group (4.2 ± 2.1 vs. 6.9 ± 3.3 units; p < 0.001). Total hospital stay, erythrocyte transfusion requirement, and inflammatory parameters (CRP, white blood cell count, NLR, PLR, and albumin) did not differ significantly between the two groups (all p > 0.05). Conclusions: Perioperative colchicine was associated with a shorter ICU stay and a reduced requirement for fresh frozen plasma transfusion in patients undergoing valvular heart surgery with CPB, suggesting that colchicine may have a potential role in this surgical population. After correction for multiple comparisons, the difference in ICU length of stay was no longer statistically significant. Larger prospective studies are warranted to confirm these findings.

OBJECTIVE: The effect of administered fibrinogen concentrates in reducing the risk of postoperative bleeding that remains a serious problem in open heart surgery is controversial. We aimed to present the effect of fibrinogen concentrates on postoperative bleeding applied after cardiopulmonary bypass (CPB) in coronary artery bypass grafting (CABG).MATERIAL AND METHODS: 67 patients who underwent CABG and measured below 2.5 g / L fibrinogen after CPB were included in the study. Data of 32 patients (Group F; n=32 patients) who were given fibrinogen concentrate were compared with 35 patients (Group NF; n=35 patients) who were not given fibrinogen concentrate.RESULTS: After CPB, fibrinogen concentrate was applied to patients in order to increase fibrinogen levels to 2.5 g/L and above. For both groups, fibrinogen levels decreased significantly after CPB compared to preoperative levels (p<0.01), however, there was no difference between the groups in terms of reduction rate (p = 0.321). 2.94±0.91 g fibrinogen was administered to the patients in Group F. Postoperative drainage between the groups was not significant in both the 0-12 hour period (p=0.142) and 12-24 hour period(p = 0.309).CONCLUSIONS: Fibrinogen concentrate may reduce the amount of postoperative drainage with secondary effects which increased low plasma fibrinogen levels and contributes to recovery of coagulation physiology. However, because this decrease was not statistically significant, we think that fibrinogen concentrates should be used only in patients with a high risk of bleeding and in patients with fibrinogen levels below <1.5 g/L after CPB.

Konstriktif Perikardite Neden Olan Perikardiyal Kist Hidatik ve Cerrahi Tedavisi Muhammet BOZGÜNEY Atriyal Fibrilasyonu Olan ve Açık Kalp Ameliyatı Olan Hastada Kriyoablasyon Uygulaması Sonrası Sinüs Ritminin Sağlanması Ziya YILDIZ - Mehmet Burak GÜLCAN - Mehmet Ali KAYĞIN Eş Zamanlı Karotid Endarterektomi ve Koroner Arter By-Pass Greft İle Patch-Plasti Mehmet Burak GÜLCAN -Ziya YILDIZ- Mehmet Ali KAYĞIN Abdominal Aort Anevrizmasının Başarısız Endovasküler Tedavisi Sonrası Açık Cerrahi Onarım İle Tedavisi Görkem YİĞİT Optik Nörit:Koroner Arter Bypass Sonrası Mehmet KARAÇALILAR Lad-Pulmoner Arter Fistülüne Cerrahi Yaklaşım Uğur DİKKAŞ -Suat Nail ÖMEROĞLU Miyokard Enfarktüsüne Bağlı Olmayan Mitral Papiller Kas Rüptürü Uğur DİKKAŞ -Berk ARAPİ -Suat Nail ÖMEROĞLU Torakoabdominal Aort Anevrizma Tamirinde “Basit Klemp ve Dik” Yönteminin Yeri Ayhan MÜDÜROĞLU - Ahmet YÜKSEL Bilateral İzole Femoral Arter Anevrizması ve Cerrahi Yönetimi Mehmet Ali YÜRÜK Lomber Diskektomi Sırasında Nadir Ama Ölümcül Olabilen Bir Komplikasyon: Abdominal Aort Yaralanması Hasan TOZ Kronik Böbrek Yetmezlikli Hastalarda Santral Ven Stenoz ve Oklüzyonu Gencehan KUMTEPE Postpartum Hastada Tip B Aort Diseksiyonu ve Dev Asendan Aort Anevrizma Yönetimi Hüseyin DURMAZ Patent LİMA Grefti olan Hastada AVR, Asendan Aorta ve Hemiarkus Replasmanı: Redo Kardiyak Cerrahi Yönetimi Ergida ALBRAHİMİ - Çiğdem TEL ÜSTÜNIŞIK -Suat Nail ÖMEROĞLU Hemodiyaliz Hastalarında Arteriyovenöz Fistüle Sekonder Gelişen Venöz Staz Yarası: Olgu Sunumu Sena GÜLEN - Ergida ALBRAHİMİ - Çiğdem TEL ÜSTÜNIŞIK

Objectives: This study aims to investigate clinical, laboratory, and neurological data and operations of the patients in patients with an extracranial carotid artery aneurysm (ECCA). Patients and methods: A total of 14 patients (11 males, 3 females; mean age: 61.6±6.3 years; range, 48 to 70 years) who were operated for an ECCA in our clinic between January 2011 and January 2021 were retrospectively analyzed. Color Doppler ultrasound (CDUS) and computed tomography angiography (CTA) were used to evaluate the patients. Data regarding patient characteristics, strokes, mortality, obstructions, and other surgical complications, as well as preoperative atherosclerotic risk factors, were recorded. Results: The surgically operated lesions were located on one side of the neck in all patients; particularly, they were located on the left side in three (22%) patients and on the right in 11 (78%) patients. The most common type of ECCA in all patients was Type 1 (saccular), and aneurysms were reported to be present only in the internal carotid artery. Primary end-to-end repair was performed in 11 (78%), saphenous vein graft interposition in two (14%), and synthetic graft in one (8%) patient. The mean length of stay in the intensive care unit was 2.1±0.4 days, the mean length of the hospital stay was 87±0.64 days, and the mean amount of drainage in the first two postoperative days was 24.4±10.8 mL. Bleeding at the wound site occurred in one patient due to the skin incision and was eliminated via suturing. A hematoma at the wound site was observed in one patient, and redness at the wound site was observed in one patient and disappeared prior to discharge with the treatments applied. The neurological examination revealed a temporary facial shift in one patient that resolved before discharge. Conclusion: The natural course of ECCAs is still not well understood, and there is no definitive consensus about their treatment. The main goal of managing ECCAs is to prevent aneurysms. They are rare entities and may occur with or without various symptoms. Early and long-term outcomes of invasive treatment of ECCAs are favorable.