SUMMARY OBJECTIVE: The aim of this study was to compare the accuracy, scientific quality, and clarity of responses generated by GPT-4o and Gemini to frequently asked patient questions related to carotid artery disease and carotid endarterectomy. METHODS: In total, 40 unique carotid endarterectomy-related questions were compiled from online sources and clinical experience. Each was entered into separate new sessions with GPT-4o and Gemini 2.5 Flash in Turkish, and responses were collected without modification. Notably, four blinded cardiovascular surgeons independently rated each answer (1–5 Likert scale) in three domains: Accuracy, Scientific Quality, and Clarity. Mean response lengths and domain scores were compared using appropriate paired tests. RESULTS: GPT-4o produced longer responses than Gemini (258.1±101.6 vs. 193.2±43.7 words; p<0.001). Overall, GPT-4o had higher Accuracy scores (4.33±0.39 vs. 4.16±0.33; p=0.04), with no significant differences in Scientific Quality or Clarity (p=0.377 and p=0.154, respectively). In rater-level analyses, Gemini scored higher in Clarity for one rater, whereas GPT-4o was superior in Accuracy and Scientific Quality for another. Overall mean scores were comparable (4.17±0.36 vs. 4.13±0.31; p=0.636). Physician referral was recommended in 62.5% of GPT-4o and 52.5% of Gemini (p=0.366). CONCLUSION: Both GPT-4o and Gemini provided "good"-quality responses to carotid endarterectomy patient questions, with GPT-4o showing a modest accuracy advantage, with no difference in other domains. Explicit disclaimers on both platforms underscore their supportive, not definitive, role in patient education. Physicians should remain the primary source for individualized decisions, and AI-generated information should always be verified.

Background and Objectives: Prolonged intensive care unit (ICU) stay following coronary artery bypass grafting (CABG) remains a major clinical challenge. The aim of this study was to identify preoperative and intraoperative factors that may predict prolonged ICU requirement in patients undergoing isolated CABG and to evaluate the impact of minimally invasive extracorporeal circulation (MiECC) utilization on this outcome. Materials and Methods: Patients who underwent isolated CABG between January 2024 and April 2025 were retrospectively analyzed. Prolonged ICU stay was defined as a postoperative intensive care duration exceeding 72 h. Predictors of prolonged ICU stay were evaluated using univariate logistic regression and four multivariable logistic regression models. Receiver operating characteristic (ROC) curve analyses were performed to assess the discriminative performance of significant and clinically relevant variables as well as the multivariable models. Results: A total of 82 patients were included and stratified into a prolonged ICU stay group (n = 32) and a non-prolonged ICU stay group (n = 50). The preoperative left ventricular ejection fraction (LVEF) was significantly lower (52.5% vs. 60%, p = 0.012) and preoperative leukocyte counts significantly elevated (8.4 vs. 7.97 × 10³/µL, p = 0.049) in the prolonged stay group. MiECC was employed in 28.1% of patients with a prolonged ICU stay and 30% of those with a non-prolonged stay (p = 0.530). Across four multivariable logistic regression models, lower preoperative ejection fraction and higher preoperative leukocyte count were identified as independent predictors of prolonged ICU stay, whereas MiECC utilization was not independently associated with this outcome. Conclusions: Lower preoperative ejection fraction and higher baseline leukocyte count were independently associated with prolonged ICU stay. No independent association between MiECC utilization and prolonged ICU stay could be demonstrated. These findings suggest that preoperative cardiac function and inflammatory status may contribute to ICU requirements following isolated CABG. Further prospective studies are warranted to validate these findings.

Objectives: This study aimed to evaluate pathological differences in aortic valve cusps from patients undergoing aortic valve replacement due to aortic stenosis. Patients and methods: In this single-blind observational study, aortic valves from 20 patients (10 males, 10 females; mean age: 69±6.36 years; range, 62-84 years) were divided into left coronary, right coronary, and noncoronary cusps between January 2013 and December 2014. The cusps were stabilized in 10% formalin and sent to the pathology lab in a blinded manner. Sections 5 µm in thickness were prepared, stained with hematoxylin-eosin and Van Gieson, and analyzed for inflammation, fibrosis, and calcification using light microscopy. Comparisons were made between right, left, and noncoronary cusps. Results: Inflammation comparisons between right, left, and noncoronary cusps showed no statistically significant differences (p=0.199, p=0.789, and p=0.379, respectively). For fibrosis, left and right coronary cusps and right and noncoronary cusps were not significantly different (p=0.079 and p=0.880); however, the comparison between left coronary and noncoronary cusps was significant (p=0.046). Regarding calcification, left and right coronary cusps and right coronary and noncoronary cusps showed no significant difference (p=0.285 and p=0.180), while the comparison between left coronary and noncoronary cusps was statistically significant (p=0.011). Conclusion: While pathological differences between aortic valve cusps are rarely emphasized in the literature, this study identified significant fibrosis and calcification differences in left coronary and noncoronary cusps. These findings could contribute to a better understanding of calcific aortic stenosis and potentially guide new treatments.

Background: The Albumin–Bilirubin (ALBI) score is an easy-to-use, objective marker of liver synthetic function that has demonstrated prognostic value in various cardiovascular conditions. However, its role in predicting postoperative bleeding after CABG has not been previously investigated. Methods: Patients were divided into two groups according to their median preoperative ALBI score (−2.97): Low ALBI (n = 78) and High ALBI (n = 79). The primary outcome was excessive postoperative bleeding, defined as cumulative drainage exceeding 1000 mL within the first 24 postoperative hours. Secondary outcomes included transfusion requirements, mechanical ventilation duration, and length of hospital stay. Correlation and regression analyses were performed to assess the relationship between the ALBI score and postoperative bleeding. Results: The High ALBI group demonstrated a significantly greater postoperative drainage volume (450 [350–700] mL vs. 350 [300–487.5] mL, p = 0.007), higher erythrocyte transfusion (p = 0.001) and fresh frozen plasma transfusion requirements (p = 0.034), and prolonged mechanical ventilation duration (p < 0.001) and hospital stay (p = 0.003) compared to the Low ALBI group. Spearman correlation analysis revealed a significant positive correlation between the ALBI score and drainage volume (rho = 0.272, p < 0.001), and thus the ALBI score was identified as a significant predictor of excessive postoperative bleeding exceeding 1000 mL (OR: 5.93, 95% CI: 1.63–21.60, p = 0.007). Conclusions: The preoperative ALBI score is an easy-to-use and readily available tool that may serve as an effective adjunct for identifying patients at an elevated risk of postoperative bleeding prior to isolated CABG.