Objectives: In this study, we present the complication data of patients we treated for chronic venous insufficiency (CVI) with cyanoacrylate adhesive closure (CAC) therapy for 2 years. Methods: Complications of 382 CAC procedures performed by the same surgeon were reviewed retrospectively. Results: Independent of patients, depending on the payment system of the state; two hundred twenty-three (58.4%) of 382 procedures were performed using the Venex system, and the Variclose system was used in 159 (41.6%) patients. A phlebitis-like reaction occurred in 46 (12%) patients, induration in 18 (4.7%) patients, hyperpigmentation in five (1.3%) patients, abscesses in four (1%) patients, cellulitis in three (0.8%) patients, and granuloma in one (0.3%) patient. In addition, as serious complications, deep vein thrombosis (DVT) developed in three patients and pulmonary embolism in one of these patients. Interestingly, temporary blindness was also observed in one patient. Conclusions: Although CAC therapy is a reliable method, its complications should not be ignored. Its use by experienced surgeons reduces the risk of complications.

Background: The COVID-19 (coronavirus disease 2019) pandemic is a global health emergency that is straining health care resources. Identifying patients likely to experience severe illness would allow more targeted use of resources. This study aimed to investigate the association between the thymus index (TI) on thorax computed tomography (CT) and prognosis in patients with COVID-19. Methods: A multicenter, cross-sectional, retrospective study was conducted between March 17 and June 30, 2020, in patients with confirmed COVID-19. The patients' clinical history and laboratory data were collected after receiving a signed consent form. Four experienced radiologists who were blinded to each other and patient data performed image evaluation. The appearance of the thymus was assessed in each patient using 2 published systems, including the TI and thymic morphology. Exclusion criteria were lack of initial diagnostic thoracic CT, previous sternotomy, pregnancy, and inappropriate images for thymic evaluation. A total of 2588 patients with confirmed COVID-19 and 1231 of these with appropriate thoracic CT imaging were included. Multivariable analysis was performed to predict the risk of severe disease and mortality. Results: The median age was 45 (interquartile range, 33–58) years; 52.2% were male. Two hundred forty-nine (20.2%) patients had severe disease, and 60 (4.9%) patients died. Thymus index was significantly associated with mortality and severe disease (odds ratios, 0.289 [95% confidence interval, 0.141–0.588; P = 0.001]; and 0.266 [95% confidence interval, 0.075–0.932; P = 0.038]), respectively. Perithymic lymphadenopathy on CT imaging had a significantly strong association with grades of TI in patients with severe disease and death (V = 0.413 P = 0.017; and V = 0.261 P = 0.002, respectively). A morphologically assessable thymus increased the probability of survival by 17-fold and the absence of severe disease by 12-fold. Conclusion: Assessment of the thymus in patients with COVID-19 may provide useful prognostic data for both disease severity and mortality.

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: Thrombocytopenia (platelet count below 150 x 10 ³ /μL) is a common finding after open-heart surgery and can lead to various complications, including patient death. This study aimed to determine the extent of non–heparin-induced thrombocytopenia in open-heart surgery and to highlight the associated factors. Materials and Methods: In this cohort study, 842 patients who underwent valve and/or coronary bypass surgery over a 5-year period were retrospectively analyzed. After open-heart surgery, patients whose platelet count was less than 150 x 10 ³ /μL on a complete blood count 12 and 24 h after surgery were classified as thrombocytopenic. Three hundred twenty patients without thrombocytopenia and 21 patients with a high probability of heparin-induced thrombocytopenia were excluded from the study. Logistic regression analysis was used to assess the association of independent variables in moderate-severe thrombocytopenia: Age groups, sex, underlying disease, symptoms, type of surgery, pump time, pulsatile or non-pulsatile duration, degree of hypothermia, hemodilution, oxygenator type, use of an intra-aortic balloon, and erythrocyte transfusion counts were included in the analysis. Results: A total of 501 patients were diagnosed as having non–heparin-induced thrombocytopenia, and 64.3% were male. Three hundred seventy-seven (75.2%) patients had mild thrombocytopenia and 124 (24.7%) had moderate-severe thrombocytopenia. The postoperative platelet count was significantly lower than the preoperative platelet count (213 x 10 ³ vs.117 x 10 ³ /μL; p < 0.001). Moderate-severe thrombocytopenia was associated with age ≥80 years odds (OR = 9.026, 95% CI: [1.757–46.363]; p = 0.008), isolated valve surgery (OR = 3.090, 95% CI: [1.867–5.114]; p < 0.001), and valve surgery with coronary bypass (OR = 4.938, 95% CI: [1.638–14.889]; p = 0.005) compared to isolated coronary bypass, type of oxygenator (Nipro vital compared with Affinity OR = 11.097, 95% CI: [1.923–64.023]; p = 0.007), erythrocyte transfusion count (OR = 1.219, 95%CI: [1.046–1.420]; p = 0.011). Conclusion: Age 80 years or older, surgical procedures including heart-valve surgery, and the number of red blood cell transfusions are associated with the risk of moderate-to-severe thrombocytopenia. This study provides a guide in terms of risk factors that may lead to moderate-to-severe thrombocytopenia after open-heart surgery. However, future multicentre prospective randomized studies may provide more detailed information on this subject.

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.