An elevated mean platelet volume is associated with increased platelet activation and thus may predict thrombotic events. The goal of this study was to investigate the association of the mean platelet volume and the major adverse events after coronary artery bypass surgery.

Aim: To reveal the coping attitudes of mothers of children who had undergone surgery to diagnose congenital heart diseases and the relationship between these attitudes and depression levels. Material and Methods: This study was a cross-sectional observational descriptive study conducted in a pediatric cardiovascular surgery clinic. The study included 32 mothers of pediatric patients who were surgically treated for congenital heart diseases. Participants were assessed with sociodemographic information form, Turkish versions of the coping orientation to problems experienced inventory (COPE), and the Beck depression inventory (BDI). Results: The median maternal age was 31.0 (range, 21-47) years. The median BDI score was 11 (range, 1-27), and the number of mothers with a BDI score of 17 and above was 13 (40.6%). Problem-focused coping was the most common problem-coping style used by 29 (90.6%) participants with a median score of 67.0 (range, 41.0-72.0). In addition, 10 (31.3%), 10 (31.3%), and 9 (28.1%) participants showed the highest scores for active coping, suppression of competing activities, and seeking instrumental social support subscales, respectively. There was a negative correlation between BDI score and active coping, restraint, seeking instrumental social support subscales, and problem-focused coping total scores. Conclusion: Our study revealed that most mothers of children with CHD used problem-focused coping more frequently. There was a negative correlation between the problem-focused coping attitude total score and the Beck Depression total scores. Interventions to target problem-focused coping could potentially protect mothers from depression.

We aimed to investigate the antiplatelet drug resistance utilizing light transmission-lumiaggregometry (LT-LA) and platelet function analyzer-100 (PFA-100) in patients undergoing cardiovascular surgery. The study included 60 patients diagnosed with stable coronary artery disease and peripheral vascular diseases that required surgery. The participants were divided into three groups: patients receiving Aspirin (ASA) (n=21), patients receiving Clopidogrel (CLO) (n=19), and patients receiving dual therapy (ASA+CLO) (n=20). Aggregation and secretion tests in LT-LA and closure time in PFA-100 were used to measure antiplatelet drug resistance. Based on the ADP-induced aggregation test, 43% of patients were resistant to ASA, 22% to CLO, and 15% to dual therapy. Diabetes, hypertension, and hyperlipidemia were the most commonly identified comorbid disorders. In patients with comorbid risk factors, the median value of platelet aggregation response to ADP was significantly higher in the ASA group than in the CLO and dual therapy groups (p=0.0001). In patients receiving ASA monotherapy, the maximum amplitude of aggregation response to platelet agonists was equal to or more than 70% in 43% of patients for ADP and 28% for collagen in LT-LA. Elevated ADP (≥0.29 nmol) and collagen (≥0.41 nmol)-induced ATP release were found in 66% of patients utilizing ADP agonist and 80% of patients using collagen agonist undergoing ASA therapy in LT-LA. Closure times in PFA-100 were normal in 28% of patients using collagen-ADP cartridges and 62% of patients using collagen-epinephrine (CEPI) cartridges who received ASA. Recurrent thrombosis and bleeding were observed in 12 (20%) of patients with cardiovascular disease. Three of these individuals (25%) showed ASA resistance, which showed normal response to ADP-induced aggregation (≥70%) and secretion (≥0.29 nmol), as well as normal CEPI closure times. Our findings suggest that antiplatelet drug monitoring with LT-LA and PFA-100 may be useful in high-risk and complicated cardiovascular patients.

Introduction: This study aims to assess the predictive efficacy of the modified Frailty Index for 30-day postoperative outcomes in elderly patients undergoing vascular surgery and to evaluate its additional value compared with conventional tools. Materials and Method: This retrospective cohort study examined 155 consecutive patients aged ≥ 65 years who underwent elective vascular surgery. The preoperative 11-item modified Frailty Index was calculated using National Surgical Quality Improvement Program variables. The primary endpoint was 30-day mortality, and secondary endpoints included surgical site infection, myocardial infarction, septic shock, reintubation, stroke, and acute kidney injury. Results: The mean age was 71.98 ± 5.59 years. The 30-day mortality rate was 16.8%. The modified Frailty Index was higher in non-survivors than in survivors (3.96±1.48 vs 1.96±1.11, p<0.001) and showed excellent mortality prediction (Area Under the Curve=0.851, 95% CI: 0.778-0.924), with a threshold of 2.5 (sensitivity 84.6%, specificity 73.6%). In the multivariate analysis, adjusting for age, sex, American Society of Anesthesiologists score, and Geriatric Nutritional Risk Index, the modified Frailty Index remained associated with mortality (adjusted OR=2.79, 95% CI, 1.52-5.13; p=0.001). Each point increase correlated with higher risk of surgical site infection (OR=1.55, 95% CI: 1.19-2.03, p=0.001), myocardial infarction (OR=2.46, 95% CI: 1.27-4.78, p=0.008), septic shock (OR =2.46, 95% CI: 1.27-4.78, p=0.008), reintubation (OR=2.70, 95% CI: 1.82-4.02, p<0.001), and renal failure (OR=2.05, 95% CI: 1.43-2.94, p< 0.001). Conclusions: The 11-item modified Frailty Index predicted adverse outcomes in geriatric vascular surgery patients. Its use in risk stratification may improve perioperative management. Keywords: Frailty; Vascular Surgical Procedures; Geriatrics; Risk Assessment; Mortality

Aim: In our study, we aimed to comparatively examine the effect of HbA1c levels and diabetes disease on patients undergoing isolated coronary bypass surgery. Material and Methods: 200 consecutive patients (152 male, 48 female, mean age 61.1) who underwent coronary artery bypass surgery (CABG) in our hospital were included in the study. The patients were divided into two groups. Group 1 consisted of patients with HbA1c ≥6.5 % (n=100) and group 2 consisted of patients with HbA1c 7.65% was the threshold value for occurrence of mediastinitis with a sensitivity of 80% and specificity of 65.6%. Conclusion: As a result, poor control of blood glucose levels following CABG is a risk factor for infection and HbA1c is a significant marker for identification of preoperative infection risk.