It is known that COVID-19 patients may experience endothelial cell inflammation, apoptosis, dysfunction, and systemic coagulation disorders. In CABG operations, graft patency plays a crucial role in survival and morbidity. Thrombosis and endothelial cell inflammation in grafts can pose challenges for CABG candidates with a history of COVID-19. This study aimed to evaluate the vasculitic effects of a history of COVID-19 among CABG patients. A total of 94 consecutive patients, including 34 with a history of COVID-19 and 60 without, who were scheduled for CABG at our clinic, were included in the study after informed consent was obtained. Patients with a history of COVID-19 underwent surgery at least 4 weeks after the recovery of infection. Thromboembolic events were monitored throughout the hospital stay, and vascular grafts obtained during surgery were pathologically evaluated for signs of vasculitis and inflammation. All COVID-19 (n = 34) cases were mild. Statistical analysis revealed no significant difference between the groups regarding vein thrombosis/thrombophlebitis (p = 0.626). Additionally, pathological evaluation showed no signs of vasculitis or inflammation. There were also no significant differences in postoperative mortality and morbidity between the two groups (p > 0.05). Based on our findings, undergoing CABG surgery after a four-week recovery period appears to be safe for patients with a history of mild COVID-19, at least in terms of early postoperative vascular outcomes.

Aortic arch disease is a major cause of acute dissections. Surgical replacement is the current curative treatment for aortic arch disease. While traditional aortic cannulation ensures lower body perfusion, axillary cannulation offers optimum cerebral perfusion. To evaluate the outcomes of aortic and axillary cannulation methods in hemiarch replacements, focusing on postoperative perfusion and survival. A retrospective analysis was conducted on 91 patients who underwent hemiarch replacement surgery between February 2007 and October 2016. Patients were divided into two groups based on the cannulation method: aortic cannulation (54 patients) and axillary cannulation (37 patients). Data regarding preoperative, intraoperative, and postoperative parameters were analyzed, including demographics, surgical outcomes, and complications. Demographic analysis showed comparable characteristics between the two groups, with notable differences in aortic disease severity and classification. Patients in the axillary group had a larger ascending aorta diameter (57.7 ± 10.8 mm vs. 51.8 ± 5.7 mm, p = 0.002) and a higher prevalence of acute dissections (27.0% (n = 10) vs. 3.7% (n = 2), p = 0.001). Cerebral protection methods varied significantly between the two groups (p < 0.001). Antegrade cerebral perfusion was used in 37.8% (n = 14) of the axillary group compared to 3.7% (n = 2) of the central group. The central cannulation group had a higher proportion of patients with temperatures under 20 °C (98.1% (n = 53) vs. 21.6% (n = 8), p < 0.001), whereas the axillary group maintained higher temperatures (24 –28 °C) in 68.6% (n = 23) of cases. AV repair/replacement was more frequent in the aortic cannulation group (48.2% (n = 26) vs. 18.9% (n = 7), p = 0.013). No significant disparities were observed in operative mortality or intraoperative complications. Statistical analysis showed no significant differences between the two groups in the in-hospital outcomes, but renal complications were more prevalent in the axillary cannulation group with 21.6% (n = 8) experiencing acute kidney injury compared to 9.3% (n = 5) in the central group (p = 0.098). The overall survival rate was slightly higher in the aortic cannulation group at various follow-up periods, yet no statistically significant difference was found between the two groups. We found no significant differences in safety and efficacy between axillary cannulation and aortic cannulation in hemiarch replacement procedures.

Diffuse coronary artery disease remains a critical issue that heart surgeons continue to research in terms of treatment options. An alternative method applied during coronary bypass surgery to achieve complete revascularization is coronary artery endarterectomy. Since the reliability of this technique and its effects on mortality and morbidity are still debated in the literature. Our objective in conducting this study is to determine the mid-term patency rates in patients who underwent LAD endarterectomy and to explore its future applicability. This study reviewed 20 patients who underwent coronary endarterectomy during CABG in our clinic between January 2014 and December 2021. The data, including contrast imaging to check graft patency, were evaluated retrospectively by reviewing hospital archives and patient files. Patients without LAD endarterectomy were excluded from the study. LAD endarterectomy and patch-plasty were performed on all patients in the study. In 17 patients, the LIMA graft was anastomosed onto the patch applied to the LAD. It was observed that 12 of the grafts anastomosed to the LAD (60%) were patent during a mean follow-up period of 32.8 ± 25.9 months. The average 4-year survival rate was found to be 95%. Perioperative myocardial infarction occurred in 5 patients (25%). There was no need for high-dose inotropic support, IABP, or ECMO in the postoperative period. Coronary artery endarterectomy should be considered a viable option for surgeons to achieve satisfactory revascularization in cases where suitable anastomosis sites on coronary arteries to ensure adequate outflow are not available. Our findings align closely with literature reports indicating that endarterectomy performed on the LAD, with LIMA used as the conduit, leads to promising outcomes.

Objectives: Despite the advances in medicine, aortic dissection remains a cardiac surgery emergency with high mortality and morbidity rates. This study examined the effects of the Glue + Felt technique, which uses biological glue and felt to repair the proximal anastomotic site, on the outcomes of patients with acute type A aortic dissection. Methods: A total of 108 patients who underwent surgery for acute type A aortic dissection at our clinic between 2007 and 2020 were included in the study. The patients were divided into two groups: the "Glue + Felt Technique" and the "Bentall-De Bono" groups, based on the surgical technique used for the aortic root. The effects of these two techniques on the development of intraoperative and postoperative complications and survival rates were statistically analyzed. Results: The Glue + Felt technique was used for 76 patients, while the Bentall-De Bono technique was used for 32 patients. The Kaplan–Meier analysis revealed significant differences in survival rates between the two groups over the entire follow-up period, both with and without propensity score matching (p < 0.001 and p = 0.02, respectively). However, no significant differences were observed in comparisons beyond the first 30 days of follow-up, either with or without propensity score matching (p = 0.573 and p = 0.561, respectively). The main factors contributing to this difference were the duration of cardiopulmonary bypass and aortic cross-clamp time (p < 0.05). During the average follow-up period of 46.2 ± 31.6 months, no re-intervention was required in patients from the Glue-Felt technique group. Conclusions: The mortality rate in aortic dissection surgery is higher with more extensive surgical intervention as the duration of cardiopulmonary bypass and aortic cross-clamp time increases. Repairing the lumen and reducing operation time in suitable patients using the Glue-Felt technique for the proximal anastomotic site positively impacts postoperative complications and improves in-hospital and 30-day survival rates, without increasing long-term re-intervention rates.

Extracranial carotid artery aneurysms (ECCA) are rare vascular lesions that may be asymptomatic or present with compression-related symptoms, depending on their size and location. Etiologies include trauma, congenital anomalies, inflammation, atherosclerosis, or prior interventions. Major complications involve cranial nerve compression, rupture, and cerebral thromboembolism. Diagnostic and therapeutic management can be challenging, with treatment options including conservative follow-up, endovascular intervention, or open surgery. We present the case of a 76-year-old woman admitted with visual disturbances and a palpable mass on the left side of her neck. Radiological imaging revealed a 2 cm aneurysm with loop formation in the left internal carotid artery. The aneurysm was treated with open surgical aneurysmectomy and end-to-end anastomosis without grafting. Postoperative recovery was uneventful. Open surgical repair remains a safe and effective treatment, particularly in anatomically complex cases in which endovascular techniques are not feasible due to arterial tortuosity.