Here we present a 47-year-old male diagnosed with a pseudocoarctation of the aorta and a funnel-like subclavian artery aneurysm with a large orifice and severe aortic valve insufficiency. The patient underwent a two-stage repair for both pathologies. After an aortic valve replacement, postcardiotomy pericardial effusion occurred and was medically managed. Six months later, the patient underwent a distal arcus aorta and subclavian artery replacement with a left posterolateral thoracotomy as the second stage. Due to the strict adhesions, pulmonary veins were not cannulated and an extracorporeal bypass between the pulmonary artery and femoral artery was used for distal body perfusion. The coincidence of subclavian aneurysms and a pseudocoarctation of the aorta is rare and a literature review was performed to identify treatment options for this pathology.

Background: To compare the clinical outcomes between isolated aortic valve replacement (AVR) using a conventional stented bioprosthetic valve (St. Jude, Epic™ Valve Porcine) and a sutureless bioprosthetic valve (Perceval). Methods: This single-center retrospective study evaluated 160 patients who underwent isolated surgical minimally invasive AVR between January 2020 and December 2024. Demographic, intraoperative, and postoperative data, as well as echocardiographic findings, were analyzed and compared. Results: Patients were divided into two groups: Perceval (n = 73) and St. Jude (n = 87). Patients in the Perceval group were older and had higher EuroSCORE 2 scores. The Perceval group showed significantly shorter cardiopulmonary bypass and aortic cross-clamp times (53.45 ± 24.18 vs. 68.02 ± 21.05 min; p < 0.001; and 40 ± 20.11 vs. 53.24 ± 17.34 min; p < 0.001). The intensive care unit (ICU) stay, intubation time, and hospital discharge time were significantly shorter in the Perceval group (p < 0.05). The requirement for inotropic support was also lower (2.8% vs. 24.1%, p < 0.001). At the 30-day follow-up, the perceval group had significantly lower mean and maximum transvalvular gradients. Complication rates were low in both groups, with one case of permanent pacemaker implantation and two reinterventions in the Perceval group. Conclusion: Sutureless AVR with a Perceval valve is a safe and effective alternative to conventional stented bioprostheses, particularly in elderly patients. It offers shorter operative times and improves early postoperative recovery without compromising the clinical or hemodynamic outcomes.

This study aims to compare the clinical outcomes of isolated aortic valve replacement using a sutureless bioprosthetic valve (Perceval) and Transcatheter Aortic Valve Implantation (TAVI). This single-center retrospective study evaluated 143 patients who underwent isolated surgical minimally invasive aortic valve replacement and TAVI procedures between January 2020 and February 2025. Demographic, intraoperative, and postoperative data as well as perioperative echocardiographic findings were analyzed and compared. The patients were divided into 2 groups: Sutureless (n = 73) and TAVI (n = 70). The Intensive care unit stay, intubation time, and hospital discharge time were significantly shorter in the TAVI group ( P < .05). The requirement for inotropic support was also lower (2.8% vs 24.1%, P < .001). At the 30-day follow-up, the TAVI group had significantly lower mean and maximum transvalvular gradient. The need for pacemaker implantation was significantly higher in the TAVI group ( P = .001). Pacemakers were implanted in 1.4% of patients in the sutureless group and 17.1% of patients in the TAVI group. The sutureless group had a significantly longer mean discharge time (5.47 ± 2.86 days) compared to the TAVI group (3.89 ± 2.93 days; P = .001). Similarly, intubation time was significantly longer in the sutureless group (11.90 ± 5.84 hours) compared to the TAVI group (3.37 ± 19.17 hours; P = .001). TAVI is a safe and effective alternative in appropriately selected patients, offering shorter operative times and improved early postprocedural recovery without compromising clinical or hemodynamic outcomes.

Hemorrhage is one of the major complications of cardiac surgery when using cardiopulmonary bypass (CPB). Despite all kinds of medical and surgical treatment, post bypass bleeding is still a serious problem. Hypothermia, acidosis, hypovolemia, and hypoperfusion lead to disruption of the coagulation process in severe trauma as well as in CPB. Hyperfibrinolysis (HF) is a life-threatening bleeding disorder in major trauma patients. The incidence of HF has been estimated in the range of 15% to 20%. The gold standard for the detection of HF is thrombelastography or thromboelastometry. Blood products and tranexamic acid are used in the treatment of hyperfibrinolysis. The agents that can be used as an alternative to tranexamic acid in HF treatment are aprotinin and epsilon aminocaproic acid. Early diagnosis and treatment of HF are life-saving. For this purpose, we wanted to share this rare pathology.