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Aim: Our study aims to share the reintervention results of patients who were operated with the diagnosis of Type A aortic dissection and to examine the factors that cause reintervention. Material and Methods: In our single-center retrospective study, 244 patients who underwent surgery due to Type A aortic dissection between November 2010 and June 2021 were included. Results for patients who underwent reintervention and factors which caused reintervention were compared with demographic data, preoperative, intraoperative and postoperative variables. Results: A total of 142 patients were included in the study and 15.5% of them underwent reintervention. Reoperation was performed in 8 (36.4%) of 22 patients who underwent reintervention, while thoracic aortic endovascular repair was performed in 14 (63.6%) patients. Post-procedure mortality was observed in 5 (22.7%) of the patients who underwent reintervention. The mean age of the patients who underwent reintervention was 46.6±13.2 and there was a statistically significant (p [Turk J Vasc Surg 2024; 33(1.000): 10-6]

Giant cell arteritis (GCA) which mostly causes thoracic aortic aneurysm is the most common vasculopathy of medium and large vessels, especially in people over 50 years of age. A 63-year-old male patient presented with pain and swelling in the right inguinal region. On examination, a pulsatile mass was palpable in the right femoral region. Computed tomographic angiography showed aneurysm enlargement reaching 70.9 mm in diameter at the level of the right common femoral artery (CFA). Aneurysm excision and Dacron graft interposition surgery was performed for the patient with local pain symptoms. The patient who had no postoperative complication was discharged 3 days later. Two weeks later, the pathology result of the aneurysm was obtained. Pathological examination of the aneurysm was GCA, and also, temporal artery biopsy was also performed to clarify the diagnosis. In this case report, we report the first defined CFA aneurysm caused by GCA and its surgical treatment. In the patient whom we did not think of as inflammatory arteritis at the first stage, we reached the actual diagnosis with pathology examination. Therefore, we recommend that all surgically removed aneurysm tissues be sent for pathology examination.

ABSTRACT Introduction: Custodiol (histidine-tryptophan-ketoglutarate) and repetitive blood cardioplegia are the solutions for myocardial protection and cardiac arrest. In this study, we aimed to compare immunohistochemical analysis, clinical outcomes, and cardiac enzyme values of Custodiol and blood cardioplegia groups. Methods: This was a randomized prospective study consisting of 2 groups and 20 patients, 10 patients for each group, who underwent mitral and mitral/tricuspid valve surgery. Group 1 was formed for Custodiol cardioplegia and group 2 for blood cardioplegia. Perioperative and postoperative cardiac events were recorded, cardiac enzymes were analyzed with intervals, and myocardial samples were taken for immunohistochemical analysis. Recorded data were statistically evaluated. Results: There was no significant difference for the Custodiol and blood cardioplegia groups in perioperative and postoperative cardiac performance and adverse events. Cardiac enzyme analysis showed no significant difference between groups. However, two parameters (eNOS, Bcl-2) were in favor of the Custodiol group in immunohistochemical studies. Custodiol performed better in cellular oxidative stress resistance and cellular viability. Conclusion: Clinical outcomes and cardiac enzyme analysis results were similar regarding myocardial protection. However, Custodiol performed better in the immunohistochemical analysis.

Objectives: A significant number of videos that provide information about deep vein thrombosis (DVT) are available on YouTube, and the quality of these videos has not been evaluated; therefore, this study aimed to evaluate the quality of these videos. Materials and methods: The terms "deep vein thrombosis," "deep venous thrombosis," and "DVT" were searched on YouTube. The quality of each video was evaluated by three independent vascular surgeons according to the DISCERN score, Journal of the American Medical Association score, and DVT patient information score. Interrater agreement was ascertained. Results: The mean total DISCERN score and mean DVT patient information score of all the videos were 38.2±12.9 and 5.0±3.4, respectively. According to the DVT patient information scoring system, eight (9.3%) videos were categorized as very useful, 37 (43.0%) as moderately useful, and 41 (47.7%) as poor. [Turk J Vasc Surg 2022; 31(2.000): 103-7]

ABSTRACT Introduction: The heart and liver are two organs that are closely related. The Albumin-Bilirubin (ALBI) score is a developed scoring system for assessing liver function. The aims of this study were to examine the correlation between preoperative ALBI score and pulmonary artery pressure and to investigate its ability to predict heart valve surgery mortality outcomes. Methods: The data of 872 patients who underwent isolated and combined heart valve surgery from 2014 to 2021 were retrospectively screened. In the preoperative period, 152 patients with laboratory tests including albumin and total bilirubin were found and analyzed retrospectively. Thirteen of these patients were excluded from the study. The remaining 139 patients were included in the analysis. Baseline demographic data, echocardiography data, performance status, laboratory data, operative data, and postoperative status were collected. The optimal cutoff value of preoperative ALBI score was calculated. Results: The cutoff for ALBI scores was calculated as -2.44 to predict in-hospital mortality (sensitivity = 75.0%, specificity = 70%). Based on the cutoff value, 90 patients had a low ALBI score (≤ -2.44, 64.7%) and 49 patients had a high ALBI score (> -2.44, 35.3%). High ALBI score was associated with an increased incidence of acute kidney injury and in-hospital mortality, and a positive correlation was found between ALBI score and pulmonary artery pressure. Conclusion: In patients with valvular surgery, high ALBI score was an independent prognostic factor of in-hospital mortality and acute kidney injury. It is easily measurable and a cost-effective way to predict mortality.

ABSTRACT Introduction: Infective endocarditis is a disease that progresses with morbidity and mortality, afecting 3-10 out of 100,000 people per year. We conducted this study to review the early outcomes of surgical treatment of infective endocarditis. Methods: In this retrospective study, 122 patients who underwent cardiac surgery for infective endocarditis in our clinic between November 2009 and December 2020 were evaluated. Patients were divided into two groups according to in-hospital mortality. Demographic, echocardiographic, laboratory, operative, and postoperative data of the groups were compared. Results: Between November 3, 2009, and December 7, 2020, 122 patients were operated for infective endocarditis in our hospital. Emergency surgery was performed in nine (7.3%) patients. In-hospital mortality occurred in 23 (18.9%) patients, and 99 (81.1%) patients were discharged. In-hospital mortality was related with older age, presence of periannular abscess, New York Heart Association class 3 or 4 symptoms, low albumin level, high alanine aminotransferase level, and longer cross-clamping time (P

Objectives: In this study, we present our experiences on peripheral vacuum-assisted closure (VAC) applications in our clinic. Patients and methods: Between January 2012 and December 2019, a total of 64 patients (40 males, 24 females; mean age 67.9 years; range, 35 to 94 years) undergoing peripheral VAC therapy were retrospectively analyzed. The VAC system was changed at weekly intervals, until a negative culture was obtained or laboratory values returned to normal ranges and were not suggestive of infections. Results: In 16 patients (25%), the main indication for VAC was previous femoral pseudoaneurysm repair. Escherichia coli was the most commonly isolated strain from the wound site. The mean length of hospital stay was 54.1 days. Conclusion: Peripheral wound infections cause a significant increase in the length of hospital stay, cost, and mortality. Vacuum-assisted closure applications may reduce these rates. It is an ideal method to be used throughout surgery to fight against surgical site infections. [Turk J Vasc Surg 2020; 29(2.000): 95-100]

Objectives: This study aims to evaluate the effect of referral and transfer of patients with acute type A aortic dissection (AAAD) and treatment outcomes in the emergency setting. Patients and methods: A total of 131 patients (75 males, 56 females; mean age 52.2±13.1 years; range, 18 to 80 years) who underwent surgery due to AAAD in the emergency setting in our center between January 2010 and December 2017 were included in the study. The patients were divided into two groups as those who were diagnosed with AAAD in another health care facility and transferred to our hospital (Group A, n=65) and those who were diagnosed in our emergency room (Group B, n=66). Results: The rate of postoperative neurological complications was 24.6% in Group A and 12.1% in Group B (p=0.74). The postoperative persistent neurological deficit rate was 10.5% in Group A and 9% in Group B (p=0.456). The overall hospital mortality rate was 23.2% (p=0.310). Hemodynamic instability, age, and cardiopulmonary bypass time were independent risk factors for overall hospital mortality. Conclusion: Although the patients diagnosed with AAAD in another healthcare facility were hemodynamically unstable compared to those diagnosed in our center, the mortality and morbidity rates did not significantly differ. Based on our study results, we recommend transferring such patients to a reference hospital. [Turk J Vasc Surg 2020; 29(1.000): 19-25]

Abstract Ascending aortic pathologies may be life-threatening. Postoperative aortic root dehiscence is a very rare but extremely dangerous complication with a high mortality rate, and redo surgery is mandatory due to high risk of spontaneous rupture. We present three cases that had undergone Bentall procedure and had postoperative aortic root dehiscence. One of the patients presented with hemiplegia caused by septic embolus while the others had mild symptoms. Dr. Yakut’s modified Bentall procedure, the flanged technique, was performed for each patient in redo surgery. Two patients were successfully discharged from the hospital, but one died due to intracranial hemorrhage and multiple organ failure.

Objectives: This study aims to compare midterm results of patch angioplasty with primary closure techniques in patients undergoing carotid endarterectomy (CEA) in terms of restenosis. Patients and methods: This prospective, single-center, randomized study included a total of 137 patients (42 females, 95 males; mean age 64.4±8.8 years; range 36 to 86 years) who underwent CEA between January 2010 and October 2015. The patients were divided into two groups: the patch angioplasty group (n=70) and the primary closure group (n=67). The mean follow-up was 2-7 years. Carotid computed tomography angiography was performed to evaluate restenosis. Restenosis was defined as a lesion of >70% in diameter. Results: During midterm follow-up, there was no statistically significant difference in the restenosis rate between the two surgical closure techniques (p=0.729). Conclusion: Our study results show that the restenosis rate is similar using both closure techniques in patients undergoing CEA. [Turk J Vasc Surg 2019; 28(1.000): 19-23]

Abstract Objectives: To investigate the association between clinical hematologic parameters and saphenous vein graft failure after on-pump coronary artery bypass surgery. Methods: A total of 1950 consecutive patients underwent isolated on-pump coronary artery surgery between November 2010 and February 2013. Of these, 284 patients met our inclusion criteria; their preoperative clinical hematological parameters were retrospectively obtained for this cohort study. And of them, 109 patients underwent conventional coronary angiography after graft failure was revealed by coronary computed tomography angiography. The primary endpoint was to catch at least one saphenous vein graft stenosis or occlusion following the coronary angiogram. We then analyzed risk factors for graft failure. In sequential or T grafts, each segment was analyzed as a separate graft. Results: In logistic regression analysis, older age, platelet distribution width, and diabetes mellitus were identified as independent predictors of saphenous vein graft failure (P