Notes

Foregut Dysmotility inside the Bronchi Transplant Affected person.
Background This study aims to present our experience with endobronchial coils in patients who underwent endobronchial lung volume reduction due to advanced emphysema. Methods The study included 46 patients (45 males, 1 female; mean age 61.7±8 years; range, 43 to 80 years) who underwent endobronchial lung volume reduction with endobronchial coils for advanced emphysema. Patients" age, gender, pulmonary function tests, post-treatment morbidity, mortality, pre- and post-treatment (6 months) six-minute walking distance, modified Medical Research Council dyspnea scores, chronic obstructive pulmonary disease assessment test and Hospital Anxiety and Depression Scale scores were recorded. Results Patients had an average of 65 pack/year smoking history. An average of 11 (range, 9-15) coils were placed per lobe (right upper lobe=35, left upper lobe=19, right lower lobe=2, left lower lobe=4). Mean follow-up duration was 12.6 months (±5.6 months). Post-treatment forced expiratory volume in one second, residual volume and six-minute walking distance values were improved with statistical significance. Also, significant improvement was seen in quality of life, quantified by modified Medical Research Council, chronic obstructive pulmonary disease assessment test and Hospital Anxiety and Depression Scale scores. While no immediate major postoperative complications occurred, three patients developed chronic obstructive pulmonary disease exacerbation, two developed pneumonia, and one developed recurrence of previous neurologic disorder within 30 days. Conclusion Endobronchial coil administration provides lower morbidity and mortality compared to lung volume reduction surgery as well as significant improvement in pulmonary functions and quality of life in selected patients with advanced emphysema. Copyright © 2019, Turkish League Against Rheumatism.Background This cross-sectional study aims to evaluate the changes in quality of life after minimally invasive procedures in patients with varicose veins. Methods The study included 150 patients (58 males, 92 females; mean age 47.1±12.0; range, 19 to 80 years) with varicose veins who were treated using minimally invasive techniques. Data were collected using patient information forms and the Venous Insufficiency Epidemiological and Economic Study-Quality of life/Symptoms questionnaire. Before the minimally invasive procedures, patients were informed about varicose veins and medical approaches for relief. They were also provided information about the use of compression stockings. Varicose vein symptoms and quality of life were evaluated before the minimally invasive procedures and four weeks following the last operation. Results Females, individuals aged between 51-60 years, those with Body Mass Index >30, or having had a pregnancy had higher prevalence of variceal disease and lower quality of life. Clinical severity of the disease decreased and the quality of life improved in patients treated with minimally invasive procedures. After treatment, 45.33% of patients put on compression stockings regularly for one month. Conclusion After minimally invasive treatment, severe disease symptoms decreased and quality of life increased in patients with varicose veins. Lifestyle modifications, use of compression stockings, and roles of nurses and healthcare workers are significant in maintaining healthy veins. Copyright © 2019, Turkish League Against Rheumatism.Background This study aims to compare the patency rates of radiocephalic arteriovenous fistulas prepared preserving the perivenous vascular tissues versus those prepared using the conventional technique. Methods A total of 169 patients (107 males, 62 females; mean age 59.5 years; range, 39 to 87 years) who underwent a radiocephalic arteriovenous fistula construction were included in this study. In 95 patients, the tissues surrounding the cephalic vein were stripped off as per the conventional method, while the no-touch technique preserving the perivenous vascular tissues was utilized for vein harvesting in 74 patients. Patients were followed-up to compare primary and secondary patency rates of the arteriovenous fistulas at one year. Results Fistula failure developed in 22 patients within the first year resulting in primary patency rates of 90.5% versus 84.2% for the no-touch and the conventional groups, respectively (p=0.225). Likewise, secondary patency rates were 94.6% versus 93.7% for the no-touch and the conventional groups, respectively (p=0.803). The two groups did not differ with regards to primary or secondary patency rates. Conclusion Findings of this study were not in favor of the no-touch technique compared to the conventional methods in terms of arteriovenous fistula patency at one year. this website Copyright © 2019, Turkish League Against Rheumatism.Background This study aims to evaluate the effect of contralateral internal carotid artery stenosis on postoperative stroke and mortality rate and blood pressure alterations following carotid artery endarterectomy. Methods Between January 2009 and April 2017, a total of 152 carotid artery endarterectomy operations in 141 consecutive patients (30 females, 111 males; mean age 70.0±10.2 years; range, 48 to 92 years) with internal carotid artery stenosis were retrospectively analyzed. The patients were divided into two groups as those with contralateral internal carotid artery stenosis 0.05) between the groups. The patients with contralateral severe internal carotid artery stenosis were younger (p=0.005). Conclusion The present study shows that the presence of a contralateral severe internal carotid artery stenosis does not increase the risk of postoperative stroke and mortality rates and blood pressure alterations. Therefore, carotid artery endarterectomy can be performed with acceptable complication rates in patients with contralateral severe internal carotid artery stenosis with strict perioperative hemodynamic monitoring. Copyright © 2019, Turkish League Against Rheumatism.Background In this study, we present our early and mid-term results of endovascular aneurysm repair in patients with infrarenal abdominal aortic aneurysms. Methods Between December 2011 and January 2017, a total of 154 patients (136 males, 18 females; mean age 71.7 years; range, 55 to 94 years) who underwent endovascular aneurysm repair were retrospectively analyzed. Data including demographic characteristics of the patients, pre-procedural additional diagnoses, mortality and morbidity rates, length of intensive care unit and hospital stays, amounts of blood products used, complications and reinterventions were recorded. Results Seven patients underwent intervention in the emergency setting due to aneurysm rupture, while 147 patients received elective surgery. The mean follow-up was 35 (range, 12 to 72) months, the mean length of intensive care unit stay was 1.1 (range, 1 to 4) days, and the mean length of hospital stay was 3.1 (range, 3 to 7) days. A mean 0.3 units of erythrocyte suspension was used during the treatment. Endoleak developed in 16 patients, occlusion in the graft leg in two patients, increased aneurysmal diameter in six patients, and wound healing problems in five patients. Cross femoral bypass was applied in two patients, balloon dilation in three patients, proximal extension in three patients, and distal extension in four patients. Intraoperative mortality occurred in one patient. The total mortality rate was 7% and first 30-day mortality rate was 2%. Conclusion Our study results suggest that endovascular aneurysm repair has certain advantages including a low operative mortality rate, short intensive care unit and hospital stays, and less blood product use. In addition, this technique can be performed with regional anesthesia in high-risk comorbid patients. Copyright © 2019, Turkish League Against Rheumatism.BACKGROUND In this study, we aimed to investigate the effect of central venous catheterization under ultrasound guidance on the success and complication rates in low-weight infants (under 5 kg) undergoing surgery due to congenital heart disease. link2 METHODS A total of 70 infants (38 boys, 32 girls; mean age of patients less then 1 month was 16.4±9.5 days [n=20; 28.6%]; 1-7.5 months was 126.3±47.8 [n=50; 71.4%]) who underwent ultrasound-guided internal jugular venous catheterization between October 2014 and October 2015 were retrospectively analyzed. All catheterizations were done under the guidance of ultrasound by two skilled anesthesiologists. Data including demographic characteristics of the patients, procedural success rate, catheter access time, number of attempts, and complications were recorded. RESULTS The overall success rate of the procedure was 92.8% (n=65). In 82% of the patients (n=53), the insertion was successful at the first attempt. The mean catheter access time (time from the first puncture to the catheter insertion) was 214±0.48 sec. Complications were seen in five patients (7.14%), and the body weight of these patients was less than 2,500 g. There was no arterial puncture in any patients. One patient (1.42%) developed pneumothorax and four patients (5.7%) developed hematoma due to repeated attempts. CONCLUSION Our study results suggest that ultrasound-guided central venous cannulation is a safe and effective technique in pediatric population weighing less than 5 kg undergoing congenital heart surgery. Copyright © 2019, Turkish League Against Rheumatism.Background TThis study aims to investigate the effect of the Jackson-Pratt drain on sternal wound complications in patients with a Body Mass Index of ≥30 kg/m2 undergoing open cardiac surgery via median sternotomy. Methods A total of 174 patients (124 males, 50 females; mean age 58.2±10.4 years; range, 33 to 78 years) with a Body Mass Index of ≥30 kg/m2 undergoing cardiac surgery via median sternotomy between January 2011 and December 2015 in our institution were retrospectively analyzed. Of the patients, 94 were inserted a Jackson-Pratt drain (JP group) following median sternotomy, while 80 patients received no drain (non-JP group). Pre-, intra, and postoperative outcomes of both groups including type of operation, length of hospital stay, and complications were compared. Results No significant difference in the age, gender, Body Mass Index, and potential risk factors was found between the groups. link3 The median of stay in the intensive care unit was two days and the median time from operation to discharge was seven days in both groups. There was a statistically significant difference in the rate of sternal wound complications between the groups. Sternal wound complications occurred in two patients (2.1%) in the drained group, compared to nine patients (11.25%) in the non-drained group (p=0.01). Conclusion Our study results show that Jackson-Pratt drain insertion after median sternotomy in patients with a Body Mass Index of ≥30 kg/m2 undergoing open cardiac surgery is a simple and reliable method to reduce the risk of postoperative sternal wound complications, compared to the conventional closure technique. Copyright © 2019, Turkish League Against Rheumatism.Background In this study, we present operation technique and outcomes of transaortic mitral valve repair in high-risk patients undergoing aortic valve replacement due to severe aortic stenosis. Methods Between January 2005 and March 2016, a total of 11 patients (7 females, 4 males; mean age 71.2±4.1 years; range, 65 to 77 years) with severe aortic valve stenosis (aortic valve area 5%, left ventricular ejection fraction less then 30%) who were operated were retrospectively analyzed. Aortic valve replacement and transaortic mitral edge-to-edge repair was applied to all patients. Operations were performed through sternotomy, cardiopulmonary bypass, and bicaval venous return. Transesophageal echocardiography was used to evaluate mitral valve before surgery and valve functions after surgery. Postoperative course of all patients was monitored, and postoperative complications were recorded. Results The mean preoperative ejection fraction was 24.5±4.1% and the mean transaortic pressure gradient was 35.8±4.8 mmHg. The mean aortic cross-clamp time was 62.
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