Background/Objectives: Tricuspid valve surgery carries a high risk of postoperative acute kidney injury (AKI) due to pre-existing right ventricular dysfunction and congestive end-organ remodeling. We aimed to evaluate the incidence and predictors of postoperative AKI, with particular focus on the prognostic value of the TAPSE/sPAP index. Methods: This retrospective, single-center study evaluated adult patients who underwent tricuspid valve surgery (isolated/concomitant) between 2010 and 2025. The primary outcome was postoperative AKI of any stage, defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Predictors were identified using a pre-specified multivariable logistic regression model including baseline estimated glomerular filtration rate (eGFR), cardiopulmonary bypass time, and EuroSCORE II; TAPSE/sPAP associations with severe renal outcomes were assessed univariably and presented as exploratory. Results: Of 80 patients, postoperative AKI occurred in 32 (40.0%), with 16 (20.0%) requiring renal replacement therapy. The pre-specified multivariable model discriminated any-stage AKI (AUC 0.86, 95% CI 0.77-0.94). Lower baseline eGFR (adjusted OR 1.82 per 10 mL/min/1.73 m2 decrease, p < 0.001) and higher EuroSCORE II (adjusted OR 1.53 per point, p = 0.03) were independent predictors. The TAPSE/sPAP index was not associated with any-stage AKI (p = 0.42), but lower values predicted advanced renal outcomes, including KDIGO stage ≥ 2 AKI (OR 2.11, p = 0.03) and the requirement for renal replacement therapy (OR 2.71, p = 0.01). Outcomes did not differ between isolated (n =14) and combined procedures (n = 66; AKI 35.7% vs. 40.9%, p = 0.77). Conclusions: Lower preoperative eGFR and higher EuroSCORE II independently predict any-stage postoperative AKI. In univariable analysis, the TAPSE/sPAP index identified the subgroup with severe renal outcomes; this exploratory finding requires prospective validation. Whether perioperative renal protection depends on addressing right-sided filling pressures rather than augmenting forward flow alone requires prospective testing.

ABSTRACT Objective: Postoperative cognitive dysfunction (POCD) is characterized by symptoms that may inhibit planning, such as dementia, memory loss, attention deficiency, and behavioral impairment. Although it is frequently in cardiac surgery, all manner of surgery can cause POCD. In this manuscript, we aimed to show the existence of a correlation among neuroinflammation markers High-mobility group box 1 (HMGB1) and YKL-40 and neurotrophic factors; brain-derived neurotrophic factor (BDNF) and Nerve growth factor (NGF), with the cognitive functions. Material and methods: Twenty-four patients who underwent coronary artery bypass graft (CABG) were analyzed prospectively. Preoperative 2nd and postoperative 5-7th day blood samples were collected, and we performed cognitive test synchronously. Correlations between YKL-40, BDNF, NGF, HMGB1, and cognitive test score (CTS) were examined. Results: We found a significant postoperative decrease in NGF (p=0.006). There was a positive correlation between NGF and postoperative CTS (r=0.542, p=0.006). Postoperative memory score was increased (p

Aim: Ischemia-reperfusion injury (IRI) results in oxidative stress. The present research investigates ozone administration in rats IRI through histopathological and biochemical assessments. Material and Methods: We assigned 24 rats, Wistar albino, into four randomized groups (n = 6 each): S, O, IRI and IRI + O. The aorta was clamped for 45 minutes, and reperfusion was followed by 120 minutes to induce IRI. Ozone (0.7 mg/kg, intraperitoneal) was administered before the reperfusion period in the IRI + O and without ischemia in the O. Muscle tissues were evaluated histopathologically in terms of neutrophil infiltration, hemorrhage, interstitial edema, and myocyte damage. In addition, biochemical analyses were performed to measure malondialdehyde (MDA) and glutathione (GSH) levels. Results: Remarkably elevated MDA values were found in the IRI than the S and O. (p=0.007 and 0.006, respectively). Although ozone reduced MDA in the IRI + O, this reduction did not meet statistical significance. GSH values were considerably decreased in the IRI according to the S and O (p=0.010 and p=0.001, respectively); but, they were elevated in the IRI + O than the IRI (p=0.007). Histopathology demonstrated significantly reduced hemorrhage, neutrophil infiltration, muscle injury, and interstitial edema in the IRI + O than the IRI (p<0.001, p=0.037, p=0.042, and p=0.029, respectively). Conclusion: Ozone therapy mitigates IR–induced skeletal muscle injury by reducing histological alterations and enhancing antioxidant defenses in rats. These findings suggest ozone as a potential agent in IRI management; however, further research is required to optimize dosing and timing.

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.

Aim: Although the precise process is not entirely elucidated, it is well-known that oxidative stress mediators contribute to ischemia-reperfusion (I/R) injury. The impact of silymarin on I/R injury in many different tissues has been examined. For this purpose, we planned to see the effect of silymarin on muscle tissue in rats subjected to lower extremity I/R injury. Material and Methods: We used 18 male Wistar albino rats weighing 225-275 g. Each of the three groups of rats [Control (C), Ischemia-Reperfusion (I/R), and Silymarin-Ischemia/Reperfusion (S-I/R)] consisted of six rats. Silymarin was administered intraperitoneally 30 minutes before the procedure. (100 mg/kg-1) In Group I/R, the infrarenal abdominal aorta was clamped with a microvascular clamp. The clamp was removed after 120 minutes, and reperfusion was achieved for the next 120 minutes. At the end of the reperfusion period, muscle tissue samples were collected, and Malondialdehyde (MDA), catalase (CAT) enzyme activity levels and histopathological parameters were compared. Results: In the histopathological examination, no degeneration was observed in the muscle fibers in the Group C, while findings of striated muscle damage such as muscle atrophy/hypertrophy, muscle degeneration/congestion, internalization of the muscle nucleus/oval/central nucleus, fragmentation/hyalinization and leukocyte cell infiltration were seen in the Group I/R. In Group S-I/R, muscle atrophy /hypertrophy, internalization of the muscle nucleus/oval/central nucleus, fragmentation/hyalinization, and leukocyte cell infiltration were observed to improve these damaged areas compared to Group I/R. MDA levels in the Group I/R were significantly higher compared to Group C and S-I/R. The activity of the CAT enzyme was much higher in Group I/R compared to Group C. Conclusion: Our study revealed that 100 mg/kg-1 silymarin administered by intraperitoneal injection 30 minutes before ischemia effectively decreased lipid peroxidation, oxidative stress, and the injury caused by I/R in muscle histology in rats. [Turk J Vasc Surg 2024; 33(3.000): 171-5]

Objective: Ischemia is characterized by an inadequate supply of nutrients and oxygen due to reduced blood circulation to specific tissues or organs. Reperfusion injury refers to the detrimental effects of abrupt exposure of the ischemic tissue to elevated oxygen levels and subsequent generation of reactive oxygen derivatives inside the tissue. In surgical procedures characterized by frequent occurrences of ischemia-reperfusion (I/R), such as transplant and cardiovascular surgery, it is crucial to prioritize the preservation of tissue integrity and mitigation of associated damage. In this study, we formulated a hypothesis suggesting that carvacrol (Car), an aromatic hydrocarbon present in some plant species, might decrease I/R injury by implication of its antioxidant, anti-apoptotic, and anti-inflammatory functions. Methods: We planned our study with 18 rats, randomly divided into three groups: control group, I/R group, and I/R + Car group. In the control group, laparotomy was performed only, and blood and lower limb muscle tissue samples were taken. In the I/R group, after laparotomy, lower extremity ischemia is achieved for 60 min, and reperfusion is achieved for another 60 min. In I/R + Car, rats were administered 100 mg/kg Car via intraperitoneal injection 30 min after ischemia. Then, 60 min of ischemia and 60 min of reperfusion were achieved. Lower limb muscle samples were examined both histologically and biochemically. We evaluated the levels of malondialdehyde (MDA), glutathione-S transferase (GST), and catalase (CAT). In addition, serum ischemiamodified albumin (IMA) levels were measured. Results: Our study showed that the findings of I/R injury decreased prominently in the I/R + Car group's samples. GST, MDA, CAT, and IMA levels were significantly higher in the I/R group than in the control and I/R + Car groups. (p=0.024, p=0.010, p=0.030 and p<0.0001; respectively). Histopathological examination revealed no degeneration in the control group. Conversely, contraction, hypertrophy, nucleus degeneration, necrotic fibers, and hyalinization were observed in the I/R group. In the I/R + Car group, inflamed areas were less frequent than in the I/R group, and vascular dilatation of myofibre was noted. Conclusion: This study demonstrates that the Car molecule protects against I/R injury. Therefore, we contend that more experimental cohort investigations are needed to examine the impact of the Car molecule on preventing I/R injury.

Background and Objectives: Lower limb skeletal muscle ischemia–reperfusion (IR) injury is associated with increased morbidity and mortality, and it is common in several clinical situations such as aortic aneurysms repairment, peripheral arterial surgery, vascular injury repairment, and shock. Although it is generally accepted that oxidative stress mediators have a significant role in IR injury, its precise mechanism is still unknown. Anecdotally, it is sustained not only by structural and functional changes in the organ it affects but also by damage to distant organs. The purpose of this report is to illustrate the effect of proanthocyanidin on IR injury. Materials and Methods: In our study, 18 male Wistar albino rats were used. The subjects were divided into three groups containing six mice each (control, C; ischemia–reperfusion, IR; ischemia–reperfusion and proanthocyanidin; IR-PRO). Intraperitoneal proanthocyanidin was given to the IR and proanthocyanidin groups 30 min before laparotomy, and 1 h ischemia led to these two groups. After one hour, reperfusion started. Muscle atrophy–hypertrophy, muscle degeneration–congestion, fragmentation–hyalinization, muscle oval-central nucleus ratio, leukocyte cell infiltration, catalase enzyme activity, and TBARS were all examined in lower-limb muscle samples after one hour of reperfusion. Results: When skeletal muscle samples were evaluated histopathologically, it was discovered that muscle atrophy–hypertrophy, muscle degeneration–congestion, fragmentation–hyalinization, and leukocyte cell infiltration with oval-central nucleus standardization were significantly higher in the IR group than in the C and IR-P groups. Oval-central nucleus standardization was significantly higher in the IR and IR-PRO groups than in the control group. TBARS levels were significantly higher in the IR group than in the control and IR-PRO groups, while catalase enzyme activity was found to be significantly lower in the IR group than in the control and IR-PRO groups. Conclusions: As a consequence of our research, we discovered that proanthocyanidins administered before IR have a protective impact on skeletal muscle in rats. Further research in this area is required.

Objective: Aortic cross -clamping and postischemic myocardial dysfunction are fundamentally related to myocardial protection during open-heart surgery. Various cardioplegia solutions have been developed because of this issue. del Nido cardioplegia (DNC) solution is one of these solutions and has a vital impact on metabolic markers and cardiac protection in individuals of all ages. This study aimed to examine the effects of DNC on the perioperative follow-up period after cardiac surgery. Methods : Preoperative and postoperative variations in selected biochemical and hematological variables of 71 patients who underwent open-heart surgery in our medical faculty between 2018 and 2020 were retrospectively examined and compared with normal values. SPSS 20.0 statistical software was used, and a statistically significant difference was defined as p<0.05. Results: Hemoglobin, platelet, albumin, and uric acid levels were significantly lower at the end of cardiopulmonary bypass and the postoperative 24 th hour than in the preoperative period. At the end of the cardiopulmonary bypass and the postoperative 24 th hour, aspartate aminotransferase and lactate dehydrogenase levels were significantly greater than those in the preoperative period. Remarkable increases in hemoglobin, albumin, urea, and platelets in the postoperative 24 th hour compared with the end of cardiopulmonary bypass were noted. We also reported substantial differences in glucose, lactate, creatine kinase-MB, and troponin levels. Conclusion: We found significant changes in different parameters critical for the perioperative period of open-heart surgery. Although our study found DNC to be a safer option, additional research into clinical usage is required.

Objective: We aimed to investigate antiplatelet drug resistance utilizing light transmission-lumiaggregometry (LT-LA) and the Platelet Function Analyzer-100 (PFA-100) in patients undergoing cardiovascular surgery. Materials and Methods: The study included 60 patients diagnosed with stable coronary artery disease and peripheral vascular diseases that required surgery. 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 by LT-LA and closure time by the PFA100 were used to measure antiplatelet drug resistance. Results: Based on the adenosine diphosphate (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 >= 70% in 43% of patients for ADP and 28% for collagen by LT-LA. Elevated ADP (>= 0.29 nmol) and collagen (>= 0.41 nmol)-induced adenosine triphosphate release were found by LT-LA in 66% of patients utilizing an ADP agonist and 80% of patients using a collagen agonist undergoing ASA therapy. Closure times obtained with the PFA-100 were normal in 28% of patients using collagenADP cartridges and 62% of patients using collagen-epinephrine (CEPI) cartridges who received ASA. Recurrent thrombosis and bleeding were observed in 12 (20%) patients with cardiovascular disease. Three of these individuals (25%) showed ASA resistance with normal responses to ADP -induced aggregation (>= 7010) and secretion (>= 0.29 nmol), as well as normal CEPI closure times. Conclusion: Our findings suggest that antiplatelet drug monitoring by LT -LA and PFA-100 may be useful for high -risk and complicated cardiovascular patients.

Cardiovascular diseases are the most common causes of death in the world and in our country. Heart transplantation maintains its importance in terminal heart failure. A 32-year-old woman who underwent a heart transplant 14 years ago, presented with complaints of nausea, vomiting, diarrhea. As a result of colonoscopy, "Graft Versus Host Disease (GVHH) was detected in the gastrointestinal tract and a successful medical treatment was performed.

Cardiovascular diseases are among the most common causes of death in the world and in our country.Venous Thromboembolism (VTE) is the most important cause of mortality after DVT.Survival is worse in patients with cancer diagnosed concomitantly with deep vein thrombosis.However, information on specific malignancies is limited.If the treatment is started after DVT and the etiology is not investigated, new diagnosis malignancy treatment may be delayed and cause mortality, especially in elderly patients.Our patient, 58 years old, was diagnosed with DVT,after the dvt clinic did not regress and was investigated for malignancy. Left Renal Cell Carcinoma was diagnosed and surgically treated.

Aim: We aimed to investigate the effects of HRSS on erythrocyte deformability in lower limb ischemia reperfusion (IR) injury in rats.Methods: Eighteen male Wistar albino rats used in this study. The animals were randomly divided into three experimental groups as control, IR and IR-HRSS. 20 mg.kg-1HRSS was administered (20 mg.kg(-1) i.p)30 min before the procedure. An atraumatic microvascular clamp was placed across the infrarenal abdominal aorta in the IR groups. 120 min ischemia and 120 min reperfusion is applied to the groups. Erythrocytes were obtained from heparinized whole blood samples for deformability measurements. Kruskal-Wallis test was used for independent samples and Mann-Whitney U test was used to analyze differences between groups.Results: Ischemia reperfusion was found to increase relative resistance to the control group. The erythrocyte deformability index was significantly higher in IR and IR-HRSS groups than the control group. HRSS application significantly decreased erythrocyte deformability index compared to IR group.Conclusion: IR induced rats decreased erythrocyte deformability was partially corrected by HRSS. We believe that the protective effects of HRSS in IR injury and its use indications can be demonstrated in detail as long as the findings we have reached in our study are supported by other studies.

Anevrizma, vücuttaki herhangi bir damarın çapında meydana gelen artışla birlikte duvarında incelme olması anlamına gelir.Sıklıkla belirti vermezler

Aneurysm definition includes widening of any blood vessel's diameter and slimming of the vessel's wall at the same time. They are mostly asymptomatic. They bear serious risk of mortality especially when they are present at aorta and intracranial arteries, thus treatment and management guides had been prepared. For surgical treatment of popliteal aneurysms, there are several options including venous grafts, synthetic grafts, homografts and endovascular treatment. In this report, we want to present a case which we used homograft for treatment, to you, our valuable colleagues.

Femoral artery is the most common vascular access site used for angiographic interventions. Various complications such as hematoma, bleeding, dissection, arteriovenous fistula and pseudoaneurysm have been described following iatrogenic puncture. However, angiosarcoma formation at the access site is very uncommon and it poses a diagnostic dilemma due to its resemblance to organized hematoma. A 75-year-old patient who had undergone coronary angiography has suffered from an angiosarcoma and its vascular complications due to local invasion at the puncture site. Although the tumor was completely excised and flow was re-established, he was lost 17 months later because of multiple metastases and their complications. Presence of a persistent mass with vascular complaints should raise suspicion for this rare and aggressive type of tumor.

Aberran sag subklavyen arter, arkus aortanin en sik gorulen konjenital anomalisidir. Siklikla asemptomatik seyreden bu durum, semptomatik oldugunda cerrahi tedavi yapilmasi gerekmektedir. Secilecek olan yaklasim yontemi ve uygulanacak cerrahi teknik hastadan hastaya farklilik gosterdiginden dolayi, olumlu sonuc alabilmek icin iyi bir durum yonetimi yapilmasi gerekmektedir. Biz bu olguyu, gorece sik gorulen bu anomaliyi hatirlatmasi ve uyguladigimiz teknigin diger meslektaslarimiza yol gosterici olmasi amaciyla paylasmayi uygun goruyoruz.

Aberrant right subclavian artery is the most common congenital anomaly of the aortic arc. This situation which is usually asymptomatic, has to be corrected surgically if it becomes symptomatic. Since the surgical approach and method differs from patient to patient, a well made management should have done in order to get positive results. We find suitable to share this case to remind this relatively common anomaly and to make our surgical method as a guide for our colleagues.