Coronary artery involvement is quite rare in the course of Behçet's disease. Complications secondary to coronary artery aneurysms, including rupture, dissection, and myocardial ischemia, may be fatal. In young patients without cardiovascular risk factors, systemic inflammatory vasculitis syndromes should be investigated in case of acute coronary syndrome secondary to dilated coronary arteries. In this report, we present our management strategy in a 31-year-old male patient with Bechet's disease.

Bu araştırmada abdominal aort anevrizmalı (AAA) hastalarda, açık cerrahinin ve endovasküler anevrizma tamirinin (EVAR) erken dönem (ilk 30 gün) sonuçlarının, eşlik eden ek hastalıkların ve risk faktörlerinin retrospektif olarak karşılaştırılması amaçlanmıştır. Merkezimizde Ocak 2002-Aralık 2014 tarihleri arasında non-rüptüre AAA (çap >5cm) sebebiyle, elektif olarak opere edilen 50 hasta incelendi. Hastalar iki gruba ayrıldı; EVAR grubu (n=31) ve açık cerrahi grubu (n=19). Demografik bilgiler (yaş, cinsiyet), semptom (karın ağrısı), risk faktörleri (sigara, hipertansiyon, koroner arter hastalığı, kronik böbrek yetmezliği, diabetes mellitus), anevrizma çapı, hastanede ve yoğun bakımda kalış süresi, kan transfüzyonu miktarı, komplikasyon ve mortalite oranları ile ilgili veriler incelendi. Hastaların cinsiyeti büyük oranda (%94) erkekti. EVAR grubunda kan transfüzyonu miktarı, hastanede ve yoğun bakımda yatış süresi daha düşük saptandı (p

Objective: Peripheral arterial disease (PAD) is a chronic, obstructive and progressive disease that occurs in adult ages, caused by atherosclerosis in the lower extremities. The aim of this study was to determine the prevalence of PAD and related factors. Material and Method: This study is a cross-sectional study conducted with 195 adult individuals between 25 September and 25 December 2016, in the Silivri district of Istanbul. The demographic characteristics, chronic diseases and smoking habit of the individuals were assessed. The walking impairment questionnaire (WIQ) was applied, height and weight of the patients, right and left systolic and diastolic blood pressures, posterior tibial arterial pressures were measured, body mass index (BMI) and ankle-brachial index (ABI) were calculated. Results: Of the participants, 33.8% were male and 66.2% were female. The mean age of the group was 54.1 +/- 13.2 years. Of the participants, 50.8% were smokers or had smoked in the past. PAD prevalence (ABI>1.3) was found to be 47.2% (confidence interval: 38.03-57.86). ABI was found higher in patients with high BMI and those who had smoked and quited smokers. ABI was found to be higher when the BMI was higher. The mean WIQ value of the group was 70.5 +/- 25.4 and the median was 77.8. The mean WIQ value was found to be statistically significantly lower in females, in the higher BMI group, and in the low education level group, and in the group who have hypertension, diabetes and coronary artery disease and PAD symptoms. Conclusion: In this study, the prevalence of PAD was found as 47. 2%. Removal of stated risk factors will provide primary protection and early detection of PAD will provide secondary protection.

Purpose: Patients with one side total/subtotal occlusion and contralateral side critical stenosis are high risk candidates for carotid interventions for the stenosed carotid side. We present our experiences with carotid endarterectomy of the stenosed side after revascularization of the occluded side. Methods: Between March 2010 and September 2013, 85 carotid endarterectomies were performed in seventy-four patients. Among the patients, 6 had one side total/subtotal occlusion and contralateral side ‡ 70% carotid stenosis. Patients received revascularization for the occluded side first followed by of the endarterectomy of the contralateral stenosed part. Results: Four patients had cerebrovascular symptoms ipsilateral to the occluded side. Operations were performed with local anesthesia. Endarterectomy priority was given to the occluded side which was followed by the endarterectomy of the contralateral side after 17.2 – 4.6 days. No neurologic deficit occured during the surgeries and shunt was not required. Mortality did not occur and patients are followed a mean of 18.4 – 6.3 months event free. Conclusion: Endarterectomy of the stenosed carotid artery contralateral to the totally/subtotally occluded side is challenging and carries high risk. The treatment of the occluded side first facilitates the endarterectomy of the contralateral carotid stenosis.

Although endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) has been recognized as less invasive than open surgical repair (OSR), only few outcome studies have closely examined the quality of life factors through a validated survey tool. The purpose of this study was to assess the physical and mental health-related quality of life measures in patients undergoing OSR or EVAR for AAA, using the Medical Outcomes Study Short-Form 36-Item (SF-36) tool.

The diagnosis and management of vascular lesions in the neck is challenging task that requires multidisciplinary approach. The diagnosis and treatment of these lesions is still evolving with high morbidity. So this rarely seen clinical entity still remains difficult to diagnosis and management. We have reviewed our experience with vascular tumors of the neck over a period of 10 years.

for ascending aortic surgery with CPB support and cardiac arrest and/or hypothermic circulatory arrest.

Dissection of the internal carotid artery is very rare; however, it is diagnosed more frequently with increasing radiographic diagnostic tools. Patients may be completely asymptomatic or may present with symptoms ranging between localized pain to severe cerebral ischemic events. Treatment is usually medical or with interventional radiographic tools. In this report, we present surgical management of internal carotid artery dissection in a 61-year-old female patient.

Endovascular stent graft repair of the thoracic aorta sometimes requires debranching of the aortic arch and reimplantation of the left common carotid and left subclavian arteries to the brachiocephalic trunk. Cerebral protection has utmost importance during such a procedure. The surgical technique detailed here offers pulsatile flow inside the internal carotid arteries despite proximal clamping of the common carotid arteries throughout the whole procedure.

Atherosclerosis is a systemic disorder and coronary artery disease may frequently coexist with aortoiliac occlusive disease. Between 2004-2014, three patients were admitted to our institution with coronary artery disease and Leriche syndrome. The patients underwent coronary artery bypass surgery and ascending aortobifemoral bypass simultaneously. One patient underwent additional carotid endarterectomy. The patients were followed over six months. Repeated postoperative computed tomography angiography at three months showed patent coronary and peripheral grafts and no additional lesions were present. In conclusion, simultaneous ascending aortobifemoral bypass appears to be an applicable procedure with promising short and mid-term results in patients receiving coronary revascularization.

Background: We aimed to assess the biochemical and histopathologic effects of Ginkgo biloba extract (EGb) in an ischemia-reperfusion (IR) model of spinal cord ischemia induced by cross-clamping of the infrarenal abdominal aorta.Methods: A total of 24 Sprague-Dawley rats were divided into 3 groups as group 1: control (sham laparotomy), group 2: IR, and group 3: IR + EGb treatment (IR + T) group. All subjects were euthanized 2 days postsurgery and their spinal cords were removed. Tissue malondialdehyde, superoxide dismutase, glutathione (GSH), and glutathione peroxidase levels were measured, and the spinal cord tissue samples were examined histopathologically.Results: No significant difference was detected in ischemia markers between control, IR, and IR + T groups, with the exception of GSH, which was significantly lower in the IR group. GSH levels in group 1 and group 3 were similar. The group 2 displayed significant ischemic damage to the medulla spinalis. This damage was less pronounced in group 3 compared with group 2 only, but in extent and intensity comparable with the controls.Conclusions: Although we were not able to demonstrate a uniform effect of EGb on biochemical markers of IR injury, the histopathologic data appear to show a protective effect conferred on the spinal cord tissue by EGb.

Behcet’s disease is an autoimmune multisystemic disorder on vasculitis base. Cardiovascular involvement is the most important predictor of morbidity and mortality. The treatment should be planned carefully for pathologies requiring interventions. In our report, we present a 45-year-old patient with spontaneous superficial femoral artery pseudoaneurysm, our treatment strategy, and circumstances we faced.

Amac: Torasik cerrahi geciren hastalarda Insentif spirometre ve devamli pozitif havayolu basinci- Continuous Positive Airway Pressure maskesinin postoperatif pulmoner komplikasyonlar uzerine etkisinin arastirilmasi. Gerec ve Yontemler: Calismaya torasik cerrahi geciren hemodinamik acidan stabil, yaslari 16-75 arasinda degisen 14’u kadin, 16’si erkek toplam 30 hasta dahil edildi. Hastalar ekstubasyonu takiben randomize olarak iki gruba ayrildi. 1. grupla “Insentif Spirometre” calismalari, 2. grupla ise “CPAP uygulamasi” yapildi. Tum olgularin postoperatif birinci ve dokuzuncu gunde arter kan gazlari, solunum fonksiyon testleri ve akciger radyolojik incelemesi yapildi ve sonuclar karsilastirildi. Bulgular: Olgularla calismaya baslandiktan sonra postoperatif birinci ve dokuzuncu gunde yapilan arter kan gazi sonuclari gruplar arasi farkli bulunmadi (p > 0.05) Her iki gruptaki hastalarin Zorlu Vital Kapasite-Forced Vital Capacity (FVC), birinci saniyede Zorlu Ekspirasyon Volumu-Forced Expiratory Volume 1 second (FEV1), ve Zorlu Eksipratuar Akim-Forced Expiratory Flow (FEF %25-75) degerlerinde postoperatif dokuzuncu gunde preoperatif olcum degerlerine gore istatistiksel olarak anlamli duzeyde azalmalar tespit edildi (p 0.05). Akciger radyolojik incelemesinde de tedavi sonrasi iki grup arasinda istatistiksel olarak anlamli fark mevcut degildi (p > 0.05). Sonuc: Torasik cerrahi geciren hastalarda solunum performansini gelistirmek icin mekanik fizyoterapi teknikleri etkilidir. Insentif Spirometre ve CPAP uygulamasinin pulmoner komplikasyonlari onleme acisindan birbirlerine ustunlukleri yoktur.

Mediastinal cysts are extremely rare clinical disorders. They usually have a pericardial origin. In this report, we present a 27-year-old male patient with a mediastinal bronchogenic cyst together with clinical presentation and management of the pathology.

Aortic aneurysms and stenosis are widely treated with endovascular procedures in the current era. In this report, we present endovascular stent grafting for symptomatic treatment of severe thoracic aortic stenosis caused by an aortic sarcomatoid carcinoma in a 73-year-old female. The peri- and post-operative courses were complicated with tumor embolisms that were managed by both endovascular and surgical measures.

Objective: Cardiopulmonary bypass deteriorates pulmonary functions to a certain extent. Patients with chronic obstructive pulmonary disease (COPD) are associated with increased mortality and morbidity risks in the postoperative period of open-heart surgery. In this study we compared 2 different mechanical ventilation modes, pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV), in this particular patient population.Patients and Methods: Forty patients with severe COPD were assigned to 1 of 2 groups and enrolled to receive PCV or VCV in the postoperative period. Arterial blood gases, respiratory parameters, and intensive care unit and hospital stays were compared between the 2 groups.Results: Maximum airway pressure was higher in the VCV group. Pulmonary compliance was lower in the VCV group and minute ventilation was significantly lower in the group ventilated with PCV mode. The respiratory index was increased in the PCV group compared with the VCV group and with preoperative findings. Duration of mechanical ventilation was significantly shorter with PCV; however, intensive care unit and hospital stays did not differ.Conclusion: There is not a single widely accepted and established mode of ventilation for patients with COPD undergoing open-heart surgery. Our modest experience indicated promising results with PCV mode; however, further studies are warranted.

Extracardiac off-pump is reported to result in better early hemodynamics and shorter mechanical ventilation periods. We present a case report of extracardiac off-pump Fontan in a 5-year-old girl with single ventricle and dextrocardia.

Metastatic tumors of the heart are more frequent when compared with the primary tumors. Among them the most common are the carcinomas. Autopsy series demonstrate secondary cardiac tumors to be 20 to 40 times more frequent than the primary masses. When a patient with a known carcinoma, being either treated or not treated, presents with the symptoms of heart failure and cardiyomegaly during the course of the disease, cardiac metastasis of the tumour should be considered in the first order. In this article, we present a patient who presented with the symptoms of heart failure and found to have most probably metastasis to the right ventricle by transthoracic echocardiography. The patient had undergone surgical treatment in 2006 for bazal cell carsinoma that developed on marjolin ulcer basis on the right leg.