RESUMO
Abstract Objective: In this retrospective study, we aimed to observe the efficacy of pericardial effusion (PE) treatments by a survey conducted at the Department of Cardiovascular Surgery, Faculty of Medicine, Atatürk University. Methods: In order to get comparable results, the patients with PE were divided into three groups - group A, 480 patients who underwent subxiphoid pericardiostomy; group B, 28 patients who underwent computerized tomography (CT)-guided percutaneous catheter drainage; and group C, 45 patients who underwent echocardiography (ECHO)-guided percutaneous catheter drainage. Results: In the three groups of patients, the most important symptom and physical sign were dyspnea and tachycardia, respectively. The most common causes of PE were uremic pericarditis in patients who underwent tube pericardiostomy, postoperative PE in patients who underwent CT-guided percutaneous catheter drainage, and cancer-related PE in patients who underwent ECHO-guided percutaneous catheter drainage. In all the patients, relief of symptoms was achieved after surgical intervention. There was no treatment-related mortality in any group of patients. In patients with tuberculous pericarditis, the rates of recurrent PE and/or constrictive pericarditis progress were 2,9% and 2,2% after tube pericardiostomy and ECHO-guided percutaneous catheter drainage, respectively. Conclusion: Currently, there are many methods to treat PE. The correct treatment method for each patient should be selected according to a very careful analysis of the patient's clinical condition as well as the prospective benefit of surgical intervention.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Derrame Pericárdico/cirurgia , Ecocardiografia/métodos , Cateterismo Cardíaco/métodos , Tomografia Computadorizada por Raios X/métodos , Drenagem/métodos , Técnicas de Janela Pericárdica/instrumentação , Derrame Pericárdico/etiologia , Pericardite/complicações , Ecocardiografia/instrumentação , Cateterismo Cardíaco/instrumentação , Drenagem/instrumentação , Reprodutibilidade dos Testes , Análise de Variância , Resultado do Tratamento , Tempo de InternaçãoRESUMO
OBJECTIVE: In this retrospective study, we aimed to observe the efficacy of pericardial effusion (PE) treatments by a survey conducted at the Department of Cardiovascular Surgery, Faculty of Medicine, Atatürk University. METHODS: In order to get comparable results, the patients with PE were divided into three groups - group A, 480 patients who underwent subxiphoid pericardiostomy; group B, 28 patients who underwent computerized tomography (CT)-guided percutaneous catheter drainage; and group C, 45 patients who underwent echocardiography (ECHO)-guided percutaneous catheter drainage. RESULTS: In the three groups of patients, the most important symptom and physical sign were dyspnea and tachycardia, respectively. The most common causes of PE were uremic pericarditis in patients who underwent tube pericardiostomy, postoperative PE in patients who underwent CT-guided percutaneous catheter drainage, and cancer-related PE in patients who underwent ECHO-guided percutaneous catheter drainage. In all the patients, relief of symptoms was achieved after surgical intervention. There was no treatment-related mortality in any group of patients. In patients with tuberculous pericarditis, the rates of recurrent PE and/or constrictive pericarditis progress were 2,9% and 2,2% after tube pericardiostomy and ECHO-guided percutaneous catheter drainage, respectively. CONCLUSION: Currently, there are many methods to treat PE. The correct treatment method for each patient should be selected according to a very careful analysis of the patient's clinical condition as well as the prospective benefit of surgical intervention.
Assuntos
Cateterismo Cardíaco/métodos , Drenagem/métodos , Ecocardiografia/métodos , Derrame Pericárdico/cirurgia , Técnicas de Janela Pericárdica , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Cateterismo Cardíaco/instrumentação , Criança , Pré-Escolar , Drenagem/instrumentação , Ecocardiografia/instrumentação , Feminino , Humanos , Lactente , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/etiologia , Técnicas de Janela Pericárdica/instrumentação , Pericardite/complicações , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Tempo , Tomografia Computadorizada por Raios X/instrumentação , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: To determine whether mean platelet volume (MPV), platelet distribution width (PDW), and platelet count could be used as determinants of mortality following coronary artery bypass graft (CABG) surgery and patency of saphenous vein grafts (SVG). METHODS: The records of 128 patients who underwent emergency or elective coronary angiography after CABG surgery, and who died at an early stage were retrospectively reviewed. Patients were divided into three groups as early death, no SVG disease (SVGD), and SVGD group. MPV, PDW, and platelet count were evaluated at different times. RESULTS: MPV was significantly higher in the stenotic group than in the nonstenotic group (9.7±1.8 fl and 8.2±0.9 fl, P<0.05). The postoperative MPV ratio was found to be higher in the stenotic group when compared to the preoperative period (9.6±1.8 fl and 7.8±0.9 fl, P<0.05). MPV values were also found to be higher in patients who died during the early stage than in surviving patients (9.4±1.9 fl and 8.0±1.0 fl, P<0.05). There was no statistically significant difference regarding platelet count and PDW ratios between the early deaths group and surviving patients. An MPV value higher than 10.6 predicted SVGD with 85% sensitivity and 45% specificity; and an MPV higher than 7.9 predicted early death with 80% sensitivity and 68% specificity were observed. CONCLUSION: MPV may be a useful indicator for the prediction of SVGD and mortality following CABG surgery.
Assuntos
Ponte de Artéria Coronária/mortalidade , Oclusão de Enxerto Vascular/sangue , Oclusão de Enxerto Vascular/mortalidade , Volume Plaquetário Médio/métodos , Veia Safena/transplante , Idoso , Constrição Patológica , Angiografia Coronária , Ponte de Artéria Coronária/efeitos adversos , Feminino , Oclusão de Enxerto Vascular/diagnóstico , Oclusão de Enxerto Vascular/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas/métodos , Período Pós-Operatório , Valor Preditivo dos Testes , Período Pré-Operatório , Curva ROC , Valores de Referência , Reprodutibilidade dos Testes , Estudos Retrospectivos , Veia Safena/diagnóstico por imagem , Grau de Desobstrução VascularRESUMO
Abstract Objective: To determine whether mean platelet volume (MPV), platelet distribution width (PDW), and platelet count could be used as determinants of mortality following coronary artery bypass graft (CABG) surgery and patency of saphenous vein grafts (SVG). Methods: The records of 128 patients who underwent emergency or elective coronary angiography after CABG surgery, and who died at an early stage were retrospectively reviewed. Patients were divided into three groups as early death, no SVG disease (SVGD), and SVGD group. MPV, PDW, and platelet count were evaluated at different times. Results: MPV was significantly higher in the stenotic group than in the nonstenotic group (9.7±1.8 fl and 8.2±0.9 fl, P<0.05). The postoperative MPV ratio was found to be higher in the stenotic group when compared to the preoperative period (9.6±1.8 fl and 7.8±0.9 fl, P<0.05). MPV values were also found to be higher in patients who died during the early stage than in surviving patients (9.4±1.9 fl and 8.0±1.0 fl, P<0.05). There was no statistically significant difference regarding platelet count and PDW ratios between the early deaths group and surviving patients. An MPV value higher than 10.6 predicted SVGD with 85% sensitivity and 45% specificity; and an MPV higher than 7.9 predicted early death with 80% sensitivity and 68% specificity were observed. Conclusion: MPV may be a useful indicator for the prediction of SVGD and mortality following CABG surgery.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Veia Safena/transplante , Ponte de Artéria Coronária/mortalidade , Volume Plaquetário Médio/métodos , Oclusão de Enxerto Vascular/mortalidade , Oclusão de Enxerto Vascular/sangue , Contagem de Plaquetas/métodos , Período Pós-Operatório , Valores de Referência , Veia Safena/diagnóstico por imagem , Grau de Desobstrução Vascular , Ponte de Artéria Coronária/efeitos adversos , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Curva ROC , Angiografia Coronária , Constrição Patológica , Período Pré-Operatório , Oclusão de Enxerto Vascular/diagnóstico , Oclusão de Enxerto Vascular/etiologiaRESUMO
OBJECTIVE: The aim of this study was to evaluate early clinical outcomes and echocardiographic measurements of the left ventricle in patients who underwent left ventricular aneurysm repair using two different techniques associated to myocardial revascularization. METHODS: Eighty-nine patients (74 males, 15 females; mean age 58±8.4 years; range: 41 to 80 years) underwent post-infarction left ventricular aneurysm repair and myocardial revascularization performed between 1996 and 2016. Ventricular reconstruction was performed using endoventricular circular patch plasty (Dor procedure) (n=48; group A) or linear repair technique (n=41; group B). RESULTS: Multi-vessel disease in 55 (61.7%) and isolated left anterior descending (LAD) disease in 34 (38.2%) patients were identified. Five (5.6%) patients underwent aneurysmectomy alone, while the remaining 84 (94.3%) patients had aneurysmectomy with bypass. The mean number of grafts per patient was 2.1±1.2 with the Dor procedure and 2.9±1.3 with the linear repair technique. In-hospital mortality occurred in 4.1% and 7.3% in group A and group B, respectively (P>0.05). CONCLUSION: The results of our study demonstrate that post-infarction left ventricular aneurysm repair can be performed with both techniques with acceptable surgical risk and with satisfactory hemodynamic improvement.
Assuntos
Aneurisma Cardíaco/cirurgia , Ventrículos do Coração/cirurgia , Revascularização Miocárdica/métodos , Idoso , Ponte de Artéria Coronária/métodos , Ecocardiografia , Feminino , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/mortalidade , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Revascularização Miocárdica/mortalidade , Valores de Referência , Estudos Retrospectivos , Medição de Risco , Volume Sistólico/efeitos da radiação , Fatores de Tempo , Resultado do TratamentoRESUMO
Abstract Objective: The aim of this study was to evaluate early clinical outcomes and echocardiographic measurements of the left ventricle in patients who underwent left ventricular aneurysm repair using two different techniques associated to myocardial revascularization. Methods: Eighty-nine patients (74 males, 15 females; mean age 58±8.4 years; range: 41 to 80 years) underwent post-infarction left ventricular aneurysm repair and myocardial revascularization performed between 1996 and 2016. Ventricular reconstruction was performed using endoventricular circular patch plasty (Dor procedure) (n=48; group A) or linear repair technique (n=41; group B). Results: Multi-vessel disease in 55 (61.7%) and isolated left anterior descending (LAD) disease in 34 (38.2%) patients were identified. Five (5.6%) patients underwent aneurysmectomy alone, while the remaining 84 (94.3%) patients had aneurysmectomy with bypass. The mean number of grafts per patient was 2.1±1.2 with the Dor procedure and 2.9±1.3 with the linear repair technique. In-hospital mortality occurred in 4.1% and 7.3% in group A and group B, respectively (P>0.05). Conclusion: The results of our study demonstrate that post-infarction left ventricular aneurysm repair can be performed with both techniques with acceptable surgical risk and with satisfactory hemodynamic improvement.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Aneurisma Cardíaco/cirurgia , Ventrículos do Coração/cirurgia , Revascularização Miocárdica/métodos , Valores de Referência , Volume Sistólico/efeitos da radiação , Fatores de Tempo , Ecocardiografia , Ponte de Artéria Coronária/métodos , Estudos Retrospectivos , Resultado do Tratamento , Mortalidade Hospitalar , Medição de Risco , Aneurisma Cardíaco/mortalidade , Aneurisma Cardíaco/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Ventrículos do Coração/diagnóstico por imagem , Revascularização Miocárdica/mortalidadeRESUMO
Objetive: Saline-irrigated radiofrequency ablation, which has been widely used for surgical treatment of atrial fibrillation in recent years, is 80-90% successful in achieving sinus rhythm. In our study, our surgical experience and mid-term results in patients who underwent mitral valve surgery and left atrial radiofrequency ablation were analyzed. Methods: Forty patients (15 males, 25 females; mean age 52.05±9.9 years; range 32-74) underwent surgery for atrial fibrillation associated with mitral valvular disease. All patients manifested atrial fibrillation, which started at least six months before the surgical intervention. The majority of patients (36 patients, 90%) were in NYHA class III; 34 (85%) patients had rheumatic heart disease. In addition to mitral valve surgery and radiofrequency ablation, coronary artery bypass, DeVega tricuspid annuloplasty, left ventricular aneurysm repair, and left atrial thrombus excision were performed. Following discharge from the hospital, patients' follow-up was performed as outpatient clinic examinations and the average follow-up period of patients was 18±3 months. Results: While the incidence of sinus rhythm was 85.3% on the first postoperative day, it was 80% during discharge and 71% in the 1st year follow-up examination. Conclusion: Radiofrequency ablation is an effective method when it is performed by appropriate surgical technique. Its rate for returning to sinus rhythm is as high as the rate of conventional surgical procedure.
Assuntos
Fibrilação Atrial/cirurgia , Ablação por Cateter/métodos , Doenças das Valvas Cardíacas/cirurgia , Valva Mitral/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/patologia , Resultado do TratamentoRESUMO
Abstract Objetive: Saline-irrigated radiofrequency ablation, which has been widely used for surgical treatment of atrial fibrillation in recent years, is 80-90% successful in achieving sinus rhythm. In our study, our surgical experience and mid-term results in patients who underwent mitral valve surgery and left atrial radiofrequency ablation were analyzed. Methods: Forty patients (15 males, 25 females; mean age 52.05±9.9 years; range 32-74) underwent surgery for atrial fibrillation associated with mitral valvular disease. All patients manifested atrial fibrillation, which started at least six months before the surgical intervention. The majority of patients (36 patients, 90%) were in NYHA class III; 34 (85%) patients had rheumatic heart disease. In addition to mitral valve surgery and radiofrequency ablation, coronary artery bypass, DeVega tricuspid annuloplasty, left ventricular aneurysm repair, and left atrial thrombus excision were performed. Following discharge from the hospital, patients' follow-up was performed as outpatient clinic examinations and the average follow-up period of patients was 18±3 months. Results: While the incidence of sinus rhythm was 85.3% on the first postoperative day, it was 80% during discharge and 71% in the 1st year follow-up examination. Conclusion: Radiofrequency ablation is an effective method when it is performed by appropriate surgical technique. Its rate for returning to sinus rhythm is as high as the rate of conventional surgical procedure.