Gündüz Yümün

This study aims to explore the effects of arteriovenous fistula locations in the arm and fistula flow rates on the potential development of heart failure in patients with arteriovenous fistula (AVF). A total of 116 patients with AVF due to chronic kidney disease were retrospectively reviewed between January 2022 and August 2022. Fifty-six patients with distal AVFs and 60 with proximal AVFs were compared in terms of demographic, clinical, and echocardiographic characteristics. Fistula flow rates were assessed using Doppler ultrasonography, while cardiac parameters were evaluated with echocardiography. The correlation between fistula location and cardiac parameters was analyzed using ROC analysis. The mean AVF blood flow rate was 1.47 (0.57–2.9) L/min for proximal fistulas and 0.85 (0.52–2.3) L/min for distal fistulas. There were statistically significant differences between the proximal and distal AVF groups regarding cardiac index, cardiac output, and cardiopulmonary recirculation values (p< 0.001). According to the New York Heart Association classification, Class III can be categorized as high cardiac output failure (HCOF), as cardiac index was calculated at 6.87 ± 1.65 L/min/m² (4.7–9.4), fistula flow rate at 2.60 L/min (2.1–2.9), and cardiac output at 8.08 ± 0.69 L/min. When heart failure develops in patients with AVF, underlying heart disease should not be the sole factor considered. Proximal high-flow AVFs, in particular, may contribute to heart failure development and warrant careful monitoring.

Popliteal artery aneurysm is the most common type of peripheral artery aneurysm. These lesions are associated with atherosclerotic disease and other arterial aneurysms. The timing and approach of surgery are critical for limb preservation and reducing the risk of amputation in symptomatic cases. This case report presents our surgical approach, technique, and graft selection for a 75-year-old female patient with swelling and pain in the leg due to a giant popliteal artery aneurysm complicated by thrombosis. We bypassed the superficial femoral artery to the distal popliteal artery below the knee, using the in situ saphenous vein. We excluded the enlarged segment by ligating it at the anastomosis sites. In situ bypass is considered a highly effective method with excellent patency rates that minimizes surgical trauma in the treatment of popliteal aneurysms extending below the knee.

Human hair is a significant biological sample in forensic science, biomedical research, and the cosmetic industry, with the presence of essential nutrients like zinc, copper, and silicon being indicative of health. This study aimed to investigate the elemental composition of human hair using Laser‐Induced Breakdown Spectroscopy (LIBS) to assess differences across age groups. Nine volunteers provided hair samples, which were analyzed using the Foster + Freeman ECCO2 LIBS system. Quantitative analysis of elemental concentrations was performed, and elemental ratios, such as Mg/Ca, Mg/Si, Mg/Fe, and Fe/Mn, were calculated to compare the samples. Results demonstrated that LIBS is a fast, accurate, and non‐destructive method for detecting and quantifying mineral elements in human hair. The study highlights age‐related differences in elemental concentrations, offering insights into the use of hair analysis for monitoring nutritional and health status. LIBS could be a promising tool for further studies in clinical and forensic applications.

Tüm bilim dallarında olduğu gibi Tıp ve Kalp Damar Cerrahisi alanında da geçen her zaman diliminde hızlı ve yeni gelişmeler yaşanmaktadır. Bunun sonucu olarak tanı ve tedavilerdeki gelişmelerin takip edilmesi gerekmektedir. Türkiye’de ve dünyada arter hastalıkları ile ilgili yapılmış çok sayıda çalışma bulunmasına karşın, “Periferik Arter Atlası”, güncel kaynakları ve çalışmaları içermesi açısından tüm değerli meslektaşlarımızın ve hekimlerimizin dikkatine sunulmuştur.

Cardiac myxoma associated with coronary artery disease is a rare pathology in an elderly patient. Herein we present an 81-year-old woman undergoing simultaneous surgical treatment for left atrial myxoma combined with coronary artery disease. The postoperative course of the patient was uneventful. The initial removal of mass should be performed to prevent systemic embolization of tumor fragments.

The saphenous vein is the most commonly used graft in coronary artery bypass surgery, since no suitable arterial graft is available. However, the frequency of late graft failure is a cause for research into graft protection. The objective of this study was to investigate the effect of synthetic adhesive cyanoacrylate administration on the saphenous vein graft for preventing vascular damage due to internal pressure on the graft. In this study we enrolled 20 volunteer subjects who had undergone coronary artery bypass surgery and who had excess saphenous vein grafts. Perivascular cyanoacrylate was administered to one of two saphenous vein grafts explanted from each patient. The other saphenous vein graft from each patient was not treated and was used as the control. A model of the arterial system was created using a saphenous vein cardiopulmonary bypass system. Circulation was maintained at 120 mmHg for 45 minutes. Afterwards, the grafts were subjected to histopathological examination. The cyanoacrylate group of grafts did not develop severe vascular damage compared with many instances of moderate and severe damage due to compression in the control group of grafts (p = 0.003). Perivascular administration of cyanoacrylate appeared to be successful in the prevention of early saphenous vein graft injury. No in vivo study has been performed to date to assess endothelial damage in the saphenous vein, in order to demonstrate the long-term effect of cyanoacrylate. Further investigations are needed in this regard.

The mortality rate in coronary artery bypass surgery increases with advancing patient age. This study was conducted to analyse and compare older (above 65 years of age) with younger patients (below 65 years of age) who had undergone coronary artery bypass surgery and had an intra-aortic balloon pump (IABP) inserted, comparing hospital stay, clinical features, intensive care unit stay, postoperative complications, and morbidity and mortality rates. One hundred and ninety patients who had undergone coronary artery bypass surgery and required IABP support were enrolled in this study. Patients younger than 65 years of age were considered young, and the others were considered old. Ninety-two patients were young and 98 were old. The mortality rates, pre-operative clinical characteristics, postoperative complications, and duration of intensive care unit and hospital stays of the groups were compared. The risk factors for mortality and complications were analysed. One hundred and thirty-eight of the patients were male, and the mean patient age was 62.7 ± 9.9 years. The mortality rate was higher in the older patient group than the younger group [34 (37.7%) and 23 (23.4 %), respectively (p = 0.043)]. The cross-clamp time, mean ejection fraction, cardiopulmonary bypass time, and length of stay in the intensive care unit were similar among the groups (p > 0.05). Cardiopulmonary bypass time was the single independent risk factor for mortality in both groups. In this study, high mortality rates in the postoperative period were similar to prior studies regarding IABP support. The complication rates were higher in the older patient group. Prolonged cardiopulmonary bypass and advanced age were determined to be significant risk factors for mortality.