Abstract Ascending aortic pathologies may be life-threatening. Postoperative aortic root dehiscence is a very rare but extremely dangerous complication with a high mortality rate, and redo surgery is mandatory due to high risk of spontaneous rupture. We present three cases that had undergone Bentall procedure and had postoperative aortic root dehiscence. One of the patients presented with hemiplegia caused by septic embolus while the others had mild symptoms. Dr. Yakut’s modified Bentall procedure, the flanged technique, was performed for each patient in redo surgery. Two patients were successfully discharged from the hospital, but one died due to intracranial hemorrhage and multiple organ failure. lifethreatening. lifethreatening life threatening. threatening life-threatening rate rupture symptoms Dr Yakuts Yakut s technique hospital failure

ABSTRACT Introduction: The heart and liver are two organs that are closely related. The Albumin-Bilirubin (ALBI) score is a developed scoring system for assessing liver function. The aims of this study were to examine the correlation between preoperative ALBI score and pulmonary artery pressure and to investigate its ability to predict heart valve surgery mortality outcomes. Methods: The data of 872 patients who underwent isolated and combined heart valve surgery from 2014 to 2021 were retrospectively screened. In the preoperative period, 152 patients with laboratory tests including albumin and total bilirubin were found and analyzed retrospectively. Thirteen of these patients were excluded from the study. The remaining 139 patients were included in the analysis. Baseline demographic data, echocardiography data, performance status, laboratory data, operative data, and postoperative status were collected. The optimal cutoff value of preoperative ALBI score was calculated. Results: The cutoff for ALBI scores was calculated as -2.44 to predict in-hospital mortality (sensitivity = 75.0%, specificity = 70%). Based on the cutoff value, 90 patients had a low ALBI score (≤ -2.44, 64.7%) and 49 patients had a high ALBI score (> -2.44, 35.3%). High ALBI score was associated with an increased incidence of acute kidney injury and in-hospital mortality, and a positive correlation was found between ALBI score and pulmonary artery pressure. Conclusion: In patients with valvular surgery, high ALBI score was an independent prognostic factor of in-hospital mortality and acute kidney injury. It is easily measurable and a cost-effective way to predict mortality. Introduction related AlbuminBilirubin Albumin Bilirubin (ALBI function outcomes Methods 87 201 202 screened period 15 13 analysis collected Results 2.44 244 2 44 -2.4 inhospital hospital sensitivity 750 75 0 75.0% 70%. 70 70% . 70%) 9 ≤ ( 2.44, 64.7% 647 64 7 4 > 35.3%. 353 35.3% 35 3 35.3%) Conclusion costeffective cost effective 8 20 1 2.4 24 -2. 75.0 64.7 6 35.3 2. -2 75. 64. 35. -

ABSTRACT Introduction: The aim of this study is to compare the postoperative outcomes and early mortality of peripheral and central cannulation techniques in cardiac reoperations using propensity score matching analysis. Methods: In this retrospective cohort, patients who underwent cardiac reoperations with median resternotomy were analyzed in terms of propensity score matching. Between November 2010 and September 2020, 257 patients underwent cardiac reoperations via central (Group 1) or peripheral (Group 2) cannulation. A 1:1 propensity score matching was performed to balance the influence of potential confounding factors to compare postoperative data and mortality rate. Results: There were no significant differences when comparing the matched groups regarding early mortality (P=0.51), major cardiac injury (P=0.99), prolonged ventilation (P=0.16), and postoperative stroke (P=0.99). The development of acute renal failure (P=0.02) was statistically less frequent in Group 1. Conclusions: Performing cardiopulmonary bypass via peripheral cannulation increases acute renal failure in cardiac reoperations. In contrast, peripheral or central cannulation have similar early mortality rate in cardiac reoperations. Introduction analysis Methods cohort 201 2020 25 1 2 11 1: Results P=0.51, P051 P P=0.51 , 0 51 (P=0.51) P=0.99, P099 P=0.99 99 (P=0.99) P=0.16, P016 P=0.16 16 (P=0.16) P=0.99. . P=0.02 P002 02 (P=0.02 Conclusions contrast 20 202 P05 P=0.5 5 (P=0.51 P09 P=0.9 9 (P=0.99 P01 P=0.1 (P=0.16 P=0.0 P00 (P=0.0 P0 P=0. (P=0.5 (P=0.9 (P=0.1 (P=0. P=0 (P=0 P= (P= (P

ABSTRACT Introduction: This study aimed to investigate the factors affecting false lumen patency in the descending thoracic aorta among patients who underwent surgery for acute type 1 aortic dissection. Methods: A total of 112 patients with acute type 1 aortic dissection, with the flap below the diaphragm level, underwent surgery between January 2010 and September 2019. Of these, 60 patients who were followed up for ≥ 12 months and whose computed tomography scans were available were included in this study. The patients were divided into two groups: group I, consists of patent false lumen (n=36), and group II, consists of thrombosed false lumen (n=24). Demographic data, operative techniques, postoperative descending aortic diameters, reintervention, and late mortality were compared between the two groups. Results: The mean follow-up period of all patients was 37.6±26.1 months (range: 12-104). The diameter increase in the proximal and distal descending aorta was significantly higher in the patent false lumen group (5.3±3.7 mm vs. 3.25±2.34 mm; P=0.015; 3.1±2.52 mm vs. 1.9±1.55 mm; P=0.038, respectively). No significant difference in terms of hypertension was found between the two groups during the follow-up period (21 patients, 58.3% vs. 8 patients, 33.3%; P=0.058). A total of 29 patients (48.3%) were found to be hypertensive in the postoperative period. Conclusion: After surgical treatment for acute type 1 aortic dissection, patients should be monitored closely, regardless of whether the false lumen is patent or thrombosed. Mortality and reintervention can be seen in patients with patent false lumen during follow-up. Introduction dissection Methods 11 level 201 2019 these 6 I n=36, n36 n n=36 , 36 (n=36) II n=24. n24 n=24 . 24 (n=24) data techniques diameters Results followup follow 376261 37 26 37.6±26. range (range 12104. 12104 104 12-104) 5.3±3.7 5337 5 3 7 (5.3±3. vs 325234 25 2 34 3.25±2.3 P=0.015 P0015 P 0 015 31252 52 3.1±2.5 19155 9 55 1.9±1.5 P0038 038 P=0.038 respectively. respectively respectively) 21 (2 583 58 58.3 33.3% 333 33 P=0.058. P0058 P=0.058 058 P=0.058) 48.3% 483 48 (48.3% Conclusion closely followup. up. 20 n3 n=3 (n=36 n2 n=2 (n=24 37626 37.6±26 1210 10 12-104 5.3±3. 533 (5.3±3 32523 3.25±2. P=0.01 P001 01 3125 3.1±2. 1915 1.9±1. P003 03 P=0.03 ( 58. 33.3 P005 P=0.05 05 48.3 4 (48.3 n= (n=3 (n=2 3762 37.6±2 121 12-10 5.3±3 53 (5.3± 3252 3.25±2 P=0.0 P00 312 3.1±2 191 1.9±1 33. 48. (48. (n= 376 37.6± 12-1 5.3± (5.3 325 3.25± P=0. P0 31 3.1± 19 1.9± (48 (n 37.6 12- 5.3 (5. 32 3.25 P=0 3.1 1.9 (4 37. 5. (5 3.2 P= 3. 1.

ABSTRACT Introduction: Infective endocarditis is a disease that progresses with morbidity and mortality, afecting 3-10 out of 100,000 people per year. We conducted this study to review the early outcomes of surgical treatment of infective endocarditis. Methods: In this retrospective study, 122 patients who underwent cardiac surgery for infective endocarditis in our clinic between November 2009 and December 2020 were evaluated. Patients were divided into two groups according to in-hospital mortality. Demographic, echocardiographic, laboratory, operative, and postoperative data of the groups were compared. Results: Between November 3, 2009, and December 7, 2020, 122 patients were operated for infective endocarditis in our hospital. Emergency surgery was performed in nine (7.3%) patients. In-hospital mortality occurred in 23 (18.9%) patients, and 99 (81.1%) patients were discharged. In-hospital mortality was related with older age, presence of periannular abscess, New York Heart Association class 3 or 4 symptoms, low albumin level, high alanine aminotransferase level, and longer cross-clamping time (P<0.05 for all). Conclusion: The presence of paravalvular abscess was the most important prognostic factor in patients operated for infective endocarditis.

ABSTRACT Introduction: Custodiol (histidine-tryptophan-ketoglutarate) and repetitive blood cardioplegia are the solutions for myocardial protection and cardiac arrest. In this study, we aimed to compare immunohistochemical analysis, clinical outcomes, and cardiac enzyme values of Custodiol and blood cardioplegia groups. Methods: This was a randomized prospective study consisting of 2 groups and 20 patients, 10 patients for each group, who underwent mitral and mitral/tricuspid valve surgery. Group 1 was formed for Custodiol cardioplegia and group 2 for blood cardioplegia. Perioperative and postoperative cardiac events were recorded, cardiac enzymes were analyzed with intervals, and myocardial samples were taken for immunohistochemical analysis. Recorded data were statistically evaluated. Results: There was no significant difference for the Custodiol and blood cardioplegia groups in perioperative and postoperative cardiac performance and adverse events. Cardiac enzyme analysis showed no significant difference between groups. However, two parameters (eNOS, Bcl-2) were in favor of the Custodiol group in immunohistochemical studies. Custodiol performed better in cellular oxidative stress resistance and cellular viability. Conclusion: Clinical outcomes and cardiac enzyme analysis results were similar regarding myocardial protection. However, Custodiol performed better in the immunohistochemical analysis.

ABSTRACT Introduction: The heart and liver are two organs that are closely related. The Albumin-Bilirubin (ALBI) score is a developed scoring system for assessing liver function. The aims of this study were to examine the correlation between preoperative ALBI score and pulmonary artery pressure and to investigate its ability to predict heart valve surgery mortality outcomes. Methods: The data of 872 patients who underwent isolated and combined heart valve surgery from 2014 to 2021 were retrospectively screened. In the preoperative period, 152 patients with laboratory tests including albumin and total bilirubin were found and analyzed retrospectively. Thirteen of these patients were excluded from the study. The remaining 139 patients were included in the analysis. Baseline demographic data, echocardiography data, performance status, laboratory data, operative data, and postoperative status were collected. The optimal cutoff value of preoperative ALBI score was calculated. Results: The cutoff for ALBI scores was calculated as -2.44 to predict in-hospital mortality (sensitivity = 75.0%, specificity = 70%). Based on the cutoff value, 90 patients had a low ALBI score (≤ -2.44, 64.7%) and 49 patients had a high ALBI score (> -2.44, 35.3%). High ALBI score was associated with an increased incidence of acute kidney injury and in-hospital mortality, and a positive correlation was found between ALBI score and pulmonary artery pressure. Conclusion: In patients with valvular surgery, high ALBI score was an independent prognostic factor of in-hospital mortality and acute kidney injury. It is easily measurable and a cost-effective way to predict mortality.

Abstract Objectives: To investigate the association between clinical hematologic parameters and saphenous vein graft failure after on-pump coronary artery bypass surgery. Methods: A total of 1950 consecutive patients underwent isolated on-pump coronary artery surgery between November 2010 and February 2013. Of these, 284 patients met our inclusion criteria; their preoperative clinical hematological parameters were retrospectively obtained for this cohort study. And of them, 109 patients underwent conventional coronary angiography after graft failure was revealed by coronary computed tomography angiography. The primary endpoint was to catch at least one saphenous vein graft stenosis or occlusion following the coronary angiogram. We then analyzed risk factors for graft failure. In sequential or T grafts, each segment was analyzed as a separate graft. Results: In logistic regression analysis, older age, platelet distribution width, and diabetes mellitus were identified as independent predictors of saphenous vein graft failure (P<0.). In contrast, preserved ejection fraction value favored graft patency (P<0.001). Conclusion: Increased platelet distribution width is easily measurable and can be used as a simple and valuable marker in the prediction of saphenous vein graft failure.