Cemil Barlas

Unusual complication of femoro-popliteal saphenous vein bypass—Aneurysm formation

An aneurysm as an unusual complication of saphenous vein bypass for femoro-popliteal occlusive disease is reported. The aneurysm developed 1 year following the bypass procedure. A diagnosis of Behçets disease based on microscopic immunological examination and the clinical picture was suspected following successful aneurysmectomy.

A brachial pseudoaneurysm at puncture site in Behçet's disease : case report

A rare case of brachial pseudoaneurysm at puncture site in a patient with Behçets disease is presented. The aneurysm developed at the level of the brach ial artery following an erroneous venipuncture. Aneurysmectomy and en doaneurysmorrhaphy were performed successfully. This kind of complication should always be kept in mind, and care must be taken during all invasive procedures in patients with Behçets disease.

An Unusual Foreign Body in Pulmonary Artery — A Case Report

An unusual case of pulmonary foreign body is reported. The foreign body, Kirschner wire, was used for clavicular fixation. It was found free in the middle part of mediastinum one and a half years after fixation in a control chest roent genogram. We discussed by which tract such a rigid substance had arrived in the pulmonary artery. We also reviewed the diagnostic techniques and surgical difficulties in removing foreign bodies from the pulmonary circulation.

Thymoma: surgical results of 73 cases.

Abstract Purpose : Thymomas are uncommon tumours; they represent a broad spectrum of morphological and clinical behaviour. The purpose of this study is to identify the factors that influence survival. Method : Seventy-three patients with thymoma who underwent thymectomy between 1980 and 2002 were reviewed. Prognostic factors assessed were: age, sex, presenting symptoms, histological features, stage at diagnosis and extent of surgical resection. Results : Complete resection was achieved in 67 patients and incomplete in 6. Survival rates of patients in the 1st or 2nd stages were 100% and 92.8% for 10 years, respectively. A high incidence of myasthenia gravis (MG) associated thymomas (80.8%) was found. These patients had better survival rates when compared to non-myasthenic patients. However the mortality rate for malign thymomas was high (65.7%) due to tumoral invasion. The histological types of thymoma did not influence the survival rate. Conclusions : The association of MG with thymoma enables earlier detection of tumour, thus higher survival rates were achieved in these patients. Survival was also related to the stage of the tumour at diagnosis and the completeness of resection.

Effects of Oxygenator and Pumping Devices on Blood Parameters in Open Heart Surgery

Despite the recent technological advances in open heart surgery, an oxygenator being absolutely harmless to blood cells and providing excellent perfusion to organ tissues, especially the brain, via an extra corporeal pump is yet to be developed.

Oxygen Supply during Cardiopulmonary Bypass (CPB) in Cyanotic Patients

Today, repair of congenital heart defects has become a routine operation with low mortality and morbidity in many subgroups of anomalies1. The knowledge that the ventricular myocardium continues to develop and conditions itself according to the loads present and that this mechanism can influence the long-term outcome in many cardiac anomalies, stress the operations towards infantile and neonatal age groups2,3. This, in turn, stresses the importance of the possible damage to the other organs and systems still developing at the time of cardiopulmonary bypass (CPB). While myocardial protection attempted by lowering the energy demands through topical cold and chemical cardioplegia1,4,5, the protection of other systems, including central nervous system (CNS), remains dependent on the oxygenation and the local wash out of metabolites by means of CPB.

The Efficacy of Pulse Oxymetry in the Postoperative Respiratory Management of Cardiac Patients

Today, early postoperative respiratory support is routine for patients with prolonged general anesthesia, especially after cardiopulmonary bypass. The adequacy of respiration during this period is evaluated by serial blood gas samplings and the appropriate changes according to the patients’ status are made on this basis.

Ten-year Follow-up of Femoropopliteal Bypass Grafts: Comparative Review of Late Patency Rates of PTFE and Saphenous Vein Grafts for Lower Extremity Ischemia

Between January, 1987 and June 1988, 335 femoropopliteal bypass (FPBP) operations were performed on 308 patients who had limb ischemia caused by femoropopliteal occlusion. The greater saphenous vein graft (SVG) was used whenever possible (165) and polytetrafluoroethylene (PTFE) prosthesis was used in 165. In addition, 4 Dacron grafts and 1 umbilical vein graft were used in 5 operations but were excluded from comparison in this study. The two groups did not differ significantly regarding stage of peripheral ischemia, preoperative indication, distal popliteal anastomotic site, and number of patent runoff ves sels. Overall cumulative patency rates according to occlusive criteria alone were calculated by the life table method. Graft occlusion was determined by angiog raphy, Doppler assessment, loss of previously palpable pulses, or return of symp toms. Diabetes mellitus was associated with a significantly lower patency rate. It is concluded from this study that the saphenous vein is superior to PTFE as femoropopliteal bypass.

Late Vascular Complications of Lumbar Disc Surgery — Case Reports

Many reports have been published describing different vascular lesions after lumbar disc surgery but the actual incidence is probably higher than has been published. Lesions of vascular structures (aorta, iliac arteries, and veins) close to the spine can arise as a consequence of the removal of disc fragments. In emergency cases, general surgeons are usually called upon to deal with these in the absence of more qualified vascular surgeons. But for an elective case, an experienced vascular surgeons knowledge of the pathogenesis and ap propriate management of these lesions is mandatory for the proper care of the patients. Herein, 3 additional cases of late vascular complications of lumbar disc surgery, their diagnostic features, and correct treatments are presented.

An Unusual Vascular Complication Following Partial Nephrectomy: Case Report

Development of a fistula between the main renal vessels after nephrectomy has heretofore been a rare occurrence, but its increasing frequency would seem to result from increased interest in detection of this fistula. The authors present a rare case of arteriovenous fistula following partial nephrectomy. Renal hyper tension following nephrectomy, also quite rare, developed in this case.