Cengiz Colak

Aberrant Right Subclavian Artery and Axillary Artery Cannulation in Type A Aortic Dissection Repair

Currently, right axillary artery cannulation and unilateral antegrade cerebral perfusion through the same cannula are preferred choices for acute type A aortic dissection repair. However, the existence of an aberrant right subclavian artery can jeopardize cerebral perfusion through the right axillary artery cannula. In this study, we intended to explain the repair of acute type A aortic dissection using right axillary artery cannulation in a patient with aberrant right subclavian artery.

Effects of electromagnetic radiation from 3G mobile phone on heart rate, blood pressure and ECG parameters in rats

Effects of electromagnetic energy radiated from mobile phones (MPs) on heart is one of the research interests. The current study was designed to investigate the effects of electromagnetic radiation (EMR) from third-generation (3G) MP on the heart rate (HR), blood pressure (BP) and ECG parameters and also to investigate whether exogenous melatonin can exert any protective effect on these parameters. In this study 36 rats were randomized and evenly categorized into 4 groups: group 1 (3G-EMR exposed); group 2 (3G-EMR exposed + melatonin); group 3 (control) and group 4 (control + melatonin). The rats in groups 1 and 2 were exposed to 3G-specific MP’s EMR for 20 days (40 min/day; 20 min active (speech position) and 20 min passive (listening position)). Group 2 was also administered with melatonin for 20 days (5 mg/kg daily during the experimental period). ECG signals were recorded from cannulated carotid artery both before and after the experiment, and BP and HR were calculated on 1st, 3rd and 5th min of recordings. ECG signals were processed and statistically evaluated. In our experience, the obtained results did not show significant differences in the BP, HR and ECG parameters among the groups both before and after the experiment. Melatonin, also, did not exhibit any additional effects, neither beneficial nor hazardous, on the heart hemodynamics of rats. Therefore, the strategy (noncontact) of using a 3G MP could be the reason for ineffectiveness; and use of 3G MP, in this perspective, seems to be safer compared to the ones used in close contact with the head. However, further study is needed for standardization of such an assumption.

Successful management of spontaneous aortic dissection type B in the third trimester of pregnancy : case report - online article

Acute aortic dissection is a life-threatening disease that requires immediate surgical intervention. Although aortic dissection is a rare condition during pregnancy, it is of high risk for both mother and foetus. Most cases of aortic dissection during pregnancy have certain risk factors, including Marfan syndrome and congenital heart diseases. In this study, we report on a case of acute aortic dissection developing spontaneously at 32 weeks of gestation. The patient delivered a baby through cesarean section, and medical management of the dissection was commenced. Both mother and neonate survived and recovered well.

Pseudoaneurysm of high origin ulnar artery after penetrating trauma.

High origin ulnar artery from the brachial artery is rare and lies superficially in the forearm. Its reported frequency ranges from 0.17% to 2%. Pseudoaneurysms of peripheral arteries are very rare, and mostly these are the result of penetrating injuries. Here, we report a case pseudoaneurysm of high origin ulnar artery from the brachial artery and its surgical approach method.

Right axilloaxillary cannulation for surgical management of a giant ascending aortic aneurysm

Aortic aneurysms larger than 10 cm are defined as “giant aortic aneurysms” and may occur in adults and infants. When these ascending aneurysms are in close proximity to the sternum, peripheral cannulation may be necessary prior to opening the chest. Currently, the axillary artery is the second most common site for arterial cannulation for ascending aortic pathology and may also be recannulated if it has been used previously. In addition, the axillary vein may also be used to initiate cardiopulmonary bypass (CPB) when the femoral venous system is diseased. We present images of a patient with a giant ascending aortic aneurysm in which axilloaxillary cannulation was used to initiate CPB. A 35-year-old male presented with dyspnea and chest pain. He had a history of chronic venous insufficiency and edema of the lower extremities. On physical examination, there was a 4/6 diastolic murmur and diffuse, bilateral varicose veins, and edema of the lower extremities. A computed tomography (CT) angio revealed a 14.5-cm ascending aortic aneurysm involving the root and extending to just below the arch vessels (Figure 1). A transthoracic echocardiogram also demonstrated 4+ aortic insufficiency, an ejection fraction of 45%, and a pulmonary artery pressure of 50/27 mmHg. Doppler ultrasound of the lower extremities revealed diffuse, dilated superficial, and deep varicose veins. Since the aneurysm was in close proximity to the sternum, it was elected to place the patient on CPB before opening the chest. The right axillary artery was directly cannulated with a 21-Fr DLP arterial cannula (Medtronic Inc., Minneapolis, MN). In view of the diseased femoral venous system, the axillary vein was directly cannulated with a 24-Fr DLP femoral artery cannula. Partial CPB

The Surgical Repair of a Hyperimmunoglobulin E Syndrome Associated Ascending Aortic Aneurysm

Hyperimmunoglobulin E syndrome (HIES) is an immunodeficiency disorder that manifests itself by affecting more than one system. Arterial aneurysms are among the significant complications associated with HIES. Surgical procedures for patients with such aneurysms are uncommon. In this study, we aim to present the case and surgical repair of a male child who was previously diagnosed with HIES and presented with rapidly expanding ascending aortic aneurysm.