Kadir Çeviker

A simple aneurysmorrhaphy technique for the management of venous aneurysm: a case of massive hemorrhage at an arteriovenous fistula

fistula vein without closing the fistula (Fig. 1B). An 18 French Foley probe was cut at 5 cm, sutured in the middle and inserted into the aneurysmal venous segment, and the aneurysmal sac was sewn shut using continuous suturing with 6/0 prolene and the new venous structure was formed with the width of the Foley catheter. The Foley catheter was removed from the vein before suturing the vessel, after the reduction tailored on the Foley frame and the procedure was completed (Fig. 1C). Doppler ultrasound showed a fistula current of 650 mL/min, and the thrill was detected. Noncomplicated dialysis was resumed through the patient’s brachiocephalic fistula two weeks later. A 6-month follow-up demonstrated effective utilization of the fistula. The pathogenesis of aneurysmal dilatation in the fistulized vein includes fibrotic differentiation and loss of elasticity on the arterialized venous wall. Additionally, excessive dilatation of the vein, mobilization, technical mistakes at anastomosis and trauma, hematoma or infection at the point of entry during surgery may induce true or false aneurysm. Options available in treating such aneurysms include aneurysmal resection, ligature, plication, endovascular graft implementation or thrombin injection (3). Among these treatments, compared to open surgery, endovascular stent placement has limited use due to high costs and the necessity of imaging units, despite simple and successful application and minimal invasion. In complicated cases, the wide area of surgical exposure eases surgical intervention and therefore renders a surgical approach more desirable and the best treatment DOI: 10.5301/jva.5000553

An unusual cause of generalised seizure following cardiac surgery: with bolus cefazolin administration

Although some of the aetiological factors of seizure, such as cerebral microemboli, cerebral oedema, hypoperfusion, cerebral hypoxia and metabolic encephalopathy cannot be completely controlled during cardiac surgery, cautious management of all steps in the procedure may prevent the administrative causes of seizure. Cefazolin, which is known to be a proconvulsant agent, may be a suspected agent of seizure complications in patients with renal insufficiency. Surprisingly, intravenous bolus administration of cefazolin may also trigger seizure in patients with normal renal function. In this case report, a complication of generalised seizure after cardiac surgery with intravenous bolus administration of cefazolin is described, along with a brief review of the literature.

Deadly portal was caught red-handed: the computed tomographic images of the source of pulmonary air embolism.

FIGURE 2. Air in right ventricle and pulmonary artery. A and B, Computed tomography scan images were rendered in minimum intensity projection method, and air was localized in right ventricle outlet (black arrow) and main, right, and left pulmonary artery (white arrow). C andD, Air located in right ventricle (black arrow) and right pulmonary artery (white arrow). Deadly Portal Was Caught Red-Handed The Computed Tomographic Images of the Source of Pulmonary Air Embolism

Hücresizleştirme; Tıp alanında yenilenebilir biyolojik materyal sağlama ve yapay doku üretiminde yeni bir dönem

Hucresizlestirme (Decellularization) hucre ve hucre ici organellerin zarlarinin butunlugunu bozarak DNA, RNA, yaglar, mitokondri ve sitoplazmik zardaki hucre kimligini tasiyan proteinler ve sitozolik icerik gibi tum hucresel yapilarin temizlenerek, onemli hucre disi matriks yapilarinin uc boyutlu ultrastruktur, temel matriks proteinleri ve buyume faktorleri gibi ogelerinin korunmasi ve sonrasinda implantasyon ile in vivo ya da in vitro ortamda dokunun kendine ait ozelliklerle basarili bir sekilde yeniden modellenmesi islemidir. Bu makalenin amaci damar dokusunun hucresizlestirilmesi islemi sirasinda kullanilan bircok farkli cesit yontemin incelenerek basarili veya basarisiz yonlerinin ortaya konmasidir.

Things may not go as planned: The role of aortoiliac dilation and elongation during the estimation vascular structures' anatomical course

Highlights • Variation of aortic morphology such as aortic dimensions, branching points, and correlation with adjacent structures is highlighted.• The mechanism of variance relies on the diseases such as arteriosclerosis, syphilis and hypertension.• Patients with hypertension, atherosclerosis, and aortic aneurysm should be excluded from the study because of the variation of aortic morphology is concluded.

Late perforation of anterior mitral leaflet after surgical resection of the subaortic membrane

A 54-year-old woman who underwent surgical resection of the subaortic membrane 10 years earlier presented with new onset dyspnea. Cardiovascular examination revealed 3-4/6 pansystolic murmur at the apex. She was found to have severe mitral regurgitation (MR) with transthoracic echocardiography; 2D and real-time-3D transesophageal echocardiography demonstrated severe MR through anterior mitral leaflet perforation with precise localization. The patient was treated with surgery in which the perforated segment was closed by direct suture technique and discharged on postoperative 5th day. <Learning objective: Late anterior mitral leaflet perforation after surgical or interventional procedures has rarely been reported. We present this case to emphasize the role of traumatic injury to weak endothelial surfaces such as a valve leaflet in the development of late leaflet perforation after surgical or interventional procedures.>.

Olgu Sunumu: Romatizmal Mitral Kapak Hastalığında Dev Sağ Atriyum

Dilation and hypertrophy of the atria occur in patients with valvular heart disease especially in mitral regurgitation, mitral stenosis or tricuspid abnormalities. Dilatation of the atriums which occurs slowly in time, becomes evident with ritim disturbances and embolic events. We report a case of an unusual giant right atrium in context of rheumatic mitral stenosis, mitral regurgitation, pulmonar hypertansion and severe tricuspid regurgitation in a 40-year-old man who underwent succesfull operations as mitral valve replacement, Maze-IV radiofrequency ablation, right atrium atrioplasty and De Vega anuloplasty.

Little thunder may be the first sign of a perfect storm: a case of postmortem diagnosed AEF and slitted esophagus.

the foot. The limb salvage rate reported by Alexandriescu et al. is among the best yet reported in the literature and their method may be the most attractive approach. Because this group of patients, defined as being inoperable by conventional or endovascular means, is relatively small and probably decreasing in number by the advancement of other techniques, the experience of the individual centers is bound to be limited. As a consequence, some of the considerations previously mentioned may be speculative rather than supported by empirical evidence. We would, however, value the opinion of the authors.