Muharrem Kocyigit

A simple method for occlusion of both venae cavae in total cardiopulmonary bypass for robotic surgery.

We describe a novel surgical technique for occlusion of the superior and inferior venae cavae which allows opening of the right atrium safely during robotic cardiac surgery.

Robotic mitral valve replacement

Robotic surgical techniques allow surgeons to perform mitral valve surgery. This procedure has gained acceptance, particularly for mitral valve repair in degenerative mitral disease. However, mitral repair may not always be possible, especially in severely calcified mitral valve of rheumatic origin. This study demonstrates the basic concepts and technique of robotic mitral valve replacement for valve pathologies that are not suitable for repair.

Endoscopic-assisted Robotic Aortic Thrombectomy and Aortobiiliac Bypass: A Case Report

In this report, not only our experience with laparoscopy-assisted robotic aortic thrombectomy and aortobiiliac bypass procedure was presented but also current status of vascular interventions via endoscopically was discussed.

Replacement of the Ascending Aorta for Severe Atherosclerosis During Coronary Artery Bypass Surgery

Abstract  Background and Aim : In the present study, we investigated the benefit of ascending aorta replacement in patients with severe aortic atherosclerosis who undergo coronary artery bypass surgery (CABG). Methods: From January 2001 to April 2011, 3842 patients underwent CABG and in 36 of these patients (31 male, 5 female) the ascending aorta was replaced due to severe atherosclerosis. Total circulatory arrest was used in 22 patients (61%). The patients were followed for 69 ± 36 months (1–133 months) and compared to a control group of patients. The control group consisted of patients who underwent CABG with or without a concomitant procedure (n = 3806). Results: For the study group, the mean additive and logistic Euroscores of the patients were nine and 20, respectively. One stroke (2.8%) was observed and this patient died in the early postoperative period. There were a total of four confirmed deaths (12%) at any time point over the length of the follow‐up among the patients who were discharged from the hospital. Two of them died of malignancy (lung and gastric tumors) and the other two from cardiac reasons. No patients had a stroke during follow‐up. For the control group the mean age was 61 ± 1, the stroke rate was 0.6%, and the mortality rate was 0.96%, and the mean logistic and additive Euroscores were 3.7 ± 4.4, and 3.5 ± 2.5, respectively. Conclusions: Replacement of highly calcified ascending aortas during CABG can be safely performed in selected patients with good long‐term outcomes. (J Card Surg 2012;27:538‐542)

Aortic valve reconstruction with autologous pericardium in a patient with osteogenesis imperfecta

Abstract Cardiac valve surgery for patients with osteogenesis imperfecta is associated with a high incidence of complications such as perioperative bleeding and valve detachment. In this report, we present a patient who was diagnosed with osteogenesis imperfecta and severe aortic insufficiency and also discussed treatment options.

Transesophageal Echocardiography: Sine Qua Non In Cardiac Surgery

Objective: Intraoperative transoesophageal echocardiography (TEE) performed during cardiac surgery provides information about the cardiac pathology and the surgical repair. The aim of this study is to determine the importance of TEE in surgical decision making phase in patients undergoing cardiac surgery. Material and Method: We reviewed the data for all patients who underwent cardiac surgery and TEE between January 2015 and December 2016. Intraoperative TEE examination was performed before and after the cardiopulmonary bypass (CPB). The data collected related to the type of surgery, preoperative echocardiographic findings, TEE findings before and after CPB and any differences between them were evaluated. Results: A total of 284 patients who underwent cardiac surgery during 2 years period were evaluated using TEE. The initial TEE findings of 15.8% (n=45) of the patients differed from those observed before cardiopulmonary bypass (CPB). The results of the TEE assessments before and after CPB affected surgical decisionmaking in 3.5% (n=10) and 2.5% (n=8) of the cases, respectively Conclusion: Perioperative TEE performed by the anesthesiologist can provide important information, may lead to alterations in the surgical strategy and improve the operative outcomes.

Comparative Effects of Blood and Crystalloid Cardioplegia on Cellular Injury and Oxidative Stress in Cardiovascular Surgery

Purpose: The purpose of this study was to evaluate the effect of different cardioplegic solutions on endothelial integrity and oxidative stress in cardiovascular surgery. Methods: In this randomized prospective study, after ethics approval and informed consent, 60 surgical patients were included. Patients undergoing coronary bypass surgery were randomized into two groups as warm blood cardioplegia (n = 30) and cold crystalloid cardioplegia (n = 30) following the cross-clamping. Measurements were performed at three time points: before induction of anesthesia (T1), at admission to intensive care unit (ICU) (T2) and at the 24th postoperative hour (T3). Besides biochemical routine hemodynamic monitoring, patients were assessed for the sialic acid (SA), ischemic-modified albumin (IMA), advanced oxide protein products (AOPPs), total thiol (SH), and free hemoglobin (fHb) level. Results: Neither crystalloid nor blood cardioplegia led to significant changes in the AOPPs, T-SH, and SA level (p >0.05). Crystalloid cardioplegia, however, increased IMA level compared to both baseline (p <0.01) and blood cardioplegia group (p <0.05). fHb levels were transiently increased in both groups at the second-time point (p <0.001). fHb level was lower in the crystalloid group compared to that in the other group (p <0.05) at T2. Conclusion: Cardioplegia type creates similar effects on glycocalyx integrity. However, myocardial protection could be provided with warm blood cardioplegia.

Robotic atrial septal defect closure

Atrial septal defect (ASD) is one of the most common congenital cardiac diseases. This pathology can be treated with percutaneous devices. However, some of the ASDs are not suitable for device closure. Also, there may be device-related late complications of transcatheter ASD closure. Currently, robotic surgical techniques allow surgeons to close ASDs in a totally endoscopic fashion with a high success rate and a low complication rate. This study demonstrates the basic concepts and technique of robotic ASD closure.

Long Term Results of Valve Sparing Aortic Root Replacement; A Single Center Experience

PP-044 The aim of this study is to investigate the early and midterm results of valve sparing aortic root replacements. Between 1999 and 2013 a total of 7220 patients underwent cardiac operations, 26 of them (0.3%) were valve sparing aortic root replacements. The aortic pathology included either