Ufuk Özergin

Clinical features and surgical treatment of cardiac myxoma: report of 18 cases.

Myxomas are the most common benign primary cardiac tumors. As many patients with cardiac myxoma suffer from cerebral or systemic embolism, which are serious complications, diagnosis of the tumor is vital. Between 1990 and 2000, 18 patients (6 males, 12 females), aged 24 to 73 years (mean, 55.3 years), were operated on for cardiac myxoma. The most common location of the myxoma was the left atrium (78%), and the transseptal surgical approach was preferred (78%) as it allows total resection of the left atrial myxoma along with its pedicle. Carney complex, a familial autosomal dominant form of atrial myxoma, was not found in any of the patients. There had been no operative or postoperative mortality and morbidity. The mean postoperative follow-up period was 5 years (mean, 1 to 10 years). No recurrence had been seen. We believe that the transseptal approach, in allowing total resection of the myxoma, prevents recurrence.

Hydatid Cyst on Right Ventricular Posterior Wall

A 14-year-old boy was investigated for unexplained tachycardia and multiple pulmonary emboli demonstrated by computed tomography. A right ventricular hydatid cyst was diagnosed by echocardiography and successfully excised under cardiopulmonary bypass.

The cerebroprotective effects of pentoxifylline and aprotinin during cardiopulmonary bypass in dogs

Objective: The purpose of this study was to investigate the cerebroprotective effects of pentoxifylline (PNX) and aprotinin in dogs using cardiopulmonary bypass (CPB). Materials and methods: Eighteen clinically healthy dogs were divided into three groups: Group 1 (control, n = 6), Group 2 (PNX, n = 6), and Group 3 (aprotinin, n = 6). PNX was administered at a dose of 300 mg/day in Group 2 three days before the operation and during the operation. Half a million IU aprotinin were added to the prime solution and 500 000 IU were transfused via a central venous jugular catheter preoperatively in Group 3. Blood samples were taken from the central jugular vein before and after CPB and interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and S100β protein were measured. Gliosis was investigated histopathologically in cerebral cortex biopsy samples under light microscopy. Results: The preoperative results of IL-6, TNF-α, and S100β protein values were found to be significantly higher (p < 0.001) when compared with postoperative values. This significant difference was observed in the same parameters between Groups 1 and 2, and 1 and 3 (p < 0.001). There was no significant difference between Groups 2 and 3. Comparison between pre- and postoperative levels of IL-6 and TNF-α for Group 2 and Group 3 revealed statistically significant differences (p < 0.001), whereas S100β protein levels did not. Histopathological examinations showed significant differences between the control group and PNX and aprotinin, and between aprotinin and PNX groups (p < 0.001). Conclusion: PNX and aprotinin might be useful in order to reduce postoperative cerebral damage in patients undergoing cardiac surgery with CPB.

A comparison of the hemodynamic and metabolic effects of extraperitoneal carbon dioxide and nitrous oxide insufflation

BACKGROUND The aim of the present study was to compare the hemodynamic and metabolic effects of extraperitoneal carbon dioxide (CO(2)) and nitrous oxide (N(2)O) insufflation. MATERIAL AND METHODS Fourteen dogs were used in the experiment. All the animals were intubated under general anesthesia. A catheter was placed into the right jugular vein for central venous pressure (CVP), pulmonary artery pressure (PAP), pulmonary wedge pressure (PWP), and heart rate (HR) monitorization. End-tidal CO(2) pressure was measured by a capnometer connected to the endotracheal tube. Another catheter was inserted into the left femoral artery for arterial blood gas analysis and blood pressure monitorization. The preperitoneal dissection was made from a 1.5 cm subumbilical incision by using a preperitoneal dissection balloon. A laparoscope was placed in the preperitoneal space and the gas insufflation was kept at a constant pressure of 12 mm Hg throughout the experiment. All the study parameters were measured at the beginning of the insufflation and at every 15 minutes for 1 hour. RESULTS Mean artery pressure increased with time in both groups, but the increase was only significant in the CO(2) group. PWP, CVP, PAP, and HR increased slightly in both groups, but there was no significant difference between the groups. The end-tidal CO(2) increased in the CO(2) group but decreased from the baseline in the N(2)O group. A significant acidosis was observed in only the CO(2) group. PaCO(2) significantly increased in the CO(2) group; hence, PaCO(2) slightly decreased in N(2)O group. The difference between the groups was significant. CONCLUSIONS N(2)O insufflation of the extraperitoneal space in dogs avoided the unwanted metabolic and hemodynamic side effects of CO(2) insufflation. Thus, N(2)O insufflation in the extraperitoneal space is a safer alternative to CO(2) insufflation experimentally, and can be preferred especially in patients with cardiac and pulmonary diseases.

Benign mature cystic teratoma of the anterior mediastinum leading to heart failure: Report of a case

A 12-year-old male child was referred to our clinic for the surgical treatment of an anterior mediastinal mass, suspected to be a thymic cyst, which was considered to potentially lead to cardiac failure. The mass was resected completely with a median sternotomy. The postoperative course was uneventful. A pathological examination revealed a mature cystic teratoma of anterior mediastinum which is a very rare cystic tumor at this location. The incidence, diagnostic procedures, complications, and treatment of mediastinal teratomas are discussed along with a review of the literature.

Infected Myocardial Hydatid Cyst Imitating Pericardial Cyst

Pericardial hydatid cyst was diagnosed by 2-dimensional echocardiography and magnetic resonance imaging in a 25-year-old female. At operation, an infected myocardial hydatid cyst was found on the lateral wall of the left ventricle.

Suppurated mediastinal and cardiac echinococcosis: report of a case.

We herein report the case of a suppurated mediastinal and cardiac hydatid cyst which occurred after the initial treatment of the patient for a primary mediastinal hydatid cyst in a radiology department. Both extracorporeal circulation and total circulatory arrest were used during the operation. We believe that surgery is the only feasible treatment for hydatid cysts located in the mediastinum, and surgery should be urgently performed whenever a possible rupture is suspected in order to avoid a possible anaphylactic reaction, mediastinal suppurations leading to serious complications, and growth into the pleural cavity.

Peripheral arterial injuries: A study of four hundred and seventeen cases

In this article 417 patients are examined retrospectively. They are reviewed according to their ages, sex, types of injuries, clinical findings, surgical approaches and complications. Most of them were young males (78%) between 11–30 years of age (65%) and 74% were injured by sharp weapons and gunshots. Femoral artery injuries were seen in 29% of all patients. Amputation was performed in 6.4% of cases, but in the popliteal artery group the amputation ratio was 14%. Thirteen patients died from hypovolemic shock or acute renal failure (3.12%).

A giant right atrial myxoma: Case report

Right atrial myxomas have rarely been reported. The authors describe a giant hourglass-shaped atrial myxoma consisting of three lobes; one of them had protruded into the right ventricle. Its size was 18×7×5 cm and weight was 170 g. The authors were not able to find another myxoma as big as this one in the literature, so they are reporting it. They review and discuss the literature involving the subject.

Bilateral aneurysms of the pulmonary artery with pectus excavatum: a case report

An eleven-year-old boy was operated on for a left-sided pulmonary artery aneurysm. The same patient had also been operated three years earlier because of a right sided aneurysm.