Effects of blood transfusion, cardiopulmonary bypass time, and bypassed vessels on mortality following isolated and combined coronary artery bypass grafting.

OBJECTIVE: This study aimed to investigate the correlation between the number of bypassed vessels, the duration of Cardiopulmonary bypass, blood transfusion requirements, revision rates, and mortality outcomes. The objective was to get insights into the potential challenges that may arise during the postoperative phase. METHODS: Our study covered a total of 677 patients from January 2015 to January 2021. The study and analysis focused on many factors including the surgical procedure, the number of bypassed vessels, transfusion requirements, comorbidities, revision rates, the administration of blood thinners, and early mortality. RESULTS: Male patients numbered 513 and female patients 164. The combined coronary artery bypass grafting surgeries were 187, whereas the isolated ones were 490. Combination procedures traditionally used one- and two-vessel bypass grafting. 30.9% of patients had three vessels, while 31.6% had four. The typical blood transfusion has 4.2 erythrocytes. Fresh frozen plasma averaged 2.9 units, platelets 2.4 units, and whole fresh blood 2.6 units. The average cardiopulmonary bypass time was 145.1 and cross-clamp time was 89.3. CONCLUSION: Six vessel bypasses have the highest revision rate. Transfusion rises with longer cardiopulmonary bypass and cross-clamp periods. Using acetylsalicylic acid before surgery increases the need for fresh frozen plasma and platelets. However, warfarin sodium increases the need for fresh frozen plasma and increases mortality. The revision highly linked with total CPB, cross-clamp times, all blood transfusions, and mortality.

Surgical treatment of giant cardiac aneurysm with pseudoaneurysm in a colon carcinoma patient.

Left ventricular pseudoaneurysm is a rare and lethal condition associated with a high risk of rapid enlargement and rupture. It develops after transmural myocardial infarction (MI), cardiac surgery, trauma, or infection. When a left ventricular pseudoaneurysm is detected, surgical repair is recommended due to the high possibility of rupture. In this report, we present surgical treatment of a giant cardiac pseudoaneurysm that occurred after MI in a colon carcinoma patient.

Ascending aortic aneurysm treatment with linear plication and external wrapping technique: mid-term results.

OBJECTIVE: The aim of this study is to assess mid-term outcomes of reduction aortoplasty and wrapping technique which is an alternative method to replacement of the aorta in ascending aortic aneurysms. We aimed to show the efficacy of this technique especially when used for patients with increased perioperative mortality or morbidity due to their concomitant pathologies. MATERIALS AND METHODS: From March 2009 to May 2011, 22 patients underwent reduction aortoplasty and wrapping for ascending aortic aneurysm. The study group consisted of 16 male and six female patients with a mean age of 68 ± 13.1 years. Linear plication with wrapping was performed as concomitant surgery in 20 patients and as a primary procedure in two patients. The diameter of the aorta was measured using a computed tomography scan 12 months after surgery and was compared with the preoperative value. RESULTS: Mean aortic clamp and cardiopulmonary bypass times were 91.0 ± 58.1 and 150.7 ± 80.9 minutes, respectively. Mortality was 9.1%. In no case was the postoperative death related to the aortoplasty procedure. The mean postoperative ascending diameter was 29.5 ± 1.04 mm (vs. preoperative 49.1 ± 4.1 mm, p < 0.001). Mean follow-up time was 17.2 ± 8.88 months. During the follow-up period we observed that there were no findings to suggest redilatation. CONCLUSION: Linear plication with external wrapping is a therapeutic option with promising mid-term results, in carefully selected, high surgical risk patients with an ascending aortic aneurysm.