ABSTRACT
AIM: To investigate and compare uncoated and phosphorylcholine-coated oxygenators in terms of induction of humoral immune response during coronary artery bypass surgery. METHODS: A total of 20 consecutive patients who underwent coronary artery bypass surgery were randomly distributed into two groups according to the type of oxygenator used during surgery. Group 1 consisted of 10 patients who were operated on using phosphorylcholine-coated oxygenators. Group 2 contained 10 patients who underwent surgery using uncoated oxygenators. Blood and oxygenator fibre samples were obtained and compared in terms of immunoglobulins (IgG, IgM), complements (C3c, C4), serum total protein and albumin levels using electron microscopy and flow cytometry. RESULTS: In group 1, levels of IgM, IgG, total protein and serum albumin were significantly increased at the end of cardiopulmonary bypass (CPB) compared to those at the beginning of CPB. In group 2, C3c and C4 levels at the beginning of CPB were found to be significantly higher than at the end. Electron microscopic examination of oxygenator fibres demonstrated that phosphorylcholine-coated fibres were less likely to be adsorbed by serum proteins and complements than the uncoated fibres. CONCLUSION: Our results indicate that phosphorylcholine-coated oxygenators seemed to induce humoral immune response to a lesser extent than uncoated oxygenators during coronary artery bypass procedures.
Subject(s)
Cardiopulmonary Bypass/instrumentation , Coated Materials, Biocompatible , Coronary Artery Bypass , Immunity, Humoral , Oxygenators, Membrane , Phosphorylcholine/immunology , Adsorption , Aged , Biomarkers/blood , Cardiopulmonary Bypass/adverse effects , Coated Materials, Biocompatible/adverse effects , Complement C3c/metabolism , Complement C4/metabolism , Coronary Artery Bypass/adverse effects , Cross-Sectional Studies , Equipment Design , Female , Flow Cytometry , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Male , Microscopy, Electron , Middle Aged , Oxygenators, Membrane/adverse effects , Phosphorylcholine/adverse effects , Phosphorylcholine/metabolism , Serum Albumin/metabolism , Serum Albumin, Human , Surface Properties , Treatment Outcome , TurkeyABSTRACT
Endovascular aneurysm repair (EVAR) is an adequate means for treating infrarenal abdominal aortic aneurysms (AAA). However, secondary interventions are required in approximately 15% to 20% of patients. The aim of this paper was to report our knowledge with stent grafts in secondary interventions after EVAR in a 73-year-old patient. One of the exceptional complications of EVAR are endoleaks which may lead to expansion of aneurysm and rupture if not repaired.
Subject(s)
Aorta, Thoracic , Aortic Diseases/complications , Echinococcosis/complications , Embolism/etiology , Adult , Albendazole/therapeutic use , Anthelmintics/therapeutic use , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/parasitology , Aorta, Thoracic/surgery , Aortic Diseases/diagnosis , Aortic Diseases/parasitology , Aortic Diseases/therapy , Aortography/methods , Biopsy , Blood Vessel Prosthesis Implantation , Echinococcosis/diagnosis , Echinococcosis/parasitology , Echinococcosis/therapy , Embolism/diagnosis , Embolism/therapy , Female , Humans , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
BACKGROUND: Aortic occlusion is rare catastophic pathology with high rates of mortality and severe morbidity. In this study, we aimed to share our experience in the management of aortic occlusion and to assess the outcomes of extra-anatomic bypass procedures. METHODS: Eighteen patients who had undergone extra-anatomic bypass interventions in the cardiovascular surgery department of our tertiary care center between July 2009 and May 2013 were retrospectively evaluated. All patients were preoperatively assessed with angiograms (conventional, computed tomography, or magnetic resonance angiography) and Doppler ultrasonography. Operations consisted of bilateral femoral thromboembolectomy, axillobifemoral extra-anatomic bypass and femoropopliteal bypass and were performed on an emergency basis. RESULTS: In all patients during early postoperative period successful revascularization outcomes were obtained; however, one of these operated patients died on the 10th postoperative due to multiorgan failure. The patients were followed up for a mean duration of 21.2±9.4 months (range, 6 to 36 months). Amputation was not warranted for any patient during postoperative follow-up. CONCLUSION: To conclude, acute aortic occlusion is a rare but devastating event and is linked with substantial morbidity and mortality in spite of the recent advances in critical care and vascular surgery. Our results have shown that these hazardous outcomes may be minimized and better rates of graft patency may be achieved with extra-anatomic bypass techniques tailored according to the patient.
