ABSTRACT
BACKGROUND: It has been suggested that off-pump coronary artery bypass grafting (CABG) surgery reduces myocardial ischemia-reperfusion injury, postoperative systemic inflammatory response, and oxidative stress. The aim of this study was to measure serum malondialdehyde (MDA), high-sensitivity C-reactive protein (hs-CRP), M30, and M65 levels and to investigate the relationship between M30 levels and oxidative stress and inflammation in patients undergoing on-and off-pump CABG surgery. METHODS: Fifty patients were randomly assigned to on-pump or off-pump CABG surgery (25 patients off-pump and 25 on-pump CABG surgery), and blood samples were collected prior to surgery, and 30 minutes, 60 minutes, 6 hours, and 24 hours after CABG surgery. RESULTS: Compared to the on-pump group, serum MDA levels at 30 minutes, 60 minutes, 6 hours, and 24 hours after the CABG surgery were significantly lower in the off-pump group (P=.001, P=.001, P=.001, and P=.001, respectively). Serum M30 levels were found to be elevated in both groups, returning to baseline at 24 hours. When compared to baseline, the hs-CRP level reached its peak at 24 hours at 13.28±5.32 mg/dL in the on-pump group, and 15.44±4.02 mg/dL in the off-pump group. CONCLUSION: CABG surgery is associated with an increase in inflammatory markers and serum M30 levels, indicating epithelial/endothelial apoptosis in the early period.
Subject(s)
Coronary Artery Bypass/methods , Coronary Artery Disease/immunology , Coronary Artery Disease/surgery , Inflammation/immunology , Oxidative Stress/immunology , Reactive Oxygen Species/immunology , Adult , Apoptosis/immunology , Female , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
Venous thromboembolus is an important cause of hospital acquired morbidity and mortality. Venous thrombosis is a very rare occurrence in patients with haemophilia A. The thrombosis originated from the right main and external iliac veins, and effects the cranial segments of the main, deep and superficial femoral veins as an acute phase thrombus. Neither any local anatomic compression nor any predisposing thrombophilic risk factors were identified. We treated the patient with enoxaparine 1 mg/kg twice a day subcutaneously and then started oral anticoagulation with warfarin.
ABSTRACT
Congenital coronary-to-pulmonary artery fistulas are rare anomalies and they generally have an asymptomatic course. We presented three symptomatic patients (2 men, 1 woman; age range 46 to 53 years) who underwent surgical repair via the epicardial approach for coronary-to-pulmonary artery fistulas. Treatment was successful in two patients. Reoperation in extracorporeal circulation was required in one patient having a plexus-like fistula. The distal orifice of the fistula was closed under direct vision from within the pulmonary artery. No complications or symptoms were seen during the follow-up of patients ranging from six months to four years. During repair of coronary-to-pulmonary artery fistulas, the presence of a plexus-like variant must be kept in mind and the treatment should be planned accordingly.
