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Objective: Assessment of the albumin, globulin score and albumin to globulin ratio (AGR) as a predictor of mortality and morbidity in patients who underwent Fontan procedure. Method: In a retrospective study, we evaluated serum albumin, globulin concentrations, and albumin- globulin ratio of 56 children who underwent Fontan procedure. Patients divided into two groups. Group 1 consisted of 44 patients who were discharged, and Group 2 consisted of 12 patients who died after surgery. Patients' preoperative and postoperative serum albumin, globulin and albumin globulin rates (AGR) were measured. Receiver-operating characteristic (ROC) curve analysis was used to determine the optimum cut-off levels of the postoperative albumin and AGR to predict mortality. Results: Twelve patients exited soon after surgeries. Postoperative albumin, and globulin values did not differ between groups, however postoperative labumin, and albumin/globulin ratios differed significantly between groups (p=0.002, and p=0.03, respectively). Cut-off value of 3,46 for postoperative albumin became an independent predictor of mortality, with 79% sensitivity, and 83% specificity. A cut-off value of 1.67 became an independent predictor for AGR with 75% sensitivity, and 89% specificity. Postoperative albumin levels below 3.46 mg/dL were associated with 11 -fold increase in the risk of mortality (OR 11; % 95CI 0,27-1,10; p=0.002). Conclusion: Postoperative albumin and AGR are a convenient and effective tool to predict the overall mortality and morbidity in patients undergoing Fontan operations. [ABSTRACT FROM AUTHOR]

Copyright of Journal of the Society of Thoracic Carido-Vascular Anaesthesia & Intensive Care is the property of Gogus Kalp Damar Anestezi ve Yogun Bakim Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Valvular aortic stenosis (AS) is a major cardiac valvular disease in geriatric patients. The conventional therapy for serious AS is surgical aortic valve replacement. But most of the geriatric patients are considered to be non-operable due to anesthetical and surgical high risks. Recently, transcatheter aortic valve replacement (TAVR) is rapidly evolving new alternative therapy option for these high risk AS patients. In this study, we aimed to share our experience in patients undergoing TAVR procedure under general anesthesia (GA). Material and Method: Sixty-seven patients with serious symptomatic AS (29 male, 38 female, mean age 78.3±6.44 years) undergoing TAVR procedure under GA were evaluated retrospectively and included in this study. Results: The mean durations of the procedure and anesthesia were 159±38 min and 193±41 min, respectively. A total of 28 (41%) patients underwent blood transfusions. Vasopressor drugs were infused to 4 (0.5%) patients intraoperatively The median stay of intensive care unit and hospital stay stay were 2 (1-7), and 7 (4-60) days, respectively. Conclusion: TAVR is a challeging procedure for anesthesiologists due to the complexity of the procedure itself and also the high risk carried by the patient population who will undergo TAVR. Anesthesiologists have to ensure hemodynamic stability, and to protect the vital functions. Optimal perioperative evaluation is important for rapid and safe approach to possible complications. The growing experience in TAVR procedures will result in increased procedure success rates. [ABSTRACT FROM AUTHOR]

Copyright of Journal of the Society of Thoracic Carido-Vascular Anaesthesia & Intensive Care is the property of Gogus Kalp Damar Anestezi ve Yogun Bakim Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)