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Objective: This study was conducted to identify the diagnostic value of carotid stump pressure for determining the need for a carotid artery shunt in patients undergoing carotid artery endarterectomy. Materials and methods: Carotid stump pressure was prospectively measured in all carotid artery endarterectomies performed under local anesthesia between January 2020 and April 2022. The shunt was selectively used when neurological symptoms appeared after carotid cross-clamping. Carotid stump pressure was compared between patients who needed shunting and those who did not. Demographic and clinical characteristics, hematological and biochemical parameters, and carotid stump pressure of the patients with and without shunts were statistically compared. To determine the optimal cutoff value and diagnostic performance of carotid stump pressure for identifying the patients who need a shunt, receiver operating characteristic analysis was performed. Results: Overall, 102 patients (61 men and 41 women) who underwent carotid artery endarterectomy under local anesthesia were included, with an age range of 51–88 years. A carotid artery shunt was used in 16 (8 men and 8 women) patients. The carotid stump pressure values of the patients with a shunt were lower than those without a shunt (median (min–max): 42 (20–55) vs 51 (20–104), p < 0.0006). In the receiver operating characteristic curve analysis performed to determine the need for a shunt, the optimal cutoff value of carotid stump pressure was ≤48 mmHg, sensitivity was 93.8%, and specificity was 61.6% (area under the curve: 0.773, p < 0.0001). Conclusion: Carotid stump pressure has sufficient diagnostic power to determine the need for a shunt, but it cannot be used alone in the clinical setting. Instead, it can be used in combination with other neurological monitoring methods. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Mother Tongue Education / Ana Dili Egitim Dergisi is the property of Journal of Mother Tongue Education / Ana Dili Egitim Dergisi 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.)

Background: We aim to compare the diameters of ascending aorta in COVID-19 patients and COVID–19-free individuals referred to our pandemic hospital. Methods: The medical records and thorax tomographies of patients admitted to the "pandemic central" state hospital with symptoms of COVID-19 were observed between April 2020 and May 2020 in this case-control study. The first group consisted of patients diagnosed with COVID-19, and the second group consisted of patients without the disease. The diameter of the ascending aorta is measured via tomography and compared to each other. The most causative risk factors for aortic enlargements underwent a multivariate regression analysis. Results: Charts of 156 patients (104 COVID-19 positives, 52 COVID-19 negatives) were reviewed. There was a statistical difference (p :.01) between the mean aortic diameter of COVID-19 patients (39 mm) and COVID-free patients (32.5 mm) even though comorbid factors and patient characteristics were similar in the two groups at the time of hospital admission. The regression analysis result demonstrates that COVID-19 (leading factor), age, and coronary artery disease were the most significant factors associated with increasing aortic dimensions. (p :.001, B: 5.3/, p :.02, B: 3.36/, p :.002, B: 0.13/, R square: 40.2%). Conclusion: This study shows that the mean aortic diameter of COVID-19 patients is larger than non–COVID-19 patients with similar comorbidities referred to a pandemic hospital. COVID-19, age, and coronary artery disease are the most influential factors that affect the aortic diameter, and the COVID-19 was the leading factor. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Studies - Educational Sciences is the property of Electronic Turkish Studies 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.)

Objectives: The aim of the study was to clarify the reliability and quality of English videos about Coronary artery bypass grafting on YouTubeTM. Methods: The study was performed between July 16 and July 30. A cardiovascular surgeon searched for terms including "coronary artery disease," "coronary artery treatment," "coronary artery bypass" and "coronary artery bypass surgery," in YouTubeTM. All videos were classified into two groups according to the source who uploaded the video as professional videos and non-professional videos. Video characteristics including duration of video on YouTube™, length of video, and view numbers for each video were recorded. Moreover, the numbers of "comments," "likes," and "dislikes" were noted. Furthermore, the target audience of the videos (professional health care worker and patients) was analyzed, DISCERN score and Global quality score (GQS) were calculated for each video. Results: Totally, 812 videos were divided into two groups according to upload sources; 448 videos were categorized as professional videos and 364 videos were categorized as non-professional videos. The mean number of views was 3220.5 for professional videos and 2216.5 for non-professional videos (p=0.001). In addition, the mean "like" numbers and mean comment numbers were significantly higher for professional videos (p=0.001 and p=0.001). The mean DISCERN score was 2.6 for professional videos and 1.5 for non-professional videos (p=0.001). Similarly, the mean GSQ was significantly higher for professional videos (3.5 vs. 2.5, p=0.001). Conclusion: YouTube™ videos which are shared by professional healthcare workers have better quality and reliability with signifi- cantly higher DISCERN score and GQS. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Reconstructive Urology is the property of Turkiye Klinikleri 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.)

Objectives: The aim of the study was to clarify public interest about cardiovascular disease during the COVID-19 pandemic using Google Trends (GT). Methods: The study was performed between November 20 and December 1, 2021. A total of 21 keywords related to cardiovascular surgery were selected. Public attention to all selected keywords was analyzed by GT with using the filters "web search," "all categories," and "Turkey." In Turkey, three COVID-19 waves (between March 12, 2020, and May 8, 2020, November 24, 2020, and January 20, 2021, and March 20, 2021, and May 16, 2021) were experienced since the beginning of the pandemic. To analyze public attention to cardiovascular surgery during the COVID-19 waves, 8-week periods during the COVID-19 waves were compared with the same times in the past 4 years (2016-2019). Results: Comparisons of March 12-May 8 2020 and the same period between 2016 and 2019 showed that total public interest about cardiovascular surgery was significantly decreased (-28.7%, p=0.001). The comparison of the second COVID-19 wave (November 24, 2020-January 20, 2021 versus November 24-January 20, 2016-2019) revealed that public interest about cardiovascular surgery was significantly lower in the COVID-19 era (-22.2%, p=0.001). Comparison of the third COVID-19 wave and the same periods in the previous 4 years demonstrated that public interest about cardiovascular disease was significantly lower in the COVID-19 era (-8.5%, p=0.001). In contrast, the term coronary angiography was searched significantly more during the third wave of COVID-19 in comparison to the same periods between 2016 and 2019 (17.9%, p=0.015). Conclusion: Our study demonstrated that public interest in cardiovascular diseases was significantly decreased in all waves of the COVID-19 pandemic. However, interest in only the term coronary angiography was significantly increased in the third wave of pandemic. [ABSTRACT FROM AUTHOR]

Background: It is critical to clarify the biochemical factors associated with thrombosis development following tunneled dialysis catheter (TDC) insertion. Methods: The study involved retrospective analysis of charts of patients hospitalized for permanent TDC placement between 2013 and 2020 in a tertiary academic center. Patients undergoing a hemodialysis schedule with permanent TDC for more than three months were included in the study. To determine predictive factors associated with thrombosis development in permanent TDC, patients were assigned to one of two groups, according to the extent of thrombosis. The groups were compared in terms of demographic characteristics, blood test values, complication and length of follow-up period. Results: A total of 350 patients (204 female, 146 male) were enrolled into the study. In patients with thrombosis the mean BMI was found significantly higher (p = 0.001) and presence of diabetes mellitus was significantly common (p = 0.014). Patients with thrombosis had significantly higher D-dimer (6.5 vs. 2.4 µg/mL, p = 0.001) and procalcitonin levels (4.1 vs. 1.4 ng/mL, p = 0.001). Additionally, patients with thrombosis had a significantly higher rate of infective complications (p = 0.014). Logistic regression analysis revealed that BMI > 30 kg/m² and infective complications increased thrombosis risk 3.842 and 3.104 times (p = 0.004 and p = 0.038, respectively). Additionally, Ddimer level > 3 µg/mL and procalcitonin level > 2 ng/mL were significantly associated with the development of thrombosis (p = 0.001 and p = 0.007). Conclusions: The present study demonstrated that the presence of infection, higher BMI > 30 kg/m², D-dimer level > 3 µg/mL and procalcitonin level > 2 ng/mL were found to increase the incidence of thrombosis. [ABSTRACT FROM AUTHOR]

This article discusses a rare case of mediastinal parathyroid adenoma and the use of indocyanine green angiography during surgery. The patient, a 55-year-old female, presented with symptoms of hyperparathyroidism and underwent sternotomy with intraoperative indocyanine green angiography. The procedure allowed for visualization and removal of the enlarged parathyroid tissue, as well as the detection of thymic tissue involvement. The use of indocyanine green angiography was found to be beneficial in reducing operation time, guiding surgical orientation, and preventing persistent hyperparathyroidism. [Extracted from the article]

Objectives: This study aims to determine the protective effect of cilostazol on myocardium in obese Wistar rats with induced ischemia-reperfusion injury (IRI). Methods: Four groups with 10 Wistar rats were included: 1] Sham Group: IRI was not established in normal weight-Wistar rats. 2] Control Group: IRI but no cilostazol in normal weight-Wistar rats. 3] Cilostazol in normal weight-Wistar rats: IRI and cilostazol was administered. 4] Cilostazol in obeseWistar rats: IRI and cilostazol was administered. Results: Tissue adenosine triphosphate (ATP) levels were significantly higher and superoxide dismutase (SOD) levels significantly lower in the control group than in the sham group and normal weight cilostazol group (p=0.024 and p=0.003). Fibrinogen levels were 198 mg/dL in the sham group, 204 mg/dL in the control group, and 187 mg/dL in the normal-weight cilostazol group (p=0.046). Additionally, plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in the control group (p=0.047). The level of ATP was significantly lower in the normal-weight cilostazol group than in the obese group (104 vs 131.2 nmol/g protein, p=0.043). PAI-1 level was 2.4 ng/mL in the normal weight cilostazol group and 3.7 ng/mL in the obese cilostazol group (p=0.029). Normal-weight Wistar rats with cilostazol had significantly better histologic outcomes than the control group and obese Wistar rats (p=0.001 and p=0.001). Conclusion: Cilostazol has a protective effect on myocardial cells in IRI models by decreasing inflammation. The protective role of cilostazol was reduced in obese Wistar rats compared with normal-weight Wistar rats. [ABSTRACT FROM AUTHOR]

Objectives: End-stage renal disease (ESRD) is very common and affecting almost 10% of the population worldwide. Arterio-venous fistulas (AVFs) become first access options for hemodialysis but AVFs may contribute to maladaptive cardiovascular remodelling. Methods: We studied the efect of radiocephalic AVFs (RC-AVFs) and brachiocephalic AVFs (BC-AVFs) creation on cardiac structure and function in patients with ESRD. In this study patients with listed for AVF creation underwent echocardiography before and six weeks after the surgery. The primary outcome was changes in left ventricle (LV) volumes and LV ejection fraction. The secondary outcome was determinining which type of fistula increases the likelihood of cardiovascular remodelling more. Results: Between November 2022 and March 2023, a total of 38 patients (mean age 62 years) who underwent AVFs surgery were included in the study. Out of these patients, 17 received RC-AVFs, while 21 patients received BC-AVFs. Echocardiography revealed a significant increase in left ventricular end-diastolic pressure (LVEDP) in both groups (p=0.02). The increase in LVEDP was found to be significantly higher in the BC-AVFs group compared to the RC-AVFs group (p=0.03). However, there were no significant changes observed in ejection fraction. Conclusions: AVF creation is a critical treatment method in ESRD. However, high-flow fistulas carry a substantial risk potential in patients with underlying cardiovascular diseases. To avoid an increase in left ventricular pressure (LVP), especially in BC-AVFs, it is possible to create smaller diameter artery and vein anastomoses. This approach can help minimize the risk of elevated LVP associated with AVFs. [ABSTRACT FROM AUTHOR]

A 32-year-old male presented with pain in the left lower extremity while walking and a pulsatile mass on the backside below the left knee level. Aneurysmal dilatation was reported in the popliteal artery in the magnetic resonance angiographic examination. Following the surgical resection of the sac and revascularization, fungal fibers were detected in the histopathological examination and microbiological evaluation of the specimen. Considering the potential etiology, a detailed cardiac assessment was carried out in asymptomatic patient. On echocardiographic evaluation significant vegetation on the anterior leaflet of the mitral valve and severe mitral insufficiency were detected. With appropriate anti-fungal treatment and successful surgical management complete recovery was achieved. [ABSTRACT FROM AUTHOR]

Pacemaker implantation in patients with tricuspid prosthesis is a challenging situation. It is not possible to pass the pacing lead through tricuspid valve in these patients. Therefore, ventricular pacing can be achieved either epicardial or endocardial left ventricular stimulation. For epicardial pacing, lead implantation can be done transvenously via coronary sinus or surgically. In this paper, we present a patient who had complete atrioventricular block (CAVB) following tricuspid valve prosthesis implantation and treated with epicardial pacing via coronary sinus. In patients who develop CAVB after tricuspid valve replacement, can be treated with permanent pacemaker implantation via CS. This technique enables a minimally invasive approach and effective stimulus in patients with inaccessible right ventricle because of the presence of prosthetic tricuspid valve. [ABSTRACT FROM AUTHOR]

Background: PDA(Patent ductus arteriosus) is a common and clinically important condition which is presented with a number of hemodynamic and respiratory problems such as intraventricular hemorrhage, pulmonary hemorrhage and necrotizing enterocolitis due to increased pulmonary blood flow and stealing from systemic circulation. The incidence of PDA among the infants that were born before the 28th gestational week is as high as 70 %; and spontaneous closure rates in very-low-birth-weight premature neonates(VLBWPN) is around 34 %. The onset, duration, and repeat number of consecutive courses of the prostaglandin synthesis inhibitor medication for PDA closure are still issues of debate. Bed-side PDA closure is a safe surgical procedure in both mature and premature babies. Here we aim to retrospectively present our 26 cases which were less than 28 weeks and 1000 grams that underwent bed-side PDA ligation. Methods: This retrospective study included 26 VLBWPN with PDA that underwent bed-side ligation between 2012 and 2015. Babies were born before the 28th gestational week (23-27 weeks) and less than 1000 grams (489-970 gr). Of the 26, 15 were female and 11 were male. Indomethacin was administered to all of the cases as the medical closing agent. The medication was stopped due to unwanted effects in 6 cases. All of the patients took medical treatment before surgery. Results: No surgical mortality occurred during our study. One case of pneumothorax was recorded as late surgical complication. Five of the 26 patients were lost, and the most common cause of mortality was sepsis (in 3 cases). The remaining 21 cases were discharged on days 86-238. The follow-up periods of the patients were 2 moths - 3 years. The most frequent problems encountered after discharge was chronic lung problems. Conclusions: Bed side PDA ligation surgery in the ICU is a safe method for VLBWPN with clinically significant PDA. [ABSTRACT FROM AUTHOR]

A 51-year-old man was referred to our institution for dyspnea on exertion and non-productive cough, of three-month history. A silent inferior myocardial infarction was detected incidentally on an ECG that manifested itself as inferior Q waves. Two-dimensional transthoracic echocardiography demonstrated a second large cardiac chamber (6x5 cm) adjacent to the inferior-basal left ventricle wall, with a narrow neck and to-and-fro signals during Doppler US evaluation. Ventriculography showed a pseudoaneurysm, like an hourglass, on the inferior wall of the left ventricle which was approximately 6x5 cm in diameter. Coronary angiography showed triple vessel disease with total occlusion of the circumflex coronary artery. These findings were consistent with left ventricular pseudoaneurysm resulting from an old inferior myocardial infarction. After diagnosis of left ventricular pseudoaneurysm and concomitant coronary artery disease, surgery was recommended. He underwent coronary artery bypass surgery including the repair of the pseudoaneurysm. But, unfortunately the patient died in during the operation. This case illustrates that pseudoaneurysm can develop after silent myocardial infarction with nonspecific symptoms. In addition, if false aneurysm invades adjacent organs such as lungs, then the risk of surgical mortality increases. [ABSTRACT FROM AUTHOR]

In this study we analyzed the surgical outcomes of reconstruction of the diffusely diseased left anterior descending artery (LAD) with saphenous vein patch, and by left internal thoracic artery (LITA) grafting on to the patch during on-pump coronary artery bypass surgery. Between 2009 and 2014, 21 patients (mean age 65.1 years) underwent vein patch angioplasty combined with left internal thoracic artery bypass. Five of them (24.8%) had a history of myocardial infarction, and 2 patients (9.5%) had unstable angina and 1 patient (4.8%) acute anteroseptal myocardial infarction. Twelve patients (54.0%) were Canadian Cardiovascular Society class III or IV, and 10 patients (48.0%) were New York Heart Association class III or IV. The mean number of distal anastomoses per patient was 3.24±0.62. The mean length of vein patch was 4.14±0.82 cm. The 30-day mortality rate was 4.8% (n=1). There were 3 late cardiac-related deaths observed at postoperaticve 2., 11., and 40. month The actual survival was 90.0% at 2, and 81.0% at five years. Follow-up angiogram (15 patients, 71.4%) revealed patent LITA graft in 93.3% of the patients. Long segmental LAD reconstruction with autologous saphenous vein patch without endarterectomy, provides alternative approach with acceptable long-term results to the patients who have diffusely diseased coronary arteries. [ABSTRACT FROM AUTHOR]

• Chaetomium species is widespread worldwide and rarely cause infection in human. • This is the first reported case of endocarditis caused by Chaetomium species. • Mortality is high for invasive Chaetomium infections. • Molecular tools are used to confirm the diagnosis in Chaetomium infections. • Appropriate treatment for Chaetomium infections is unknown. Chaetomium globosum is a dematiaceous, filamentous fungus belonging to the large genus saprobic ascomycetes and is rarely involved in human infection. We present the case of a 25-year-old man undergoing tricuspid valve replacement due to recurrent prosthetic ring endocarditis. Initially, it was considered culture-negative endocarditis; however, the diagnosis of Chaetomium globosum could only be provided by DNA isolation of the mold isolate grown in culture and the valve tissue samples taken from the patient. This report describes the first documented tricuspid endocarditis caused by Chaetomium species and discusses the importance of molecular tools to enhance the diagnostic process in culture-negative endocarditis, especially for fastidious and nonculturable microorganisms. [ABSTRACT FROM AUTHOR]

Keywords: atrial septal defect; myxoma; surgery EN atrial septal defect myxoma surgery 707 708 2 01/28/21 20210201 NES 210201 A 47-year-old woman was referred to the cardiology clinic because of dyspnea. During transesophageal echocardiography, a pedunculated, highly mobile left atrial mass approximately 0.9 cm in diameter, originating from the interatrial septum, was noticed along with atrial septal defect (Figure 1A,B). Atrial septal defect, myxoma, surgery. [Extracted from the article]

Objectives: The aim of the study was to clarify the reliability and quality of English videos about Coronary artery bypass grafting on YouTubeTM., Methods: The study was performed between July 16 and July 30. A cardiovascular surgeon searched for terms including "coronary artery disease," "coronary artery treatment," "coronary artery bypass" and "coronary artery bypass surgery," in YouTubeTM. All videos were classified into two groups according to the source who uploaded the video as professional videos and non-professional videos. Video characteristics including duration of video on YouTube™, length of video, and view numbers for each video were recorded. Moreover, the numbers of "comments," "likes," and "dislikes" were noted. Furthermore, the target audience of the videos (professional health care worker and patients) was analyzed, DISCERN score and Global quality score (GQS) were calculated for each video., Results: Totally, 812 videos were divided into two groups according to upload sources; 448 videos were categorized as professional videos and 364 videos were categorized as non-professional videos. The mean number of views was 3220.5 for professional videos and 2216.5 for non-professional videos (p=0.001). In addition, the mean "like" numbers and mean comment numbers were significantly higher for professional videos (p=0.001 and p=0.001). The mean DISCERN score was 2.6 for professional videos and 1.5 for non-professional videos (p=0.001). Similarly, the mean GSQ was significantly higher for professional videos (3.5 vs. 2.5, p=0.001)., Conclusion: YouTube™ videos which are shared by professional healthcare workers have better quality and reliability with significantly higher DISCERN score and GQS., Competing Interests: None declared., (©Copyright 2023 by The Medical Bulletin of Sisli Etfal Hospital.)

Objectives: This study aims to determine the protective effect of cilostazol on myocardium in obese Wistar rats with induced ischemia-reperfusion injury (IRI)., Methods: Four groups with 10 Wistar rats were included: 1] Sham Group: IRI was not established in normal weight-Wistar rats. 2] Control Group: IRI but no cilostazol in normal weight-Wistar rats. 3] Cilostazol in normal weight-Wistar rats: IRI and cilostazol was administered. 4] Cilostazol in obese- Wistar rats: IRI and cilostazol was administered., Results: Tissue adenosine triphosphate (ATP) levels were significantly higher and superoxide dismutase (SOD) levels significantly lower in the control group than in the sham group and normal weight cilostazol group (p=0.024 and p=0.003). Fibrinogen levels were 198 mg/dL in the sham group, 204 mg/dL in the control group, and 187 mg/dL in the normal-weight cilostazol group (p=0.046). Additionally, plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in the control group (p=0.047). The level of ATP was significantly lower in the normal-weight cilostazol group than in the obese group (104 vs 131.2 nmol/g protein, p=0.043). PAI-1 level was 2.4 ng/mL in the normal weight cilostazol group and 3.7 ng/mL in the obese cilostazol group (p=0.029). Normal-weight Wistar rats with cilostazol had significantly better histologic outcomes than the control group and obese Wistar rats (p=0.001 and p=0.001)., Conclusion: Cilostazol has a protective effect on myocardial cells in IRI models by decreasing inflammation. The protective role of cilostazol was reduced in obese Wistar rats compared with normal-weight Wistar rats., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objectives: The aim of the study was to clarify public interest about cardiovascular disease during the COVID-19 pandemic using Google Trends (GT)., Methods: The study was performed between November 20 and December 1, 2021. A total of 21 keywords related to cardiovascular surgery were selected. Public attention to all selected keywords was analyzed by GT with using the filters "web search," "all categories," and "Turkey." In Turkey, three COVID-19 waves (between March 12, 2020, and May 8, 2020, November 24, 2020, and January 20, 2021, and March 20, 2021, and May 16, 2021) were experienced since the beginning of the pandemic. To analyze public attention to cardiovascular surgery during the COVID-19 waves, 8-week periods during the COVID-19 waves were compared with the same times in the past 4 years (2016-2019)., Results: Comparisons of March 12-May 8 2020 and the same period between 2016 and 2019 showed that total public interest about cardiovascular surgery was significantly decreased (-28.7%, p=0.001). The comparison of the second COVID-19 wave (November 24, 2020-January 20, 2021 versus November 24-January 20, 2016-2019) revealed that public interest about cardiovascular surgery was significantly lower in the COVID-19 era (-22.2%, p=0.001). Comparison of the third COVID-19 wave and the same periods in the previous 4 years demonstrated that public interest about cardiovascular disease was significantly lower in the COVID-19 era (-8.5%, p=0.001). In contrast, the term coronary angiography was searched significantly more during the third wave of COVID-19 in comparison to the same periods between 2016 and 2019 (17.9%, p=0.015)., Conclusion: Our study demonstrated that public interest in cardiovascular diseases was significantly decreased in all waves of the COVID-19 pandemic. However, interest in only the term coronary angiography was significantly increased in the third wave of pandemic., Competing Interests: None declared., (© Copyright 2022 by The Medical Bulletin of Sisli Etfal Hospital.)

We present endovascular treatment of abdominal aortic aneurysm in a 26-year-old man with a 10-year follow-up. A young patient presenting with an abdominal aortic aneurysm is extremely rare, and data describing this population are limited. Open aneurysm repair (OAR) is the treatment of choice in these patients. However, since its introduction, endovascular aneurysm repair (EVAR) has revolutionized the treatment of abdominal aortic aneurysms. The long-term durability and late complications after EVAR may have more significance when considering the optimal treatment for young patients with a longer life expectancy. Our good long-term outcome will help to support the use of EVAR as a reasonable alternative to OAR in young patients with suitable anatomic findings., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Infective endocarditis due to Aspergillus species is an uncommon infection with a high mortality rate. It mostly occurs after the implantation of prosthetic heart valves. Parenteral nutrition, immunosuppression, broad-spectrum antibiotic regimens, and illegal intravenous drug use are the risk factors for developing infection., Case Report: We report a case of Aspergillus flavus native mitral valve endocarditis in a patient who had allogeneic stem cell transplantation in the past due to myelodysplastic syndrome., Conclusions: Although it is rare and there is limited experience available with the diagnosis and treatment, early recognition and therapeutic intervention with systemic antifungal therapy and aggressive surgical intervention are critical to prevent further complications that may eventually lead to death. In addition, better novel diagnostic tools are needed to facilitate more accurate identification of patients with invasive Aspergillus and to permit earlier initiation of antifungal treatment.

Background: Carotid body tumors are rare, highly vascularized neoplasms that arise from the paraganglia located at the carotid bifurcation. Surgery is the only curative treatment. However, treatment of bilateral carotid body tumors represents a special challenge due to potential neurovascular complications., Case Report: We present the therapeutic management of a 34-year-old woman with bilateral carotid body tumors. The patient underwent surgical resection of the largest tumor. It was not possible to resect the tumor without sacrificing the ipsilateral vagal nerve. Due to unilateral vagal palsy, we decide to withhold all invasive therapy and to observe contralateral tumor growth with serial imaging studies. The patient is free of disease progression 5 years later., Conclusions: Treatment of bilateral CBTs should focus on preservation of the quality of life rather than on cure of the disease. In patients with previous contralateral vagal palsies, the choice between surgery and watchful waiting is a balance between the natural potential morbidity and the predictable surgical morbidity. Therefore, to avoid bilateral cranial nerve deficits, these patients may be observed until tumor growth is determined, and, if needed, treated by radiation therapy.