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Objectives: Transposition of the great arteries (TGA) is a rare congenital heart disease that occurs in 3 in 10,000 newborns and is rapidly fatal (90%) within one year if left untreated. The prognosis of this pathology changed after introducing an early arterial switch operation (ASO), while the left ventricle could still adapt to systemic high-pressure conditions. Appropriate regulation of thyroid hormones positively impacts metabolism, cardiac function, and postoperative recovery. Therefore, regular thyroid hormone monitoring and thyroid function monitoring of TGA patients may help to improve the health status and prognosis of this group of postoperative patients. Methods: In our study, 127 patients who underwent ASO at our pediatric cardiac surgery clinic between 01.01.2014 and 18.09.2021 were retrospectively analyzed and included. Among the patients, 43% (n=54) were females, and 57% (n=73) were males. Results: The coronary arteries were normal in 89.7% (n=114) and abnormal in 10.3% (n=13) of the patients. Twenty-one of the patients exited, and mortality was calculated to be 16.5%. There were no significant differences in mortality or thyroid stimulating hormone (TSH), free thyroxine (T4), or free triiodothyronine (T3) values (P=0.674, P=0.345, P=0.478). In our study, in which we investigated the effect of thyroid hormone levels on prognosis in neonatal patients with TGA with normal free T3, T4, and TSH values, we found that TSH levels were greater in the group with advanced aortic regurgitation and exitus, although the effect of thyroid hormones on postoperative results was not statistically significant. Conclusions: Congenital hypothyroidism is a common disease with cardiac effects. During the neonatal period, this disease may conceal itself. Careful, expert clinical follow-up and clinical trials are crucial to improve outcomes in the surgical treatment of transposition of the great arteries, a complex congenital heart disease. [ABSTRACT FROM AUTHOR]

Background: Diaphragmatic paralysis due to phrenic nerve injury is a rare but potentially serious complication following congenital cardiac surgery, with reported incidences ranging from 0.28 to 5.6%. Early plication has been recommended for children diagnosed with diaphragmatic paralysis, especially those requiring prolonged respiratory support after cardiopulmonary bypass. It is important to note that late plication may jeopardize the results of successful surgical plication due to diaphragm atrophy. Results: This retrospective study was performed between May 2020 and June 2023. Patients who could not be weaned from the ventilator and underwent diaphragmatic plication in symptomatic patients after phrenic nerve injury were included in the study. During the study period, 22 (3.5%) of 624 pediatric patients operated for congenital heart disease required diaphragm plication. The mean age of the patients ranged from 1 month to 13 years with a mean of 23.88 ± 37.99 months. Fourteen (63.6%) of the patients were female, and 8 (36.4%) were male. Two of the patients (9%) were exited due to ventilator-associated pneumonia and sepsis. Conclusions: In conclusion, diaphragmatic paralysis after congenital heart surgery is a rare but important complication that can lead to serious respiratory and cardiac problems. Diaphragmatic plication has been shown to be an effective intervention for pediatric patients with the potential to improve pulmonary function, reduce dyspnea, and minimize complications associated with diaphragmatic paralysis. Careful consideration of patient selection, timing, and potential complications is crucial in optimizing the outcomes of this surgical intervention. [ABSTRACT FROM AUTHOR]

Copyright of Itobiad: Journal of the Human & Social Science Researches / İnsan ve Toplum Bilimleri Araştırmaları Dergisi is the property of Itobiad: Journal of the Human & Social Science Researches 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.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU 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.)

Copyright of Hamidiye Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI 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: Red Cell Distribution Width (RDW) is a commonly used biomarker that assesses the variation in erythrocyte volume. Higher RDW levels are associated with conditions such as absolute iron deficiency, inflammation-induced iron sequestration, ischemia, and oxidative stress. These factors can contribute to unfavorable outcomes following cardiac surgery. While previous studies have explored the prognostic value of elevated RDW as a predictor of increased early and late mortality after Coronary Artery Bypass Grafting (CABG), it remains understudied in large-scale series within Turkey. Therefore, the objective of our research is to examine the predictive capability of RDW in relation to early and late-term mortality subsequent to CABG surgery. Metod: This study included all 1867 patients who underwent isolated Coronary Artery Bypass Grafting (CABG) surgery at our hospital between July 2011 and August 2013. The mean age of the patients was 60.4 ± 10.1 years (59.8 ± 9.9 years for males and 62.4 ± 10.7 years for females). Among the patients, 22.2% (n=414) were female. Early mortality was defined as deaths occurring within the first 30 days of hospitalization or within the hospital premises. Long-term mortality data were obtained through the mortality reporting system. The mean follow-up duration was 116.1 ± 6.8 months. Early mortality rate was 3.9% and the long-term mortality rate was determined as 29.6%. Mortality data were reevaluated based on patients preoperative RDW levels. Results: The overall mortality rate observed in this study was 32.4% (n=604), with an early mortality rate of 3.9% (n=72). The median RDW value for all patients was 14.8% (14.1-15.8). Significantly higher median RDW levels were observed in the subgroup of patients who experienced early mortality compared to those who survived (15.4% vs 14.8%, p<0.05). To further investigate the relationship between RDW and mortality, the remaining patients were stratified into three groups based on preoperative RDW values: Group 1 (0-25th percentile), Group 2 (25-75th percentile), and Group 3 (>75th percentile). During the ten-year follow-up period, the survival rates were 74.7%, 72.3%, and 61.2% respectively for each group. Patients in Group 3 demonstrated significantly lower survival rates compared to the other groups (Table 1), indicating a long-term impact of elevated RDW levels on mortality (p<0.001). Univariate analysis revealed a statistically significant association between RDW levels and mortality prediction (p: 0.000; OR: 1.166 CI: 1.096-1.239). Conlcusion: Elevated RDW levels may be considered as a predictor for both early and late mortality following coronary artery bypass grafting (CABG) in the Turkish population too. However, the significance of normalizing RDW values during the preoperative period and its impact on mortality remains unknown, necessitating further extensive studies to elucidate this relationship. [ABSTRACT FROM AUTHOR]

Background: Numerous studies including our previous series have consistently shown an increased mortality rate among women compared to men following isolated coronary artery bypass graft (CABG) surgery. While the impact of gender on early mortality rates is widely acknowledged, conflicting findings exist regarding its effects on long-term outcomes. This study aims to elucidate the influence of gender on both early and long-term mortality rates following isolated CABG surgery. Methods: All patients who underwent isolated CABG surgery at our hospital between July 2011 and August 2013 were included in this study. Early mortality referred to deaths within the first 30 days or during hospitalization, while deaths occurring beyond this period were classified as long-term mortality. Long-term mortality data were obtained through the mortality reporting system. Patients were grouped according to gender, and mortality rates were analyzed in three categories: overall, early-stage, and long-term mortality, using Kaplan-Meier analysis. Results: A total of 1867 patients were included in this study, with 22.2% (n=414) being female. The mean age of female patients was 62.3 ± 10.6 years, which was significantly higher than that of male patients (59.7 ± 9.9 years) (p<0.001). The mean follow-up duration was 116.1 ± 6.8 months. During this period, a total of 604 patients (32.4%) died, with 154 (25.5%) of them being female. There was a statistically significant difference in overall mortality rates based on gender (Table 1) (p<0.05), with a higher mortality rate observed in females (37.3% vs 31.1%). In light of these findings, patients were further analyzed based on early and late mortality outcomes. Of the 72 patients who experienced early mortality, 26 (36.1%) were female. Early mortality rates were significantly higher in female patients compared to males (6.3% vs 3.2%) (p<0.05). However, the mean age of female patients who died early was similar to that of male patients (mean age of males: 67.74 ± 9.99 years, mean age of females: 68.04 ± 9.66 years) (p>0.05). After excluding patients with early mortality, a total of 1795 patients were followed for an average of 116.1±6.8 months. During the follow-up period, 532 patients (29.6%) died. The mortality rate was 33.1% (n=128) in females and 28.8% (n=404) in males. There was no statistically significant difference in long-term mortality between females and males (p>0.05). However, as seen in Table 2, the Kaplan-Meier curve shows a divergence in favor of males starting from the 72nd month. Conclusion: These findings suggest that once early-stage mortality cases are removed from the analysis, there is no statistically significant disparity in long-term mortality rates between genders. Nonetheless, the Kaplan-Meier curve demonstrates a notable divergence favoring male patients after the 72nd month, indicating a potential long-term impact. Further investigations are warranted to thoroughly understand the underlying factors contributing to this divergence. [ABSTRACT FROM AUTHOR]

Objective: The amount of epicardial adipose tissue (EAT) is associated with atrial fibrillation (AF). In the study, we measured epicardial adipose tissue thickness (EATT) and some hormone levels in the preoperative period in patients planned for coronary artery bypass grafting (CABG) surgery. We aimed to examine the relationship between these values and postoperative complications, especially postoperative atrial fibrillation (POAF). Methods: Between September 2020 and July 2021, 161 patients were included in the study. The patients' data were collected prospectively from their files. EATT was measured by echocardiogram (ECHO) and computed tomography (CT) and adiponectin, leptin, and resistin hormone levels were measured in the preoperative period for patients undergoing CABG operation. The study evaluated the relationship between those levels and some postoperative complications in patients. Results: A total of 161 patients, 130 male (80.7%) and 31 female (19.3%), were included in the study. The mean age was 61±9 years, body mass index (BMI) was 28.72±5.22 kg/m², and the waist circumference was 100.5±11.1 cm. POAF developed in 29 of the patients (18.0%). There was a statistically significant difference in terms of EATT and left ventricle end-diastolic diameter between the group with POAF and the groups without POAF (EATT in the group with POAF: 6.4±1.9 mm, EATT in the group without POAF: 5.5±1.8 mm) (p<0.05). In multivariate logistic regression analysis, epicardial adipose tissue thickness was shown to be an independent predictor factor in the development of POAF (OR: 1.24, CI: 1.01-1.53, p=0.04). A statistically significant difference was found between EATT and BMI and waist circumference (p=0.002 and p<0.001, respectively). Conclusions: Measuring EATT preoperatively can provide an idea about the development of POAF. A high correlation was found between EATT values measured by CT and ECHO. In this regard, ECHO can be considered a good alternative to CT, which is the gold standard in EATT measurement. ECHO is more accessible, reproducible, and cost-effective without radiation exposure. [ABSTRACT FROM AUTHOR]

Introduction: Ischemic mitral regurgitation can have a significant impact on morbidity and mortality in patients undergoing coronary bypass surgery. There is ongoing debate over the treatment of moderate mitral regurgitation. In this study, we aimed to examine the mid- and long-term results of treating moderate ischemic mitral regurgitation. MATERIALS AND Methods: This retrospective, cross-sectional, observational study included 126 patients. We analyzed 52 patients in two groups: isolated CABG and CABG+MVR/r. We conducted early period, 1-year, and 5-year echocardiographic and survival analyses of the patients. Results: Our analysis revealed that patients who underwent isolated CABG had higher mitral regurgitation grades at the post-op 1st year (p<0.05), but there was no statistically significant difference in the 5-year follow-up (p>0.05). There was no significant difference between the two groups in terms of 1-year and 5-year survival. The number of revascularized vessels (p=0.007, HR: 0.605 CI:0.421-0.869) and a history of postoperative cerebrovascular disease (p=0.001, HR: 20.794 CI:3.669-117.856) were independent predictive factors affecting survival. Conclusion: Our findings suggest that moderate ischemic mitral regurgitation management requires careful preoperative echocardiographic and clinical evaluation, and postoperative LV remodeling. Accurate quantification of the degree of mitral regurgitation and evaluation of all treatment options in accordance with guideline recommendations are essential. [ABSTRACT FROM AUTHOR]

BACKGROUND: Coronary artery bypass surgery is considered the gold standard treatment method for severe coronary artery disease and has been successfully applied in Turkey since the 1970s. Numerous studies have investigated early-term mortality following the operation. However, there is a lack of comprehensive research specifically addressing long-term mortality within the context of Turkey. The objective of our study is to elucidate the mortality rates after isolated CABG in our country and fill this important knowledge gap in the literature. Metod: All patients who underwent isolated CABG surgery at our hospital between July 2011 and August 2013 were included in the study. Early mortality was defined as deaths occurring within the first 30 days of hospitalization or within the hospital premises. Long-term mortality data were accessed through the mortality reporting system. Patients were reevaluated based on their age, gender, and the number of distal anastomoses performed during the operation. Results: Data of all 1867 patients who underwent isolated CABG surgery between July 2011 and August 2013 were checked through the mortality reporting system. The mean age of the patients was 60.4 ± 10.1 years (59.8 ± 9.9 years for males, 62.4 ± 10.7 years for females). 22.2% of the patients (n=414) were female. The mean follow-up duration was 116.1 ± 6.8 months. After excluding the data of 72 patients (26 females, 46 males) who had early mortality (3.9%), the long-term mortality rate was determined as 29.6% (n=532) (Table 1). In female patients, this rate was 33.1% (n=128), while in male patients, it was 28.8% (n=404) (p>0.05). The mortality rate in patients below 60 years old was 21,0%, whereas it was 36.4% in the age range of 60-75, and 57.3% in those aged 75 and above. Regarding the number of distal anastomoses performed during the operation, the long-term mortality rate was 37.6% (n=103/274) in patients who underwent single-vessel CABG, 27.9% (n=131/470) in those with two-vessel CABG, 30.2% (n=218/722) in those with three-vessel CABG, and 24.8% (n=80/322) in patients who received four or more grafts. Conclusion: The long-term mortality rates following isolated CABG in our country are comparable to those observed in developed countries. However, further extensive studies are needed to identify the factors influencing long-term mortality. [ABSTRACT FROM AUTHOR]

The decision-making process consists of finding the best solution to an analyzed problem. This search is carried out in the face of countless interactions when analyzing an alternative criterion by criterion, under which weights are assigned that distinguish the degree of importance they have for the decision-makers. The definition of weight for each criterion gives rise to three lines of thought on the subject. There are objective, subjective, and hybrid methods. This discussion concerns the degree to which experts define the criteria weights. Based on this discussion, we developed a hybrid method to integrate the Entropy and CRITIC methods with the PROMETHEE method, called EC-PROMETHEE. The innovation of this method is that the combination of the Entropy and CRITIC methods does not result in a single set of weights. In reality, the weights generated by each method are used to define each criterion's upper and lower limits. The range of weights generated for each criterion is emulated "n" times and builds a set of weights that are applied to the ranking definition process. The model generates "n" rankings, defining a single ranking. In this article, we demonstrate a step-by-step application of a tool developed in Python called EC-PROMETHEE and use it as an example of the problem of choosing rotary-wing airplanes for application in the military police service.➢ The method reduces discretion in determining the weights of the criteria; ➢ The innovation lies in the use of a range of weights for criteria; ➢ Consistency in defining the final ranking., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier B.V.)