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Objective: Prevention of postoperative infections in cardiovascular surgery is possible with the treatment of preoperative infections. However, there is no routine clinical protocols agreed on patients without clinical complaints with normal laboratory findings but culture positive cultures and lower respiratory or urinary tract colonizations In our study we examined the clinical implication of asymptomatic patients with normal laboratory findings and colonization in their preoperative tracheal/urine cultures. Hence we aimed to identify major risk groups and share possible clinical results. Method: Tracheal / urine cultures were obtained preoperatively from the CVS patients who had normal examination and laboratory findings between January 2016 - and June 2019 in our hospital. The patients were retrospectively divided into two groups as those having non reproductive (GI) and reproductive (G-II) cultures, and were compared in terms of demographic data, risk factors, cross-clamping/bypass times, intensive care/hospital stay, blood product consumption, major complications, systemic infection and mortality. Results: Bacterial growth was found in 90 of 307 (61.1 %) patients with normal findings. Most frequently in trachea, Pseudomonas spp., and in urine E.coli were grown. Colonization was found significantly higher in female gender. There was no difference between the groups in terms of DM, HT, creatinine,albumin, EF and PAP values while there was significant difference between smokers and COPD patients. Also, it was found that G-II patients had longer ICU/hospital stay, more frequently required blood products and developed a higher rate of postoperative infection. There was no statistical difference between groups in terms of mortality. Conclusion: We believe that smoking and COPD are serious risk factors in CVS operations,and tracheal/ urine culture samples taken during preoperative period may be the guiding reference to high risk cardiovascular patients such as smokers and COPD who may suffer from postoperative infection. [ABSTRACT FROM AUTHOR]

Objective: In cardiac surgery, low serum albumin level is an important risk factor that increases mortality and morbidity in the postoperative period. Diabetes mellitus may affect this clinical condition by causing albumin loss with proetinuria. In this study, the effects of preoperative albumin values and the presence of diabetes mellitus (DM) on postoperative renal failure were investigated. Method: Patients who underwent coronary artery bypass grafting between 01.01.2015-31.12.2019 in our clinic were retrospectively analyzed. Patients who received dialysis treatment in the preoperative period, whose ejection fraction was below 50%, and who underwent emergency surgery were excluded from the study. The patients were divided into 3 groups according to the serum albumin levels before surgery. Patients with serum albumin level ≥3.5 mgr/dL Group 1; those between 2.5-3.5 mg/dL Group 2; patients with ≤ 2.5 were named as Group 3. Later, these 3 groups were divided into 2 subgroups according to the presence of DM. Results: 308 patients who underwent coronary artery bypass surgery were included in the study. The demographic characteristics, peroperative data and operative data of the patients were similar. The need for renal replacement therapy was higher in Group 2 and Group 3 than in Group 1 in the postoperative period. Conclusion: Preoperative low serum albumin is a risk factor for the development of acute renal failure in the postoperative period, and the presence of DM adversely affects this condition. Close follow-up of these patients positively contributes to reducing mortality and morbidity. [ABSTRACT FROM AUTHOR]

Objective: Although crystalloid solutions are recommended as first choice for fluid replacement after cardiac surgery, abumin and synthetic colloids are used in special condition. In this study, the effects of preoperative albumin level on postoperative period and the effects of albumin on outcomes were investigated. Method: Patients who underwent cardaic surgery between 01.01.2014 and 12.31.2018 were evaluated retrospectively. Patients were divided into two groups according to preoperative albumin levels. Patients with preoperative albumin levels < 4 g/dL and ≥4 g/dL constituted Groups 1, and 2 respectively. Effects of preoperative albumin levels on early postoperative morbidity and mortality and its relationship with fluid replacement were evaluated. Results: Hypoalbuminemia persisted also during the postoperative period in patients with low preoperative albumin levels. During follow-up, 13 patients developed minor complications, of which 12 were in Group 1, and 10 had albumin replacement. Although 7 patients underwent albumin replacement 9 patients in Group 1, and 1 patient in Group 2 exited during postoperative period It was seen that preoperative albumin value under 4 g/dL increased the risk of postoperative complications 14 times and the application of albumin replacement in these patients did not provide the expected contribution to the outcome. Conclusion: Although low preoperative albumin value is associated with increased morbidity and mortality during the postoperative period, albumin replacement does not contribute positively to the outcome. In accordance with the recommendations of current guidelines, it would be appropriate to consider crystalloid solution as the first choice in cases where blood replacement is not required after cardiac surgery. [ABSTRACT FROM AUTHOR]

In our study, we evaluated the safety and efficacy of carotid artery stenting(CAS) in high surgical risk patients. 22 consecutive patients who underwent carotid artery stenting(CAS) between March 2009 and December 2011 were eligible. Only symptomatic stenosis were studied in high surgical risk patients as defined by the SAPPHIRE(Stenting and Angioplasty with Protection in Patients at High-Risk for Endarterectomy) trial. The mean age was 77.8 (range 67-87). Of the study group, 17 male(77.27%) and 5 female(22, 72%). Procedural success was achieved in 21 patients(95.4%). The mean stenosis in patients was 90.68 °5.4%. Reasons for stenting included cardiac/pulmonary risk(63%), contralateral carotid artery occlusion( 72%), age older than 75(72%). None of the patients suffered from major stroke, MI or death due to CAS during their hospital stay. The overall rate of in-hospital adverse events (TIA, permanent bradycardia, hypotension) was 18.1 %(4 of 21). Bradycardia in 2(9.5%), hypotension in one(4.7%) and transient ischemic attack in one(4.7%) were observed during procedures. Our results support the use of CAS in high surgical risk patients with significant symptomatic carotid artery disease. [ABSTRACT FROM AUTHOR]

This study retrospectively reviewed early outcomes after the carotid endarterectomy combined with coronary artery bypass grafting (CABG). Between January 2007 and March 2011, 52 patients who underwent combined myocardial revascularization and carotid endarterectomy in a single-stage procedure. The principal indication was the need for symptomatic or asymptomatic carotid stenosis of 80% stenosis or more. The mean age was 66.4 ±6.6 years (range 50-75). 34 patients (65.4%) were male, 18 patients (34.6%) female. Mean number of the grafts 2.7, mean ejection fraction was (EF) % 49.6 °8.4. A total of 22 patients (42.3%) had a previous myocardial infarction, 7 patients (13.4%) presented with unstable angina and one patient (1.9%) had prior coronary artery bypass grafts. The average cardiopulmonary bypass time was 83.2°41.7 (range 30-204) min and crossclamping time was 31.8°11.8 (range 18-67) min. Early overall mortality was 3 (5.7%), of which 2 were cardiac related (3.8%). Other cause of death was fatal stroke in one patient (1.9%). Perioperative morbidity included myocardial infarction in 1 patient (1.9%), neurologic deficit in 3 (5.7%), 2 patients (3.8%) low cardiac output syndrome. Carotid endarterectomy and myocardial revascularization in conjunction with cardiopulmonary bypass is a method safe enough to prefer its routine use with acceptable low operative risk. [ABSTRACT FROM AUTHOR]