Abstracts: Suppl. 1 to Vol. 10 (April 15, 2010)

Abstracts/Interactive CardioVascular and Thoracic Surgery S1 Interactive CardioVascular and Thoracic Surgery Abstracts – 59th ESCVS Objective: To implement the importance of cardiovascular screening tests in patients with end-stage chronic renal insufficiency who have been referred to the organ transplantation unit for renal transplantation here at Gaziosmanpasa Hospital between 2007 and 2009. Introduction: Cardiovascular diseases are the most common causes of death in patients with dialysis-dependent chronic renal insufficiency. Renal transplantation significantly increases the longevity and the quality of life in patients with dialysis-dependent chronic renal insufficiency. Due to the increased number of renal transplantations, the incidence of coincidentally diagnosed ischemic heart diseases during the preoperative evaluation for renal transplantation has also increased. Coronary arterial bypass revascularization has been preferred as the method of choice for myocardial revascularization over PTCA in these patients since PTCA is less successful in these patients when compared to the normal population. Due to the concomitantly present hypertension, diabetes mellitus and hyperlipidemia, both the surgical procedure and the postoperative follow-up for these patients are complex and very important. Methods: Fifteen patients with dialysis-dependent chronic renal failure awaiting renal transplantation were treated by the Cardiovascular Surgery Clinic at the Gaziosmanpasa Hospital in between 2007 and 2009. In about 60–90 days following surgery, the patients had renal transplantation. 73.3% of the patients were men and 26.7% of them were women. Of these, eight patients had angina pectoris while seven of them were asymptomatic. Fourteen patients (93.4%) had CABG and one patient (6.6%) had ASD closure. Amongst the patients who have had CABG one of them had full arterial revascularization with the rest having at least one arterial graft. Results: The incidence of atherosclerotic cardiovascular disease is very high in patients with dialysis-dependent chronic renal failure. Thus, all patients awaiting renal transplantation should be evaluated for the presence of coronary heart disease regardless of their presenting symptoms and age. Full arterial revascularization in these patients is especially important in the long-term. These patients can safely have renal transplantation following open heart surgery. C1-2 THE RESULTS OF THE EARLY REVASCULARIZATION IN ACUTE MYOCARDIAL INFARCTION H. Kazaz1, M.B. Erdogan1, S. Gunasti2, H. Turhan3 1Department of Cardiovascular Surgery, Medical Park Hospital, Gaziantep, Turkey; 2Department of Anesthesia, Medical Park Hospital, Gaziantep, Turkey; 3Department of Cardiology, Medical Park Hospital, Gaziantep, Turkey Objective: The optimal timing for a patient who undergoes CABG after myocardial infarction is unclear, because there have been no randomized trials to answer this question. Unstable patients often need to early and urgent surgery. Also these patients are the most surgical risky patients. We try to give some new perspective for the surgical timing for the C1-3 COMPARING EFFECTS OF PREOPERATIVE FREE T3 AND FREE T4 HORMONES LEVELS ON POSTOPERATIVE EXTUBATION AND LENGTH OF STAY IN ICU AND HOSPITAL FOLLOWING OPEN HEART SURGERY B. Oc, M. Oc, I. Pasaoglu TDV Private 29 May Hospital, Ankara, Turkey Objective: Thyroid hormones levels not only affect cardiac and peripheral vascular systems but also all systems’ functions (1). Most of studies have shown that freeT3 (fT3) and freeT4 (fT4) levels depress during and after cardiopulmonary bypass. Differences of preoperative thyroid hormones levels may influence postoperative extubation, length of stay in intensive care unit and hospital discharge in patients undergoing coronary artery bypass graft (CABG) operation. The aim of our study was to compare the effects of preoperative fT3 and fT4 levels on postoperative extubation, ICU and hospital discharges in patients undergoing cardiopulmonary bypass (CPB) and CABG operations. Methods: Retrospectively 654 patients had preoperatively normal fT3 and fT4 levels (fT3: 1.71–3.71 pg/ml, fT4: 0.70–1.48 ng/dl) undergoing CABG operation in our hospital between years 2007 and 2010 were included. According to fT3 and or fT4 levels (fT3≤2.71, fT4≤1.09) 226 patients in group 1, (fT3>2.71, fT4>1.09) 336 patients in group 2 were investigated. Ninety-two patients had unsuitable thyroid functions for determined criteria, preoperative and postoperative cardiac failure, chronic obstructive lung disease, renal failure and additional disease, BMI>35, irregular blood glucose levels, further ventilation requirement were excluded from this study. Age, sex, weight, number of graft, CPB and aorta clamping times, extubation times, ICU and hospital discharge days were recorded. All of the patients premedicated one night before and 30 min before operation with 10 mg diazepam orally. Anesthesia induction maintained by 0.3 mg/kg etomidate, 0.1 mg/kg vecuronium, 5 µg/kg fentanyl. During CPB 2 mg/kg/h propofol was infused. Patients provided for determined extubation criteria were extubated and provided for discharge ICU criteria were hospitalized. Datas were analyzed by χ2-tests and one way ANOVA test. Results: There were no differences between groups demographically (P>0.05). In group 1 extubation times were longer than group 2 (P<0.05) but ICU and hospital discharge times were similar (P>0.05). Conclusions: We concluded that in open heart surgery, preoperative fT3 and fT4 hormones levels between normal range and high limits, shorten extubation time postoperatively, and do not effect length of stay in ICU and hospital. Thursday C1-1 OPEN HEART SURGERY IN PATIENTS WITH END-STAGE RENAL INSUFFICIENCY AWAITING RENAL TRANSPLANTATION K. Sever, I.C. Ozbek, C. Izgi, S. Kacar, A. Gurkan, D. Mansuroglu Department of Cardiovascular Surgery, Gaziosmanpasa Hospital, Istanbul, Turkey acute myocardial infarction beyond the evaluation of the results of these patients. Methods: We have analyzed the 109 unstable patients’ surgical results after acute myocardial infarction with early revascularization. Thirty-six patients had surgery with cardiopulmonary resuscitation from the angio table or from the intensive care unit. The main reasons for the early surgery are: (i) hemodynamic instability, (ii) cardiopulmonary resuscitation, (iii) in spite of medical or intra aortic balloon treatment continuous cardiac unstable pain, (iv) early 6–12 h of anterior S-T myocardial infarction with a critical LAD lesion, (v) malign arrhythmia. Results: Twenty-four of the 36 CPR patients survived (66.66%). In all cases mortality rate was 16.5% (18 patients). Mortality rate was 8.21% (6 patients) when we excluded the CPR patients. The average EF was 48.4 at the second month post-surgery and the NYHA functional capacity was 0–1 in 49 patients, 2 in 9 patients and 3 in 3 patients. Conclusions: The possible increased risk (...truncated)