Hemodialysis refers to the regulation of renal function through ultrafiltration and diffusion via central venous catheters in emergency conditions or until the maturity of a surgically created arteriovenous fistula is obtained. Successful hemodialysis treatment includes choosing an appropriate hemodialysis catheter, selection of a suitable site for insertion, and percutaneous placement of the catheter without any problems. This article reviews hemodialysis catheters together with their characteristic features and percutaneous placement techniques. Turkish Baslik: Hemodiyaliz Kateterleri ve Kateterizasyon Teknikleri Anahtar Kelimeler: Kateterizasyon, santral venoz/enstrumantasyon/ yontem; bobrek yetmezligi, kronik; juguler ven; renal diyaliz; subklavyan ven Hemodiyaliz, renal fonksiyonun difuzyon ve ultrafiltrasyon esasina dayali olarak saglanmasidir. Hemodiyaliz, cerrahi olarak olusturulan arteriyovenoz (A-V) fistulun olgunlasmasina kadar gecen zamanda ya da acil durumlarda santral venoz kateterler araciligiyla saglanabilir. Hastaya uygun kateterin secilmesi, kateterin takilacagi bolgenin belirlenmesi ve sorunla karsilasmadan perkutan takilmasi, hemodiyaliz tedavisinin basarisi acisindan onemlidir. Bu makalede hemodiyaliz kateterlerinin ozellikleri ve perkutan takilmalarina iliskin teknikler gozden gecirildi.
We aimed to evaluate emergency vascular complications of the lumbar disc reconstructive surgery in this study.Between March 2006 and February 2020, nine patients (six males and three females; mean age: 53.4 ± 9.6 years; range: 38-64 years) who underwent emergent vascular intervention during lumbar spinal disc reconstructive surgery in our clinic were included in this retrospective study.The left common iliac artery injury, the left common iliac artery and left common iliac vein injuries, bilateral common iliac artery and abdominal aortic injuries, and vena cava inferior injury with left common iliac vein and right common iliac vein injuries were detected in two, three, two, and two patients, respectively. In addition, 16 mm Dacron tube graft interposition and graft patch plasty were performed in one and two patients who had an abdominal aortic injury, respectively. Also, 8 mm polytetrafluoroethylene straight graft interposition was performed in two patients with left common iliac artery injury, and lateral wall repair was performed in other patients. Graft patch plasty and 8 mm polytetrafluoroethylene graft interposition were performed in one patient with vena cava inferior injury and left common iliac vein injury, respectively. Also, lateral wall repair was performed in other patients with venous injuries. Deep venous thrombosis had developed in three patients, and one patient of these had a pulmonary embolism.The incidence of vascular injury after the lumbar disc surgery is relatively low; however, the emergency vascular operation should be performed as soon as possible.
Aim: There is no consensus between different clinics about the usage of remaining blood in venous reservoir during coronary bypass surgery with cardiopulmonary bypass operation. Our prospective study, we aimed to research effects of the use of remaining blood in venous reservoir after cessation of cardiopulmonary bypass for patients undergoing coronary bypass surgery on drainage, need for blood and blood products, postoperative infection complications, duration of intensive care unit and total hospitalization time.
Cardiac involvement in hydatid disease is more seldom than the involvement of the liver and the lungs.Cardiac cyst hydatid disease is diagnosed incidentally or by means of symptoms such as dyspnea and angina pectoris.Here, we present the case of a 45-year-old male patient who underwent open heart surgery for a randomly detected cardiac cyst hydatid during investigations carried out in a healthcare institution after accidentally falling from height.On the other hand, this patient did not have any complaints associated with hydatid disease before this event.
Background: Postoperative brachial plexus injury is often reported because the brachial plexus is stretched by sternotomy and the use of sternal retractors during open heart surgery. In many studies, brachial plexus injuries have been demonstrated by postoperative electrophysiological studies in susceptible patients. In this study, we estimated the incidence, severity, and type of brachial plexus injuries by routine preoperative and postoperative electrophysiological studies of patients undergoing open heart surgery. Methods: Patients undergoing coronary artery bypass grafting (CABG) surgery (Group 1), heart valve surgery (Group 2), or peripheral vascular surgery (Group 3) were included in the investigation. Electrophysiological studies of both upper extremities were performed five days before and three weeks after the operation. Results: Peripheral nerve problems were found preoperatively in 23 of the 112 patients (21 %). These problems persisted, but similar findings were obtained postoperatively from the left upper extremities of six of the 42 CABG (14 %) and two of the 24 heart valve (8 %) patients who had had normal preoperative evaluations. The patients with injured nerves were older and had undergone longer operation times. There were no differences between the patients with injured nerves and the others with respect to mammary artery harvesting or other operative variables. Conclusions: There are no reports in the literature of routine preoperative and postoperative electrophysiological studies in large patient groups to evaluate brachial plexus injury during open heart surgery. It is known that heart surgery sometimes causes partial brachial plexus injury, especially in the lower trunk. However, these peripheral nerve problems are usually not considered clinically important and are not investigated. Patients undergoing open heart surgery must be closely followed up for peripheral nerve injury during the postoperative period.
The objective of this study is to report our experience with surgical revision of dialysis access-induced ischemia syndrome.Between January 2005 and July 2013, 1254 patients underwent arteriovenous fistula operation, and 86 of them [53 males, mean age: 55 ± 25 (range: 25 to 75) years; 33 females, mean age: 50 ± 20 (range: 30 to 70) years] subsequently developed steal syndrome. These patients were treated with arterial pressure-controlled polytetrafluoroethylene banding or constriction with polypropylene suturing technique. Patients were followed in the outpatient clinic at regular intervals.Symptoms were not relieved during the first 15 days in 4 patients; therefore, reintervention was performed. Thrombosis occurred in one patient after reintervention. No early or late complications were detected in other patients, and fistulae were suitable for hemodialysis. Patency rates at 6 and 12 months were 96% and 92%, respectively, and thrombosis rates were 7% and 9%. There was no hospital mortality in our study, but one patient died from unrelated causes and two other patients quit follow-up after 6 months.We think that arterial pressure-controlled surgical revision is an effective and safe technique in patients with fistula-related hand ischemia.