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    Asymptomatic isolated aortic arch dissection: A peculiar case
    (Kuwait Medical Assoc, 2024) Cuglan, Bilal; Kyaruzi, Mugisha; Gungen, Belma Dogan
    We hereby represent a case of a chronic aortic arch dissection in a 69 -year -old male who was diagnosed incidentally during cranial computed tomography (CT) angiography scan screening due to transient ischemic attack. Due to asymptomatic nature, size and a follow up period of one and six months with no noticeable changes, we recommended medical follow up of every six months with thorax CT angiography scan.
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    Can minimally invasive multivessel coronary revascularization be a routine approach?
    (GEORG THIEME VERLAG KG, 2022) Kyaruzi, Mugisha; Gülmez, Harun; Demirsoy, Ergun
    Backgrounds Advancement in the field of cardiovascular surgery has emerged with various minimally invasive approaches for the treatment of multivessel coronary disease to improve outcomes and minimize the burden associated with conventional cardiac surgery. This study describes our routine technical approach and clinical experience of minimally invasive coronary artery bypass via left anterior minithoracotomy for the treatment of patients with multivessel coronary lesions. Methods Our experience includes 100 consecutive patients who were operated between July 2020 and April 2021. The left internal thoracic artery was harvested in all patients. Radial arterial grafts and saphenous vein grafts were harvested endoscopically. Patients were operated either under cardiopulmonary bypass (CPB) with blood cardioplegia through left anterior minithoracotomy of 5 to 7 cm or off-pump via left anterolateral minithoracotomy. Results We had single mortality (1%), no early postoperative myocardial infarction was observed. None of our patients was converted to sternotomy (0%). The mean number of bypass was 3.1 +/- 0.8, the mean cross-clamping time was 78.1 +/- 20.6 minutes, the mean CPB time was 153.2 +/- 37.5 minutes, the average intubation time was 6.33 +/- 11.29 hours, the mean intensive care unit stay was 1.62 +/- 1.78 days, the mean hospital stay was 4.98 +/- 3.01 days, the average total operation time was 4.20 +/- 0.92 hours, and the average pleural drain was 393.8 +/- 169.7 mL. Conclusion Minimally invasive coronary artery bypass grafting via left anterior minithoracotomy can be routinely performed with safety and it is feasible, reproducible with a short learning curve. Further multicenter studies are needed for the standardization of our technique.
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    Strategies and pitfalls during minimally invasive total coronary artery revascularization via left anterior minithoracotomy: a promising future
    (Taylor & Francis Online, 2021) Kyaruzi, Mugisha; Demirsoy, Ergün
    For many years up to date coronary artery bypass surgery has been performed via sternotomy as a gold standard approach. However recently there has been alternative approaches for coronary artery bypass grafting in minimal invasive ways to reduce complications associated with sternotomy such as sternal wound infections, impared pulmonary functions and cosmetic related problems. Most of these minimal invasive procedures have been associated with long learning curve, high costs and sophiscated instruments used during surgery. Minimal invasive coronary artery bypass grafting via left anterior mini-thoracotomy is equally effective as a gold standard sternotomy with the same principles of suturing techniques and provides a great comfort in many aspects as sternotomy. It is safe and does not require sophiscated tools which require long learning curve and high expanses. This type of surgery requires the use of novel strategies, especially in patients who hold the highest potential for postoperative morbidity. In this paper, we will highlight the strategies and pitfalls associated with minimally invasive total coronary revascularization via left anterior minithoracotomy.