Purpose: Our study aimed to examine the impacts of blood cardioplegia (BC) and del Nido cardioplegia (DNC) solutions, which we used in isolated coronary artery bypass grafting, on early mortality and major adverse events. Material and method: We retrospectively analyzed 329 consecutive patients who underwent coronary artery bypass grafting (CABG) operations in our clinic between January 2016 and January 2020. Myocardial infarction, reoperation, cardiac tamponade, stroke, renal failure, extracorporeal membrane oxygenator requirement, and cardiopulmonary resuscitation were defined as major adverse events. The group for which del Nido cardioplegia was used was named Group D, and the group for which blood cardioplegia was used was named Group B. Group D consisted of 181 (55%) patients, and Group B consisted of 141 (45%) patients. Results: No statistically significant difference was determined between the groups regarding age, weight, body surface area, gender, or EuroSCORE ( p=.615, p=.560, p=.934, p=.365, p=.955, respectively). Although there was no statistically significant difference between the groups in terms of aortic cross-clamp time ( p=.712), the cardiopulmonary bypass duration was longer in Group B ( p=.001). Even though the incidence of stroke was higher in Group B ( p=.030), no statistically significant difference was observed between the groups regarding the total incidence of major adverse events, mortality, mechanical ventilation time, length of stay in the intensive care unit, or length of hospital stay ( p=.153, p=.130, p=.689, p=.710, p=.613, respectively). Conclusion: We found no significant difference in MAE, mortality, duration of MV, ICU stay, or hospitalization in the DNC and BC groups. We believe that both solutions can be used safely for cardiac protection in the adult patient population.

Objectives: We aimed to compare the short- and mid-term results of perfusion strategies used for arch reconstruction surgery. Material and Methods: One hundred and seventy-three consecutive patients who underwent aortic arch reconstruction surgery for transverse arcus hypoplasia between January 2011 and February 2020 were retrospectively analyzed. The patients were divided into two groups, as beating heart group and cardiac arrest group. Results: The cardiac arrest group comprised 60 (35%) patients and the remaining 113 (65%) patients were in the beating heart group. The median age of the patients was 30 (IQR 18–95) days. The incidences of acute renal failure and delayed sternal closure were higher in the cardiac arrest group (P = 0.05,P < 0.001 respectively). Balloon angioplasty was performed in 5 (2%) patients and reoperation was performed in 11 (6%) patients due to restenosis. There were no statistically significant differences between the two groups in terms of reoperation or reintervention rates (P = 0.44 and 0.34, respectively). Conclusions: Both strategies were associated with satisfactory mid-term prevention of reintervention and reoperation. Given the lower incidence of acute renal failure and delayed sternal closure in the postoperative period and similar mid-term outcomes, we believe that the beating heart strategy is preferable.

Background: Prolonged pleural drainage after the Fontan procedure is a common complication. Various protocols have been described, but there is no definitive consensus for the treatment of this complication. Materials and Methods: Our primary aim was to determine the effect of the protocol on the duration of drainage and hospital stay. Our secondary aim was to determine parameters affecting prolonged drainage after the Fontan procedure. Ninety two consecutive patients who underwent the Fontan operation retrospectively analyzed. A protocol-based postoperative management was adopted at July 2018. Patients operated before the protocol were defined as Group 1(n=48), and patients operated after the protocol were defined as Group 2(n=44). Results: The mean age was 5(IQR 4.0-6.9) years the mean body weight was 17.3 (IQR 15.1-21.8) kg.There were statistically significant differences between groups in terms of total drainage, duration of pleural drainage, prolonged drainage and, LOHS(p=0.05,p=0.04, p=0.04,p=0.04,respectively). In the multivariate analysis, the application of the protocol was observed to be the only factor for prolonged drainage (OR:2.46, 95% CI Lower-Upper:1.03-5.86,p=0.04). Conclusion: Standardization and strict application of the medical treatment within a specific protocol without being affected by doctor, nurse or patient-based factors increases the success. After the changes in our medical management strategy, along with the decrease in total drainage and duration of pleural drainage, LOHS was also reduced, of course together with a reduction in the cost. Key Words: Fontan, pleural drainage, hospital stay, protocol