AAA (Abdominal Aortic Aneurysm), which emerges as a result of the weakening of aortic wall, causes a ballooning in the vein. If it is not diagnosed and treated, the aneurysm grows and bursts over time. Aneurysms occur most often in in the aorta which is the main vein in the chest and abdomen.

AAA is mostly diagnosed with ultrasound and computed tomography. These are simple stand-up tests that do not place a burden to the patient. These tests are also used in size determining, which is an important element in determining of the abdominal aortic aneurysm treatment.

Aortic aneurysm is a treatable situation when diagnosed early. It does not present any symptoms in the youth; therefore, it is important for people under the risk to see a doctor periodically.

If the diameter of the abdominal aortic aneurysm is 5-5.5 cm, it requires treatment. Before deciding the treatment, the bursting risk of the aneurysm and existing health conditions should be considered. The treatment is also required for the small aneurysms that grows rapidly and that causes back and abdominal ache. In Liv Hospital Vascular Surgery Clinic, aneurysm is removed with an abdominal laceration during the surgery and is replaced with a synthetic graft. In the cases where a complication does not occur, most of the patients are hospitalized for five to seven days. After the patients recover, the aneurysms are completely treated.

Aorta begins from the heart and moves along the thoracic and abdominal cavities. The veins that carry oxygenized blood to our organs emanates from the aorta. The case where the diameter of a vein increases more than 50% is called “aneurysm”. Aneurysm can occur in all vein in the body; however, it is mostly seen in aorta.

High blood pressure, atherosclerosis, smoking, infections (tuberculosis), trauma or genetic susceptibility (bicuspid aortic valve diseases, Marfan syndrome), use of stimulants (cocaine) are the most common causes of aneurysm.

In Liv Hospital, methods such as x-ray, ultrasound, computed tomography, magnetic resonance imaging and angiography are used to diagnose aneurysm. Pharmacotherapy can be used in aneurysm treatment to decrease the blood pressure, to relax the blood vessels and to decrease the risk of bursting. If aneurysm is over a certain diameter or if it grows rapidly, a bursting risk is existent. Surgical intervention is required immediately.

Aortic tears are called “dissection”. Dissections occur due to the reasons that cause aneurysm. Dissections can occur both in aneurysmal aortas and in aortas of normal diameter. During dissection, layers of aorta detach. The symptoms are generally “stab-like” pains in the back and abdomen. Dissection treatment is surgical; it is performed in endovascular or classical standard tube placing methods.

In cardiovascular surgery, by the help of bloodless bypass method especially used in bypass and cardiac valve surgeries, the patient can be operated by his/her own blood, without needing additional blood transfusion from external sources. As an externally sourced blood transfusion does not occur by this method, the infection risk decreases significantly and blood-borne diseases risk decreases accordingly.

Finding 4-5 units of blood and making blood transfusion to the patient was requiredbefore the classical bypass surgery. However, by the help of this method which is being used in our country and in the world for a while, the patient can be operated by his/her own blood, without needing additional blood transfusion from external sources.

In approximately 190 hospitals in the world together with Liv Hospital, the “Bloodless Cardiac Surgery Procedure” is used without blood transfusion. For the 88% of the patients who have cardiac surgery, blood and blood components (FFP, thrombocyte etc.) are not used. Even though application of 2 units of blood transfusion is called “bloodless surgery” in some hospital, in Liv Hospital 0 transfusion is called “bloodless surgery”.

Bloodless Surgery shortens the healing duration of the patient and protects the individual against respiratory and renal impairment that develop due to blood transfusion, infection and HIV and hepatitis type diseases that are seen due to blood transfusion. Besides, as the patient recovers a lot quicker, length of hospitalization also decreases. The studies on the field points out that not using blood and blood components in the cardiac surgeries increases the rate of survival.

Heart Valve Surgery

In Liv Hospital, valve surgeries are performed separately or during coronary bypass simultaneously. In 20% of the patients, repair procedures are applied protecting the own valve tissue. It is fundamental to determine the most convenient treatment method via assessments unique to the patient. In valve surgeries, the age of the patient, the type of the pathology and the choice of the patient are determinant for the treatment method to be chosen.

In the Cardiovascular Surgery Clinic, the most important point is to pre-surgical patient-oriented assessment and explaining the advantages and disadvantages of the options in the operation to the patient in detail. Approximately 35% of the prosthetic valves used are biological valves that do not require anticoagulant use. Also, for the convenient patients, these operations can be performed with inframammary and axillary cuts. Robotic surgical methods can successfully be performed especially in mitral valve isolated repairs.

a) Mitral Valve Surgery

Mitral valve is an anatomical-functional structure that consists of two leaflets and resides between the left atrium and left ventricle. In Liv Hospital Cardiovascular Clinic, both mitral valve repair and mitral valve replacement can be performed with “small cuts”.

b) Aortic Valve Surgeries

Aortic valve consists of three leaflets and locates on the junctiın of the aorta and heart. In Cardiovascular Clinic, aortic valve surgeries are performed by stopping the heart and the lungs with an open-heart surgery method and can also be performed through a “small cut” in convenient patients.

In the coronary bypass surgeries, which are defined as reinstating the blood stream by connecting new veins to the area of the myocardium where enough blood cannot be carried, the features of the veins used is the most important factor that determines the protectiveness period. While the veins taken from the legs can deteriorate earlier, bypasses performed with the use of mammary arteries are known to stay open for a long time. Performing bypass with the bilateral use of mammary arteries provides huge advantages for the convenient patients. Also the veins taken from the arms are successfully used in bypass operations.

In the coronary bypass operations performed in Liv Hospital Cardiovascular Surgery Clinic, the operation strategies that will protect the coronary gap for the longest time period. Therefore, mammary arteries whose potential of occlusion is the least are used commonly. In 98% of the patients, at least one mammary artery is used. In 41% bilateral mammary arteries are used and if total bypassed veins are checked, it will be seen that mammary arteries are preferred in the 60%

In the bypass operations performed using mammary arteries in the Cardiovascular Surgery Clinic, the success rate of 10 years (the rate of no occlusion in the vein) is 97% in the literature. In the year 2013, mammary arteries are used in the 95% of our patients in our clinic. The consecutive application of the use of mammary arteries, which is known as the golden standard in Liv Hospital Cardiovascular Surgery Clinic (bypassing one mammary artery to more than one coronary vein), is performed successfully. Besides, for the convenient patients, bypass operations can be applied both with small cuts and robotic approaches.