The Society of Thoracic and Cardio-Vascular Anesthesia and Intensive Care was founded in 1990 in Istanbul and 580 members by 2019. The Association continues its’ decisive and pioneering role in the field by conducting scientific researchs, organizing national and international congresses, regional meetings, workshops and cooperations with other national and international associations (EACTA, SCA). The annual national congresses of our association have been going on for many years with the participation of foreign guest speakers from all over the world as well as speakers from various centers in the country which are the theoretical and practical masters of the subjects. A creative environment in which the most sophisticated fields of anesthesia shared with up-to-date residency courses and pro-con discussions is targeted. Furhermore The Journal of The Society of Thoracic Cardio-Vascular Anaethesia and Intensive Care has been published since the foundation of the association. This year 25th National Congress will be held. In this review, it is aimed to summarize the history of the establishment and the early years of the 29-years of association.

INTRODUCTION: In patients which undergoing Video Assisted-Thoracoscopic Surgery (VATS) for effective analgesia, multimodal analgesia should be used. Serratus anterior plane block (SAPB) was introduced in 2013. SAPB is used in our clinic for postoperative analgesia in VATS. The aim of this study was to evaluate the total analgesic consumption and the postoperative pain scores in patients performed with the SAPB undergoing VATS.
METHODS: After approval for the study, a total of 34 patients underwent VATS between May 2016 and June 2017 were examined retrospectively. The patients were divided into two groups. 24 patients were performed SAPB and iv PCA (intravenous patient-controlled analgesia) and 10 patient’s pain management were provided with only PCA. No block was administered to 10 patients because of anticoagulant therapy and patient refused block application. The demographic data of the patients (age, gender, operation type, and duration) were obtained from the anesthesia forms. Total analgesic consumption in 24 hour, postoperative pain scores evaluated with a visual analog scale (VAS) at 1, 6, 12 and 24 hours and complications, were taken from forms.
RESULTS: The demographic characteristics of the patients and operating time were similar. Total analgesic consumption in 24 hours and VAS scores at 1, 6, 12 and 24 hours postoperatively statistically significantly lower in SAPB group. No difference was determined between groups in respect of complications.
DISCUSSION AND CONCLUSION: SAPB is an effective and preferable analgesia method and can be one of the multimodal analgesia components for postoperative pain management in VATS operations.

INTRODUCTION: The aim of the study was to compare sugammadex and neostigmine in terms of reversing time, recovery time and extubation time in reversal of rocuronium induced neuromuscular block in patients undergoing lung resection surgery.
METHODS: A total of 60 patients under 75 years of age with an ASA status of II-III undergoing elective pulmonary resection (lobectomy, pneumectomy, wedge resection) were included in this study on the basis of adequate left ventricle function (EF > 40%), normal renal and hepatic functions, absence of carotid lesions, and normal mental functions. Patients were assigned into neostigmine (Group N, n=30) and sugammadex (Grup S, n=30) groups.
RESULTS: Time from starting of neuromuscular blockade reversing agent till reaching TOF>0.9 was significantly shorter in Group S (p= 0.001). Similarly, extubation time and recovery time were significantly shorter in Group S (p=0.05; p=0.012, respectively). No statistically significant differences were observed between the two groups in terms of the operation time and duration of ICU stay. Postoperative adverse events and complications were similar in both groups. Post-operative residual curarisation was not observed in both groups.
DISCUSSION AND CONCLUSION: In lung resection surgery, sugammadex appears to be a superior selective relaxant binding agent as compared to neostigmine in the reversal of rocuronium induced neuromuscular block with earlier recovery and earlier achievement of TOF 0.9 ratio.

INTRODUCTION: Endotracheal intubation is the gold standard for providing adequate ventilation. During laryngoscopy and endotracheal intubation, airway stimulation results in reflex sympathetic system activation and unfavorable hemodynamic response. We aimed to evaluate the effect of videolaryngoscope (C-MAC VL) and conventional Macintosh direct laryngoscopy (DL) applications in endotracheal intubation under general anesthesia on hemodynamic response and time duration in patients with and without hypertensive.
METHODS: Normotensive (n=100) and hypertensive (n=100), aged between 18 and 75 years old (ASA I-II) who were scheduled to undergo elective surgery under general anesthesia, were included in the prospective study. Hypertensive patients were further divided into two subgroups; those intubated with videolaryngoscopy (group HV, n=50) and those with conventional direct laryngoscopy (group HD, n=50). Normotensive patients were also divided into two subgroups as videolaryngoscopy subgroup (group NV, n=50) and conventional direct laryngoscopy subgroup (group ND, n=50). Hemodynamic parameters, airway evaluation measurements, procedure duration and patients demographic characteristics were recorded.
RESULTS: There was no significant change in the hemodynamic parameters other than heart rate in the four groups compared to baseline measurements. The median intubation time of all videolaryngoscopy group (HV and NV) (10 sec) was shorter than that of all direct laryngoscopy group (HD and ND) (11.5 sec).
DISCUSSION AND CONCLUSION: Hemodynamic response behaves alike in all goups. However, intubation time takes least amount of time with the C-MAC VL than the conventional Macintosh DL. We think that using VL during intubation is practical and useful in the cases with sudden loss of consciousness, in which airway tone cannot be maintained.

INTRODUCTION: Transcatheter Aortic Valve Implantation (TAVI) poses significant challenges about anesthesia management. There is no current consensus on which type of anesthesia is safer for high-risk patients undergoing TAVI procedures. The aim of this retrospective cohort study was therefore to describe the pre- and perioperative issues related to anesthesia and to compare the outcomes of high-risk patients treated with general anesthesia (GA) versus local anesthesia plus sedation (LAPS) during TAVI procedures.
METHODS: We conducted a study with 49 patients who underwent TAVI under general anesthesia or local anesthesia plus sedation. Patients were retrospectively allocated to two cohort-study groups: GA (n=23) and LAPS (n=26). Demographic characteristics and procedure data were recorded at important time points.
RESULTS: The two groups were similar with respect to demographic characteristics. Total colloid consumption was significantly higher in GA (p < 0.001). Heart rates after valve implantation in GA were significantly lower (p < 0.05). Mean arterial pressures were similar. Peripheral oxygen saturations before and after valve implantation in GA were significantly higher. The durations of anesthesia and procedure in LAPS were significantly shorter (p < 0.001).
DISCUSSION AND CONCLUSION: Careful preoperative assessments of anesthetic agent preferences, of complications related to catheterization and of hemodynamic stability, as well as a requirement of immobility and adequate analgesia, are very important for successful outcomes. Particularly for cases where there is no need for transesophageal echocardiography or for a cardiovascular surgeon to dissect and repair the artery, we therefore conclude that LAPS can be used safely during TAVI procedures.

INTRODUCTION: In the tetralogy of Fallot, a wide spectrum of cardiac anomalies, dynamic physiological changes including the effects of anesthetic agents, type of surgical intervention (palliative intervention or correction operation) and non-cardiac malformations complicate intraoperative management. In this retrospective study, we aimed to evaluate perioperative anesthesia management in 40 pediatric patients undergoing tetralogy of Fallot surgery in our hospital.
METHODS: Forty patients who underwent tetralogy of Fallot surgery between October 2016- September 2018 in our hospital were evaluated retrospectively.
RESULTS: 25 patients were cyanotic and 15 patients were acyanotic. There was no statistically significant difference between these patients in terms of cardiopulmonary bypass, cross-clamp and operation time and consumption of fluid, blood and blood products. Similarly, patients with and without multiple aortopulmonary collaterals were compared and no difference was found. Hypercyanotic spell attack was observed in 6 patients during anesthesia induction. 3 patients died in the postoperative period.
DISCUSSION AND CONCLUSION: Preoperative cardiac anomaly should be defined when planning cardiac repair operations of tetralogy of Fallot patients. Appropriate anesthesia, surgery and cardiopulmonary bypass management should be provided by taking into consideration the intraoperative anesthesia management, the comorbidities and the post-operative problems in the intensive care unit.

INTRODUCTION: Taurine is an amino acid synthesized in the liver through methionine and cysteine sulfinic acid, is not used in protein synthesis. Its antiinflammatory and hypoglycemic effects were shown. In this study the postoperative level of taurine and its effects on inflammation were evaluated.
METHODS: Thirty-four patients with heart surgery were included in the study. Plasma taurine, C-reactive protein (Crp), HbA1c levels were measured in the blood taken on the third postoperative day. All patients included in the study were divided into two groups according to Group 1: HbA1c levels of 6 or less(with good glycemic control) and Group 2: HbA1c levels of 6 patients with diabetes(poor glycemic control).The dose of methyl prednisolone given during the operation was recorded retrospectively.
Normal adult serum taurine concentration ranges between 45-130 micromol/L.


RESULTS: Normal plasma taurine levels were detected in only eight out of 34 patients and taurine levels were lower in the other patients. The mean taurine level was 34.30±34.81 micromol/L.The amount of methylprednisolone given to patients with HbA1c≤%6,0 (group1) was found to be significantly higher than that of methylprednisolone given to patients with HbA1c>6.0% (group 2)(p <0.05).
There were no difference in Crp levels between the groups (group1;15,22±4,15 and group2;14,2±4,87mg/dl,p>0,05). Blood glucose and taurine values were not significantly different between the groups(p> 0.05).

DISCUSSION AND CONCLUSION: Twenty-six cases had a low taurine plasma level. The fact that Crp was not significantly different between the groups indicated that inflammation could be controlled equally in both groups. In Group2, equal antiinflammatory control with group 1 could be achieved and the methyl-prednisolone level given in this group was significantly lower (for group2; 8.36±1.04, for group1 9.78±1.68 mg/kg,p<0.006). Plasma taurine aminoacid, which is found to be higher in Group2, may be thought to have contributed to the antiinflammatory effect. Further studies including the preoperative taurine levels should be planned.

A 69-year-old woman has been using atorvastatin for 3 years. ECMO is used in the treatment of multiple organ failure in developing rhabdomyolysis. Despite a successful case shared in the literature, our case is mortal

For an anesthesiologist, it is important to manage the hemodynamics of patients who develop atrial fibrillation (AF) in the perioperative period. In a patient undergoing whipple surgery, atrial fibrillation, which is thought to occur with an astonishing cause intraoperatively, has not been reported in the literature. There are multiple risk factors for the development of new onset AF such as older age,diabetes,hypertension, hypovolaemia, electrolyte imbalances, hypoxia, underlying heart disease,etc. But also, during surgery, direct irritation of diaphragmatic surface of the heart with retractor may trigger AF.

Introduction:
Internal juguler ven (IJV) is frequently preferred for central venous catheterization (CVC) in terms of accessibility. However, USG, CT and cadaver studies have also reported cases of IJV being undetectable or hypoplasic. We aimed to present our case of incidental left IJV agenesis.
Case:
A 53-year-old male patient undergoing elective total gastrectomy due to malignant neoplasm was scheduled for insertion of left IJV since he had a right subclavian port catheter due to chemotherapy treatment.
Due to failure in insertion of left IJV catheterization with the aid of anatomical markers, USG was used to view left neck vascular structures. It was seen that the left IJV did not exist. The patient then underwent left subclavian catheterization. Postoperative radiology study showed no left IJV existence but right neck vascular structures were normal.
Discussion:
It is shown that unilateral variation of IJV was 17.3%, bilateral variation was 8.7%, and right IJV variations were more common than left IJV variation. Incidentally asymptomatic cases of IJV agenesis have also been reported in CT scans. Another condition that complicates CVC is IJV thrombosis and can interfere with agenesis. There is no thrombosis history in our case.
Conclusion:
CVC can be applied according to the experience and preference of the clinician by anatomic markers or USG coexistence. USG-guided cannulation has the advantage of detecting vascular variations and anomalies. So in some cases USG can be crucial in avoiding unnecessary interventions and complications in catheterizations despite adequate clinical experience.