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Öğe Comparison of early and midterm Results of Kalangos Bioring® versus De Vega annuloplasty in functional tricuspid regurgitatione(John Wiley & Sons Ltd, 2010) Ketenciler, S.; Ege, T.; Sungun, M.; Canbaz, S.; Gurkan, S.; Huseyin, S.; Duran, E.[Abstract Not Available]Öğe Comparison of the efficacy of the cardiac hypothermia and normothermia to myocardial damage in coronary artery bypass graft surgery with systemic normothermic cardiopulmonary bypass(Edizioni Minerva Medica, 2013) Cakir, H.; Gur, O.; Ege, T.; Kunduracilar, H.; Ketenciler, S.; Duran, E.Aim. The aim of our research is to investigate the cardiac damage formed by either local cardiac hypothermia or cardiac normothermia technique in patients who undergone isolated coronary artery bypass graft (CABG) surgery. Methods. The total of 40 patients who underwent isolated CABG operation under normothermic cardiopulmonary bypass (CPB) were studied. Patients were randomly divided into two groups as cardiac hypothermia and cardiac normothermia. Myocardial temperature was measured from the interventricular septum before aortic cross-clamp (ACC) (baseline), the ACC 20th minutes (ischemia) and after 20 minutes removal of the ACC (reperfusion). The coronary sinus blood samples were simultaneously obtained from the retrograde cardioplegia cannula while myocardial temperature was being measured. Complement component 3 (C3), complement component 4 (C4), troponin I and tumor necrosis factor-alpha (TNF-alpha) was measured from the coronary sinus blood samples. Results. Myocardial temperature was between 18-28 degrees C (deep hypothermia) during ACC in group 1. Myocardial temperature was over 34 degrees C (normothermia) during ACC in group 2. TNF-alpha values of group 1 for ischemia and reperfusion were higher than group 2, and it was found statistically significant (P<0.05). Conclusion. Myocardial damage was less than in normothermia group according to hypothermia group. The results show that ice-cold blood cardioplegia and local ice treatment of the heart during CPB seems to harm the heart more than warm blood cardioplegia.Öğe Early Results of surgical radiofrequency ablation in patients with atrial fibrillation undergoing open heart surgery(John Wiley & Sons Ltd, 2010) Gurkan, S.; Huseyin, S.; Ege, T.; Canbaz, S.; Canturk, M.; Dikmengil, M.; Duran, E.[Abstract Not Available]Öğe Evaluation of Iloprost to Prevent Vasospasm in Coronary Artery Bypass Grafts(Field House Publishing Llp, 2010) Ege, T.; Gur, O.; Karadag, C. H.; Duran, E.This study assessed the efficacy of iloprost in relieving vasospasm in coronary artery bypass grafts. Radial artery (RA), left internal thoracic artery (LITA) and saphenous vein (SV) grafts were taken from 20 patients (13 men and seven women, mean age 63.8 years [range 48 - 74 years]) scheduled to undergo coronary artery bypass grafting. Ten 3 mm vascular rings were cut from each graft and kept under tension for at least 60 min. They were kept alive with 37 degrees C oxygenated Krebs solution. Smooth muscle contraction was achieved with phenylephrine before iloprost was administered every 2 min, starting at a concentration of 10(-9) mol/l and increasing in logarithmic increments to a concentration of 10(-5) mol/l. The vasodilation response to iloprost started in all samples at a concentration of 10(-9) mol/l and increased with each incremental increase in iloprost concentration up to 10(-5) mol/l. These data suggest that local administration of iloprost has a role in relieving graft vasospasm during harvesting and preparation for coronary artery bypass grafting.Öğe Histopathological comparison of vascular wall damage created by external cross-clamp and endoluminal balloon occlusion techniques(Edizioni Minerva Medica, 2009) Ozalp, B.; Canbaz, S.; Huseyinova, G.; Duran, E.Aim Almost all cross-clamps utilized in vascular surgery, even atraumatic clamps, have been shown to cause mechanical damage to the vascular wall. in recent years, surgical procedures using an endoluminal balloon technique have been reported as an alternative occlusion strategy. This study discusses the histopathological characteristics and comparison between vascular wall damage secondary to the two occlusion techniques in the early postoperative period. Methods. Twelve adult rabbits were divided into two experimental groups: the clamp group (N.=6) and the balloon group (N.=6). External cross-clamp occlusion was applied to the abdominal aorta for 30 minutes via laparotomy in the clamp group. in the balloon group, occlusion was applied for 30 minutes by inflating the catheter balloon, which was inserted through the iliac artery and advanced into the abdominal aorta. The appropriate aortic segments were subsequently extracted in both groups and tissue samples were examined by fight and electron microscopy. Finally, the samples were scored for grade of tissue damage. Results. In both experimental groups, tissue damage was apparent. in the investigations carried out under light microscopy, it was observed that the damage caused by balloon occlusion was remarkably less than the damage caused by the cross-clamp technique. in the balloon group, eight tissue samples (66.7%) had grade 1 damage. On the other hand, five tissue samples had grade 3 damage, all of which were in the clamp group. Investigation by electron microscopy revealed that greater intimal, medial, and adventitial damage occurred in the vascular walls of the clamp group samples, and this also corresponded with an increase in immune response and intraluminal thrombosis. Conclusion. External clamp and internal balloon occlusion techniques applied to the aorta were compared, and widespread intimal and medial damage were observed in both techniques. However, endoluminal occlusion of the aorta should be the technique of choice in properly selected cases, since it results in lower damage grades, and it should also be used if application of an external clamp is technically difficult.Öğe Iatrogenic femoral arterio-venous fistula and pseudoaneurysm following catheter insertion for hemodialysis(Edizioni Minerva Medica, 2007) Gur, O.; Canbaz, S.; Karaca, O. G.; Duran, E.[Abstract Not Available]Öğe In vitro effects of lidocaine hydrochloride on coronary artery bypass grafts(Edizioni Minerva Medica, 2012) Gur, O.; Ege, T.; Gurkan, S.; Gur, D. Ozkaramanli; Karadag, H.; Cakir, H.; Duran, E.Aim. Coronary artery bypass grafting (CABG) is one of the most common procedures performed to improve blood supply to myocardium. The characteristics of grafts, mechanical stress and pharmacological agents have substantial influence on the short and long term graft patency. Lidocaine is among the most frequently used antiarrhytlunic agents perioperatively. The aim of this study was to evaluate the in vitro effects of lidocaine on internal mammarian artery (IMA), radial artery (RA) and saphenous vein (SV) grafts. Methods. Using standard tissue bath techniques, responses to increasing concentrations of lidocaine hydrochloride were obtained, in segments of IMA, RA and SV grafts. Twenty patients were enrolled in the study with a total number of 48 grafts (16 for IMA, RA and SV grafts each). In vitro lidocaine concentrations between 10(-9)M and 10(-3.5)M were studied to represent therapeutic plasma concentration of 1.5-5 mcg/mL. Results. In IMA and RA grafts, lidocaine hydrochloride caused vasodilatation (40.5 +/- 1.9% and 39.1 +/- 2.6 % respectively) at concentrations between 10(-9) to 10(-7.5) M while causing a dose dependent vasoconstriction response at concentrations above 10(-7.5)M. In SV graft samples, lidocain hydrochloride caused vasodilatation (24.4 +/- 1.9 %) at concentrations between 10(-9) to 10(-7.5) M while causing dose dependent vasoconstriction at concentrations above 10(-7) M. For vasoconstriction effect, mean +/- SD values for E-max were calculated as: 120.1 +/- 6.6% in IMA, 83.35 +/- 5.06% in RA, and 154.0 +/- 13.8% in SV. The vasoconstriction in the SV samples was higher than in the RA and IMA. The mean SD LogEC(50) values were -5.15 +/- 0.27, -5.76 +/- 0.11 and -5.56 +/- 0.19 for SV, IMA and RA grafts respectively.) There was a statiscally significant differences in the Log EC50 values between SV, IMA and RA (P<0.005) Conclusion. Based on the results of our study, we conclude that, increasing doses of lidocaine in the perioperative period may cause vasospasm in IMA, RA and SV grafts. Thus, avoiding high doses may have a role in improving perioperative and long term mortality.Öğe Late manifestation of a pseudoaneurysm in the descending thoracic aorta(Verlag Hans Huber, 2006) Gurkan, S.; Sunar, H.; Canbaz, S.; Duran, E.Rupture of the descending aorta following deceleration trauma is a catastrophic event because it has a high mortality. Prompt surgical treatment is generally considered to be mandatory. However, a few injured patients may leave the hospital with an undiagnosed aortic rupture which may give rise to a chronic pseudoaneurysm. In this report, a 28-year-old man is presented in whom a pseudoaneurysm, of the descending thoracic aortic was diagnosed six months after a car accident.Öğe The reoperations that performed for bleeding after open heart surgery(John Wiley & Sons Ltd, 2010) Huseyin, S.; Gurkan, S.; Canbaz, S.; Ege, T.; Arslan, K.; Dikmengil, M.; Duran, E.[Abstract Not Available]Öğe The Role of Inflammation in Atrial Fibrillation following Open Heart Surgery(Sage Publications Ltd, 2008) Canbaz, S.; Erbas, H.; Huseyin, S.; Duran, E.This study investigated the role of systemic inflammation in the development of atrial fibrillation (AF) after coronary artery bypass grafting (CABG). CABG was performed using cardiopulmonary bypass in 77 patients. Pre-operative AF was present in six patients (7.8%) and postoperative AF developed in 13 (18.3%) of the 71 patients with pre-operative sinus rhythm. Post-operative mediastinal drainage was significantly increased in patients with post-operative AF compared with those with sinus rhythm. Plasma E-selectin, P-selectin and vascular cell adhesion molecule levels were not significantly different between patients with pre- and post-operative sinus rhythm, those with pre-operative sinus rhythm and post-operative AF, and those with pre- and post-operative AF. There were significant differences between pre- and post-operative C-reactive protein, interleukin (IL)-6 and IL-10 levels within all three groups, but no differences in these parameters between the groups. Thus, in all groups there were significant alterations in mediators indicative of systemic inflammation following CABG, but comparisons between the groups revealed no differences predictive of AF.Öğe The role of n-acetylcysteine in lower extremity ischemia/reperfusion(Edizioni Minerva Medica, 2006) Ege, T.; Eskiocak, S.; Edis, M.; Duran, E.Aim. To evaluate the efficacy of N-acetyl cysteine (NAC) in lower extremity ischemia/reperfusion. Methods. A total of 23 patients who underwent surgical intervention due to acute femoral artery occlusion were assigned into 2 groups: control group (group 1, n=12); and NAC group (group 2, n=11). Patients in NAC group received NAC before reperfusion, and 8 and 16 h after reperfusion (3x300 mg), while patients in control group received only NaCl 0.9% (3x100 ML). Catalase, malondialdehyde (MDA) and thiol concentrations were determined in femoral vein samples collected at 6 different time points: before reperfusion (t(1)), and 30 min (t(2)), 2 h (t(3)), 6 h (t(4)), 12 h (t(5)) and 24 h (t(6)) after reperfusion. Alveolar-arterial oxygen gradient (A-aO(2)) was calculated in radial artery blood samples simultaneously collected at the same time points. Results. No significant differences between the two groups with regard to age (control group 61 +/- 13 and NAC group 64 +/- 11 years), gender (control group M/F: 7/5, NAC 6/5) and the average time from onset of symptoms (control group 9.6 +/- 3.5 h, and NAC group 10.2 +/- 3.1 h) were present. Catalase enzyme activity increased with reperfusion in both groups and there were no differences between the two groups. MDA levels did not change significantly with reperfusion in NAC group, whereas they were significantly higher in control group at t2 and t3 compared to NAC group (P<0.05). Thiol concentrations decreased with reperfusion in control group, and in NAC group increases that started with reperfusion returned back to baseline levels after 24 hours. Although the A-aO(2) gradient increased in both groups with the beginning of reperfusion, the most prominent increase occurred in control group (P<0.05). Conclusion. In control group, the significant increase in MDA levels and A-aO(2) gradient in reperfusion phase were considered a sign of local and end organ injury. We did not observe these changes in NAC performed group thus showing the efficacy of NAC.Öğe A splenic injury due to ruptured abdominal aortic aneurysm(Edizioni Minerva Medica, 2007) Gur, O.; Canbaz, S.; Halici, U.; Duran, E.[Abstract Not Available]Öğe The use of esmolol and magnesium to prevent haemodynamic responses to extubation after coronary artery grafting(Lippincott Williams & Wilkins, 2007) Arar, C.; Colak, A.; Alagol, A.; Uzer, S. S.; Ege, T.; Turan, N.; Duran, E.Background and Objective: The haemodynamic responses during extubation can cause complications after openheart surgery. In this study, we aimed to examine the effect of esmolol and magnesium before extubation on these haemodynamic responses. Methods: Following the approval of local Ethics Committee, 120 patients having coronary artery bypass grafting with extubation in the intensive care unit were included in the study. Patients were allocated to receive esmolol 1 mg kg(-1) (group 1, n = 40), magnesium 30 mg kg(-1) (Group 11, n = 40) or normal saline (Group 111, n = 40). Study medication was administered as a 20-min infusion in a volume of 20 mL. Patients were extubated just after termination of the infusion. Heart rate, blood pressure and central venous pressure were recorded prior to drug administration, before extubation, during extubation and I min after extubation. Results: Heart rate was lower in Group I than in Groups 11 (P < 0.05) and III (P < 0.001) and lower in Group 11 than in Group III (P < 0.05) during extubation. It was also lower in Group I than in Group III (P < 0.05) after extubation. Systolic blood pressure was lower in Group I than in Groups 11 and III (P < 0.001) during extubation. Diastolic blood pressure was higher in Group III than in Groups I and 11 during extubation (P < 0.001) and after extubation (P < 0.05). Mean arterial pressure was lower in Group I than in Groups 11 and III (P < 0.001) during extubation, lower in Group III than in Group III (P < 0.05) during extubation and lower in Group I than in Group III (P < 0.05) after extubation. Conclusion: We found that using esmolol before extubation following coronary artery bypass graft surgery prevents undesirable haemodynamic responses while magnesium reduces undesirable haemodynamic responses but does not prevent them.
