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Öğe Effect of pericardial fluid pro-inflammatory cytokines on hemodynamic parameters(Academic Press Ltd Elsevier Science Ltd, 2003) Ege, T; Canbaz, S; Yuksel, V; Duran, EWe investigated the effects of pro-inflammatory cytokines of pericardial fluid on hemodynamic parameters in patients undergoing coronary artery surgery. Seventy-eight patients were included in the study and they were allocated to three groups: group I, stable angina pectoris (SAP, n = 15); group 2, unstable angina pectoris (USAP, n = 34); group 3, post-myocardial infarction (PMI, n = 29). Pericardial fluid and arterial blood samples were obtained from all patients and interleukin (IL)-1beta, IL-2 receptor, IL-6, IL-8 and tumor necrosis factor-alpha (TNF-alpha) levels were measured. Pericardial IL-1beta concentration (pg/mL) was significantly higher in the USAP group (26.6 +/- 10.9) compared to the SAP (5.0 +/- 0.1) and PMI (5.8 +/- 1.0) groups. IL-2R, IL-6, IL-8 and TNF-a concentrations of pericardial fluid were significantly higher than serum in all groups; difference was more prominent in the PMI group compared to the SAP and the USAP groups. Serum IL-1beta concentrations (pg/mL) were significantly higher in the USAP group (21.8 +/- 3.4) compared to the SAP group (5.0 +/- 0.1) and the PMI group (5.4 +/- 11.6). Cardiac index (CI) before opening the pericardial sac was found to be lower in the USAP group (1.6 +/- 0.3 L/min/m(2)) compared to the SAP (2.2 +/- 0.5 L/min/m(2)) and the PMI (2.1 +/- 0.5 L/min/m(2)) groups (p = 0.028 and p = 0.011, respectively). In the USAP group, there was a relationship between reduction of CI and increase of IL-1beta levels in serum and pericardial fluid. (C) 2003 Elsevier Ltd. All rights reserved.Öğe The importance of aprotinin and pentoxifylline in preventing leukocyte sequestration and lung injury caused by protamine at the end of cardiopulmonary bypass surgery(Georg Thieme Verlag Kg, 2004) Ege, T; Arar, C; Canbaz, S; Cikirikcioglu, M; Sunar, H; Yuksel, V; Duran, EBackground: Protamine has adverse effects on pulmonary gas exchange during the postoperative period. The objective of this study was to investigate the importance of aprotinin and pentoxifylline in preventing the leukocyte sequestration and lung injury caused by protamine administered after the termination of cardiopulmonary bypass (CPB). Methods: Participants (n = 39) were allocated into three groups at the termination of CPB: Group 1, (control group, n = 16); Group 2 (aprotinin group, n = 12), who received protamine + aprotinin (15 000 IU/kg); and Group 3 (Pentoxifylline group, n = 11), who received protamine + pentoxifylline (10 mg/kg). Leukocyte counts in pulmonary and radial arteries were determined after the termination of CPB and before any drug was given (t(1)), and 5 minutes (t(2)), 2 hours (t(3)), 6 hours (t(4)) and 12 hours (t(s)) after the administration of protamine. Alveolar-arterial O-2 gradient (A-aO(2)) and dynamic pulmonary compliance were measured at t(1), t(2) and t(3). Results: In the control group, an increase in pulmonary leukocyte sequestration was observed 5 minutes and 2 hours after protamine administration, after which this difference disappeared. No significant degree of pulmonary sequestration was detected in any measurements after protamine was administered in the aprotinin and pentoxifylline (PTX) groups. Dynamic lung compliance was 50.1, 45.2 and 47.2 ml/cm H2O in the control group, 49.2, 61.1 and 56.3 ml/ cm H2O in the aprotinin group, and 49.5, 54.5 and 50.4 ml/cm H2O in the PTX group. The A-aO(2) gradient was 212.2, 263.3 and 254.3 mmHg in the control group, 209.4, 257.1 and 217.3 mmHg in the aprotinin group, and 211.3, 260.8 and 219.2 mmHg in the PTX group. Conclusion: Aprotinin and PTX treatments have favourable effects on lung function by reducing protamine-induced leukocyte sequestration into lungs at the end of CPB.Öğe Importance of internal mammary artery perfusion in cardiac ischemia and reperfusion(Sage Publications Ltd, 2003) Ege, T; Eskiocak, S; Yuksel, V; Taskiran, A; Duran, EPurpose: Our purpose was to investigate the changes in antioxidant defense systems due to internal mammary artery (IMA) perfusion during coronary artery bypass graft (CABG) operations in which proximal anastomoses were completed under partial bypass with the aid of a side-biting clamp. Material and Method: Twenty-five patients to be studied were divided into two groups according to the criterion of whether during proximal anastomoses left internal mammary artery (LIMA) perfusion was applied (n = 15, LIMA group) or not (n = 10, non-LIMA group). The erythrocyte catalase (CAT), superoxide dismutase (SOD), serum lipid peroxidation (LPO) products and whole blood reduced glutathione (GSH) levels were measured in the blood samples taken from the coronary sinus before cardiopulmonary bypass (CPB) (t(1)), before declamping (t(2)), at the 5th min after declamping (t(3)) at the 5th (t(4)) and 15th (t(5)) min after removing the side-biting clamp. Results: While erythrocyte CAT enzyme activity decreases in both groups after the basal measurements, no significant difference was detected between the groups. Although the GSH levels did not differ at t(1), t(2) and t(3), they were found to be higher in the LIMA group at t(4) (p = 0.006) and t(5) (p = 0.021). The erythrocyte SOD enzyme activity decreased after the basal measurements in both groups, but this reduction was less in the LIMA group at t(4) (p = 0.034) and t(5) (p = 0.018) compared to the other group. LPO products rose in both groups when reperfusion started after declamping. The levels of LPO products were significantly higher at t(4) and t(5) in the non-LIMA group than the other group (p = 0.011 and p = 0.008). Conclusion: If proximal anastomoses of coronary grafts are completed under partial bypass, permitting LIMA perfusion during this procedure will be beneficial to antioxidant defense systems.Öğe Pseudoaneurysm of the posterior tibial artery as a complication of thrombectomy(Edizioni Minerva Medica, 2004) Canbaz, S; Sunar, H; Yuksel, V; Duran, E[Abstract Not Available]Öğe Surgical management of iatrogenic femoral artery pseudoaneurysms: A 10-year experience(Lithographia, 2013) Huseyin, S.; Yuksel, V; Sivri, N.; Gur, O.; Gurkan, S.; Canbaz, S.; Ege, T.Background: Vascular complications of cardiac catheterization have increased in line with increasing number of percutaneous interventions. Open repair is the standard method of treatment for true and false aneurysms of femoral artery. We report results of patients operated due to femoral artery pseudoaneurysm after cardiac catheterization. Methods: Data from 12,261 patients who underwent percutaneous intervention for cardiac catheterization between January 2003 and January 2013 were evaluated. Diagnosis of pseudoaneurysm was established mainly by doppler ultrasonography in patients with complaints of pain and hematoma at the intervention site. Pseudoaneurysms less than 2 cm in diameter were treated non-operatively and were followed up by regular ultrasonographic examination at the outpatient clinic. Pseudoaneurysms with a diameter of 2 cm or more underwent primary repair. All patients were followed up for one year. Results: We detected 55 (0.44%) patients with femoral artery pseudoaneurysm and 42 of them were operated. The mean age was 60.7 +/- 6.3 years. Thirty nine (94.5%) patients underwent elective surgery, three (5.5%) patients were operated on under emergency conditions. Operation was performed under local anesthesia in 32 patients, under local anesthesia and sedation in eight patients, and under general anesthesia in three patients. Location of the pseudoaneurysm was the superficial femoral artery in 29 (69%), the common femoral artery in nine (21.4%), and the deep femoral artery in four (9.6%) patients. No limb loss occurred, no patient died and no recurrence was detected during the follow up. Conclusions: Performing vascular reconstruction before the rupture of pseudoaneurysm is important in terms of morbidity and mortality. We concluded that surgical repair in pseudoaneurysms larger than 20 mm is safe and essential.