Background: In this study we investigated the effect of opening the pleura on the rates of early postoperative bleeding and/or cardiac tamponade. Methods: The clinical data of 2110 patients who underwent coronary artery bypass grafting... more
Background: In this study we investigated the effect of opening the pleura on the rates of early postoperative bleeding and/or cardiac tamponade. Methods: The clinical data of 2110 patients who underwent coronary artery bypass grafting (CABG) between January 2007 ...
ABSTRACT Background: This study aims to investigate the results of coronary artery bypass graft (CABG) surgeries in terms of the relation of postoperative atrial fibrillation, coronary vasculature, and the nature and extent of coronary... more
ABSTRACT Background: This study aims to investigate the results of coronary artery bypass graft (CABG) surgeries in terms of the relation of postoperative atrial fibrillation, coronary vasculature, and the nature and extent of coronary artery disease. Methods: Between January 2011 and May 2011, 94 consecutive CABG patients (68 males, 26 females; mean age 61.4±10.9 years; range 38 to 87 years) who were operated in our clinic were enrolled in this prospective observational study. Logistic regression analysis was performed for the factors influencing the occurrence of postoperative atrial fibrillation. The perioperative parameters (Gensini score, Rentrop score, number of revascularized vessels, dominant coronary artery system, revascularization of the dominant coronary artery system, left main coronary artery disease, clinical status on admission, left ventricular dysfunction, and left atrium diameter) were analyzed as independent variables. Results: Twenty-three patients (24.5%) developed perioperative atrial fibrillation. Twenty patients returned to normal sinus rhythm with amiodarone therapy. In-hospital mortality was observed in three patients (3.2%). There was no statistically significant difference in mortality rates among the patients with and without atrial fibrillation. Left ventricular dysfunction (p=0.034) and left main coronary artery disease (p=0.019) were found to be significantly associated with the occurrence of postoperative atrial fibrillation. The rate of renal complications (p=0.030) and the need for sternal revision surgery (p=0.003) were not significantly different between both groups. Conclusion: Postoperative atrial fibrillation is a frequently encountered complication of cardiac surgery. The left ventricular dysfunction is a significant risk factor for postoperative occurrence of atrial fibrillation. Although no significant association between coronary vasculature and atrial fibrillation, the left main coronary artery disease is a serious risk factor for postoperative atrial fibrillation.
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Most episodes of fistula thrombosis are consequences of underlying physioanatomic abnormalities. However, some dialysis access thrombosis develops independent from any obvious anatomic cause. We aimed to clarify the role of thrombophilias... more
Most episodes of fistula thrombosis are consequences of underlying physioanatomic abnormalities. However, some dialysis access thrombosis develops independent from any obvious anatomic cause. We aimed to clarify the role of thrombophilias in primary and secondary AVF failure. One hundred eighty nine arteriovenous fistulas in 116 adults on maintenance hemodialysis were analyzed. All subjects were evaluated for many thrombotic factors. Fistula information was obtained both from the patients' self reports, and from their medical records. Twenty-seven AVFs in 18 cases (14.3%) had pAVFF. The percentage of subjects with a BMI < 20 kg/m(2) was significantly lower than no-pAVFF group (P = 0.03). ATIII levels and albumin values were significantly lower in patients with sAVFF compared to those with no sAVFF. Other parameters were similar. There was no statistically significant difference between pAFFF versus No-pAFFF and sAFFF versus No-sAFFF groups with respect to all mutant alleles count. Routine extended analyses of all thrombophillic factors are not recommended in AVFF.
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Research Interests: Comorbidity, Belgium, Humans, Female, Male, and 9 moreRisk factors, Length of Stay, Aged, Middle Aged, Adult, Prognosis, Risk Factors, Indexation, and Postoperative care
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IntroductionThe aim of the study was to assess the midterm results of left atrial bipolar radiofrequency ablation combined with a mitral valve procedure in patients with mitral valve disease and persistent atrial... more
IntroductionThe aim of the study was to assess the midterm results of left atrial bipolar radiofrequency ablation combined with a mitral valve procedure in patients with mitral valve disease and persistent atrial fibrillation.MethodsBetween October 2006 and July 2009, 95 patients with mitral valve disease and persistent atrial fibrillation underwent a mitral valve procedure and left atrial bipolar radiofrequency ablation. The postoperative data of the combined procedure were collected at the time of discharge and at one, three, six and 12 months after the operation.ResultsHospital mortality rate was 6.3% (six patients). Normal sinus rhythm was achieved in 77.2% of patients during the early postoperative period in hospital, and in 73.3, 72.0 and 75% of patients at three, six and 12 months postoperatively, respectively. Patients were followed up for a mean duration of 14.02 ± 5.71 months (range: 6–19 months). During this midterm follow-up period, nine patients had late recurrence of atrial fibrillation. No risk factor was identified for late recurrence of atrial fibrillation.ConclusionOur midterm follow-up results suggest that the addition of left atrial bipolar radiofrequency ablation to mitral valve surgery is an effective and safe procedure to restore sinus rhythm in patients with chronic atrial fibrillation.
Research Interests: Africa, Turkey, Treatment Outcome, Risk assessment, Humans, and 18 moreChronic Disease, Female, Male, Atrial Fibrillation, Young Adult, Risk factors, Mitral Valve Repair, Recurrence, Aged, Middle Aged, Adult, Time Factors, Chi Square Distribution, Risk Factors, Risk Assessment, Catheter ablation, Hospital Mortality, and Cardiopulmonary bypass
Research Interests: Treatment Outcome, Adolescent, Humans, Child, Female, and 6 moreMale, Young Adult, Prevalence, Middle Aged, Adult, and Retrospective Studies
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Internal thoracic artery (ITA) grafting to the left anterior descending artery (LAD) may have catastrophic consequences and can be fatal due to "ITA malperfusion syndrome." We have investigated the efficacy of a second graft in... more
Internal thoracic artery (ITA) grafting to the left anterior descending artery (LAD) may have catastrophic consequences and can be fatal due to "ITA malperfusion syndrome." We have investigated the efficacy of a second graft in this syndrome. A total of 35 patients, 29 males (82.9%) and 6 females (17.1%), with a mean age of 53.0 +/- 8.7, (range: 38 to 70) undergoing coronary artery bypass grafting required a second supply to LAD due to ITA malperfusion syndrome. This was performed using a saphenous vein graft. The mean number of distal anastomosis was 2.7 +/- 0.45 per patient (range: 1 to 5). The decision for an additional grafting procedure was made in the first operation for 18 patients (51.4%) (Group I). For the remaining 17 patients (48.6%) (Group II), the additional grafting procedures were performed during a reoperation after the development of ischemic complications in the intensive care unit (ICU). The early mortality rate was 8.6% (3 of 35). Two patients had perio...
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In up to 36% of patients undergoing cardiac surgery prolonged intensive care unit stay may be necessary. Mortality rates of these patients range from 11% to 94%, causing enormous clinical and ethical issues. To identify preoperative,... more
In up to 36% of patients undergoing cardiac surgery prolonged intensive care unit stay may be necessary. Mortality rates of these patients range from 11% to 94%, causing enormous clinical and ethical issues. To identify preoperative, perioperative and postoperative risk factors of mortality in patients with prolonged intensive care unit stay after elective, isolated on-pump coronary artery bypass grafting surgery. Clinical data of 137 patients who underwent an elective, isolated on-pump coronary artery bypass grafting operation, and had an intensive care unit stay of > or = 3 days were retrospectively evaluated. Survivors and non-survivors were compared with regard to preoperative, perioperative and postoperative characteristics to identify the risk factors for mortality. Multivariate analysis demonstrated that diabetes mellitus (OR = 3.62, 95% CI 1.07-12.26, p = 0.039), postoperative renal dysfunction (OR = 3.86, 95% CI 1.26-11.75, p = 0.018), postoperative intra-aortic balloon ...
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Off-pump coronary artery bypass (OPCAB) grafting has the potential to reduce morbidity and mortality, compared to on-pump cardiac surgery. We compared the early results of OPCAB lateral and posterior wall revascularisations in... more
Off-pump coronary artery bypass (OPCAB) grafting has the potential to reduce morbidity and mortality, compared to on-pump cardiac surgery. We compared the early results of OPCAB lateral and posterior wall revascularisations in 'low', 'intermediate' and 'high' risk patients as defined by the EuroSCORE system. Eighty-nine patients who underwent OPCAB with lateral and posterior wall revascularisation from January 2006 to December 2008 were included in this study. Patients were allocated to one of the three risk groups according to the EuroSCORE system: low, moderate and high risk groups. Perioperative and early postoperative results of the three groups were compared. Significantly fewer patients required prolonged ICU stay in the low risk group, compared to moderate (19.4 vs. 50%) and high risk groups (19.4 vs. 36.7%). In addition, prolonged mechanical ventilation was more common in moderate (39.3 vs. 9.7%) and high risk groups (36.7 vs. 9.7%), compared to the l...
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Our aim was to express the importance of emergency diagnosis and surgical approach in penetrating cardiac trauma patients. Koşuyolu Heart and Research Hospital moved to its new location in Cevizli Kartal in June 2005. Due to its close... more
Our aim was to express the importance of emergency diagnosis and surgical approach in penetrating cardiac trauma patients. Koşuyolu Heart and Research Hospital moved to its new location in Cevizli Kartal in June 2005. Due to its close proximity to the main roads of the city, the number of trauma cases has increased tremendously. We have retrospectively examined our penetrating cardiac trauma cases treated between June 2005 and September 2008. Twenty-six trauma cases were admitted to our clinic with penetrating cardiac trauma. Twenty of them were operated on an emergency basis. One (5%) had a gunshot wound while the other 19 (95%) had stab wounds. Four were female (20%) and 16 were male (80%). Average age of the patients was 24.9+/-10.1 (12-49) years. Telecardiography and transthoracic echocardiography were used for diagnosis. Surgical approaches were median sternotomy in 14 and left anterolateral thoracotomy in 6 cases. The right ventricle was damaged in 12, left ventricle in 7 and ...
Research Interests: Treatment Outcome, Adolescent, Humans, Child, Female, and 6 moreMale, Young Adult, Prevalence, Middle Aged, Adult, and Retrospective Studies
Atrial fibrillation (AF) is a common problem in cardiac surgery patients. We evaluated the mid-term results of patients who underwent open heart surgery and radiofrequency ablation (RFA). The study included 79 patients (53 females, 26... more
Atrial fibrillation (AF) is a common problem in cardiac surgery patients. We evaluated the mid-term results of patients who underwent open heart surgery and radiofrequency ablation (RFA). The study included 79 patients (53 females, 26 males; mean age 53+/-11 years; range 32 to 76 years) who underwent concomitant RFA for AF during open heart surgery under cardiopulmonary bypass. The majority of patients were in NYHA class III (n=68, 86.1%) and had (n=67, 84.8%) rheumatic heart disease. The mean preoperative AF duration was 47+/-41 months. The most frequent procedure involved the mitral valve (64 replacements, 11 reconstructions). A unipolar probe was used in 60 patients (76%) and a bipolar probe in 19 patients (24.1%). The mean follow-up period was 20.8+/-14.7 months (range 1 to 59 months). The mean perfusion and cross-clamp times were 102.4+/-15.7 min (range 48 to 171 min) and 76.1+/-25.0 min (range 27 to 145 min), respectively. In-hospital mortality occurred in two patients (2.5%) ...
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Aortic dissection is associated with high mortality. Despite its rarity, it is often fatal. We have retrospectively analysed acute aortic dissections occurring intraoperatively (IAAD). Patients' preoperative risk factors, and... more
Aortic dissection is associated with high mortality. Despite its rarity, it is often fatal. We have retrospectively analysed acute aortic dissections occurring intraoperatively (IAAD). Patients' preoperative risk factors, and operative and postoperative courses were analysed from the hospital records retrospectively. From 1985 to 2009, we performed 29 683 cardiac operations. Ten patients (0.43 per thousand) (mean age 66.5+/-7 years) were diagnosed with IAAD. There were type 2 dissections in 9 and one patient had it extending beyond the arcus. Four patients were operated on for coronary artery disease, 2 for mitral and 2 for aortic valve diseases. Two patients had concomitant valvular or valvular and coronary procedures. IAAD was identified after decannulation in 5, after creating the holes for proximal anastomoses in 3 and after declamping the aorta in 2 patients. Preoperatively, 6 (60%) patients had hypertension and 4 had hypercholesterolaemia (40%). No other significant risk f...