Kaan Kirali | Kosuyolu Heart Center (original) (raw)
Papers by Kaan Kirali
Türk kardiyoloji derneği arşivi, Jul 1, 2001
... Dr. Suat N. ÖMEROGLU, Op. Dr. Hasan B. ERDOGAN, Op. Dr. Deniz GÖKSEDEF, Doç. Dr. Ali GÜRBÜZ*,... more ... Dr. Suat N. ÖMEROGLU, Op. Dr. Hasan B. ERDOGAN, Op. Dr. Deniz GÖKSEDEF, Doç. Dr. Ali GÜRBÜZ*, Prof. ... Ulusal Kardiyoloji Kongresi, 11-14 Ekim 2000, Belek, Antalya ve VI. Ulusal Gögiis Kalp Damar Cerrahisi Kong-resi, 21-25 Ekim 2000, Belck, Antalya'da sunulmu§tur. ...
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Van Tıp Dergisi, 2007
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Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2003
Kırk yaşındaki bayan hasta ayaklarında şişlik, mide bulantısı ve halsizlik şikayetleri ile kliniğ... more Kırk yaşındaki bayan hasta ayaklarında şişlik, mide bulantısı ve halsizlik şikayetleri ile kliniğimize başvurdu. Hasta son iki yıl içerisinde gittikçe artan nefes darlığından yakınmakta idi. Son üç aydır geceleri iki yastık kullanarak yatan hasta paroksismal noktürnal dispne tarifliyordu. Son ...
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Anadolu Kardiyoloji Dergisi-the Anatolian Journal of Cardiology, 2003
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PubMed, 2003
Background: The purpose of this study was to use serum markers for myocardial tissue damage to ev... more Background: The purpose of this study was to use serum markers for myocardial tissue damage to evaluate the effect of the severity of left anterior descending artery (LAD) lesions after 1-vessel off-pump coronary artery bypass grafting. Methods: A consecutive series of 20 patients with a totally occluded LAD and only retrograde filling (group T; n = 10) or critical stenosis (70%-99%) and only antegrade filling (group C; n = 10) were included in this study. One patient in group C who displayed no increases in the levels of markers for myocardial ischemia was excluded from the study because of the intraoperative repetition of the anastomosis. Creatine kinase activity (CK), CK-MB activity, and CK-MB mass, myoglobin, lactate, and cardiac troponin I (cTnI) concentrations were determined in venous blood samples taken immediately before and after the anastomosis and at 4, 8, 12, 24, and 48 hours postoperatively. Results: There were no perioperative myocardial infarctions. One patient in group T developed low cardiac output syndrome 48 hours after the operation and died after 1 month. His enzyme levels did not increase in the first 2 days postoperatively. Anastomosis times were similar for the T and C groups (6.85 +/- 0.9 minutes versus 8.4 +/- 2.2 minutes, respectively; P =.069). The levels of all cardiac markers except cTnI increased significantly in the first 24 postoperative hours. CK-MB activity, CK-MB mass concentration, and cTnI concentration were not different between the 2 groups. Four patients in each group were evaluated for the patency of the anastomosis, and all control angiography and myocardial scanning tests showed patent anastomoses and no ischemia. Conclusions: One-vessel off-pump coronary artery bypass grafting can be performed safely in patients with serious LAD stenosis and borderline antegrade blood flow without the need for any coronary collateral circulation support. A short anastomosis time prevents myocardial injury during off-pump coronary surgery.
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PubMed, Sep 1, 2003
Objective: Diagnostic and therapeutic cardiac interventions have being performed in expanding num... more Objective: Diagnostic and therapeutic cardiac interventions have being performed in expanding numbers during last years. Forty-two cases with peripheral vascular injuries requiring surgical therapy after 64.911 cardiac interventions in our center between 1985 and 2002 were evaluated retrospectively. Methods: Thirty-three of vascular injuries (78.6%) occurred after angiography/catheterization, and the remaining vascular injuries (21.4%) occurred after angioplasty/stent procedures. There were 12 female (28.6%) and 30 male (71.4%). The mean age was 51.3+/-4.1 years. The localization of the arterial injuries were femoral region in 37 cases (88.1%) and brachial region in 5 cases (11.9%). The complications were recorded as arterial thrombosis in 19 cases, pseudoaneurysm in 14 cases, hematoma in 5 cases, arteriovenous fistula in 2 cases, deformed stent stuck in 2 cases. Arterial injuries were treated by performing embolectomy in 16 cases, embolectomy and saphenous patch plasty in 3 cases, resection of pseudoaneurysm and PTFE patch plasty in 1 case, draining of hematoma and primary repair in 5 cases, primary repair of femoral arteriovenous fistula in 2 cases and removal of the deformed stent from femoral artery in 2 cases. Results: The incidence of vascular complications was significantly higher in brachial interventions when compared with femoral interventions (p<0.0001). The postoperative morbidity was found as 14.3% in our cases. Conclusion: The early diagnosis and treatment are very important in peripheral vascular complications after cardiac interventions; otherwise, delay can cause loss of related extremity.
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PubMed, Jul 1, 2001
Background and aim of the study: Prostheses used to treat heart valve disease improve patient sur... more Background and aim of the study: Prostheses used to treat heart valve disease improve patient survival, but have certain disadvantages. Paravalvular leakage (PVL) is a rare complication after mitral valve replacement (MVR), and can impair cardiac function and reduce the patient's functional capacity, depending on the degree of periprosthetic regurgitation. Methods: Between 1985 and July 1999, 2,502 patients underwent MVR with or without concomitant cardiac procedures. Of these patients, 33 (18 males, 15 females; mean age 39.8+/-15.3 years; range: 12-62 years) had PVL of differing degree. The interval between MVR and observation of PVL was 30.5+/-31.5 months (range: 1-126 months), and the period after diagnosis was 22.6+/-31.5 months (range: 2-114 months). Fourteen patients (42.4%) underwent reoperation (RO group), and 19 (57.6%) were followed medically (ME group). Indications for reoperation were reduction of functional capacity, echocardiographically proven serious mitral regurgitation, and hemolysis. Results: Reoperative mortality was 3.0% (1/33), and late mortality 3.1% (1/32) for all patients. Cumulative survival after PVL was 90.2+/-6.7% at both five and ten years. Annular calcification (33.0%) and infective endocarditis (18.2%) were important predictive factors for development of PVL. Only one patient required second re-do surgery. Univariate and forward stepwise logistic regression analyses showed that there was no predictor for the development of severe PVL requiring a second reoperation. No difference was observed between left ventricular dimensions before and after periprosthetic regurgitation. The only significant finding between groups was an increase in left atrial diameter in RO patients after the development of PVL (p <0.05). Conclusion: Among patients undergoing MVR there are no clinical features to distinguish who will develop severe PVL during follow up. If PVL reduces the patient's functional capacity or causes serious hemolysis, or if severe PVL is evaluated echocardiographically, then reoperation must be performed. Mild or moderate mitral regurgitation without impairment of functional capacity may be followed medically. In asymptomatic patients, enlargement (>5%) of the left atrial diameter following development of moderate PVL may be a valuable criterion for deciding when to reoperate.
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Damar Cerrahi Dergisi, 1998
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Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2009
Amaç: Bu çalışmada, atan kalpte tam revaskülarizasyon uygulanan hastaların perioperatif dönem kar... more Amaç: Bu çalışmada, atan kalpte tam revaskülarizasyon uygulanan hastaların perioperatif dönem karakteristikleri incelendi, erken morbidite ve mortalite nedenleri ortaya konarak, ameliyatlarda kullanılan greftlere ait kısa dönem anjiyografik sonuçlar belirlendi. Çalışma ...
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Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2000
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Turkiye Klinikleri Cardiovascular Surgery - Special Topics, 2012
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Asian Cardiovascular and Thoracic Annals, Sep 1, 2001
Partial left atrial resection was performed in 8 males and 12 females, aged 19 to 63 years, with ... more Partial left atrial resection was performed in 8 males and 12 females, aged 19 to 63 years, with giant left atrium and mitral valve disease. Preoperatively, 18 patients had atrial fibrillation, and 2 had normal sinus rhythm. Echocardiography revealed left atrial thrombosis in 3 patients and spontaneous echo contrast in 5. The lateral wall of the left atrium, the region between the pulmonary veins, the roof of the atrium, and the tissue parallel to the mitral annulus were resected. Resection was performed using the cardiac autotransplantation technique in 6 patients. The mitral valve was replaced in 9 patients and reconstructed in 11. Mean aortic crossclamp time was 101 ± 35 minutes and total perfusion time was 135 ± 26 minutes. Mean follow-up was 20.4 ± 1.1 months. There was no operative mortality. One patient (5%) died suddenly in the late postoperative period. Left atrial volume was reduced from 265.3 ± 125 mL to 83 ± 43 mL (p &lt; 0.01). Left atrial diameter decreased from 8.02 ± 1.31 cm to 4.4 ± 1.23 cm (p &lt; 0.01). Sinus rhythm was detected in 13 patients (65%) postoperatively. No left atrial thrombosis or spontaneous echo contrast were found during follow-up. Statistically significant reductions in cardiac size and improvements in functional capacity were observed.
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Journal of Cardiac Surgery, Mar 1, 2009
Hypercholesterolemia has been found to be associated with aortic valve stenosis and to resemble t... more Hypercholesterolemia has been found to be associated with aortic valve stenosis and to resemble the inflammatory process of atherosclerosis in many studies. The aim of this study was to investigate the role of hypercholesterolemia in development of aortic valve calcification in different etiologies. The study included 988 patients with rheumatic, congenital, or degenerative aortic stenosis, who underwent aortic valve replacement at Koşuyolu Heart and Research Hospital between 1985 and 2005. Effects of hypercholesterolemia and high low-density lipoprotein level on calcific aortic stenosis or massive aortic valve calcification were analyzed for each etiologic group. Both univariate and multivariate analyses revealed that the high serum cholesterol level (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;200 mg/dL) was related to massive aortic valve calcification in all patients (p = 0.003). Hypercholesterolemia was linked to calcific aortic stenosis and massive calcification in patients with degenerative etiology (p = 0.02 and p = 0.01, respectively) and it was related to massive calcification in patients with congenital bicuspid aorta (p = 0.02). Other independent risk factors for calcific aortic stenosis and massive calcification in the degenerative group were high low-density lipoprotein level (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;130 mg/dL; p = 0.03 and p = 0.05, respectively) and high serum C-reactive protein level (p = 0.04 and p = 0.05, respectively). Hypercholesterolemia is related to increased risk of aortic valve calcification in patients with degenerative and congenital etiology. Preventive treatment of hypercholesterolemia could play an important role to decrease or inhibit development of aortic valve calcification.
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Maltepe tıp dergisi, Dec 1, 2017
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Anadolu Kardiyoloji Dergisi-the Anatolian Journal of Cardiology, 2005
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Damar Cerrahi Dergisi, 2000
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Archives of the Turkish Society of Cardiology, 2000
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Türk kardiyoloji derneği arşivi, Jul 1, 2001
... Dr. Suat N. ÖMEROGLU, Op. Dr. Hasan B. ERDOGAN, Op. Dr. Deniz GÖKSEDEF, Doç. Dr. Ali GÜRBÜZ*,... more ... Dr. Suat N. ÖMEROGLU, Op. Dr. Hasan B. ERDOGAN, Op. Dr. Deniz GÖKSEDEF, Doç. Dr. Ali GÜRBÜZ*, Prof. ... Ulusal Kardiyoloji Kongresi, 11-14 Ekim 2000, Belek, Antalya ve VI. Ulusal Gögiis Kalp Damar Cerrahisi Kong-resi, 21-25 Ekim 2000, Belck, Antalya&amp;#x27;da sunulmu§tur. ...
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Van Tıp Dergisi, 2007
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Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2003
Kırk yaşındaki bayan hasta ayaklarında şişlik, mide bulantısı ve halsizlik şikayetleri ile kliniğ... more Kırk yaşındaki bayan hasta ayaklarında şişlik, mide bulantısı ve halsizlik şikayetleri ile kliniğimize başvurdu. Hasta son iki yıl içerisinde gittikçe artan nefes darlığından yakınmakta idi. Son üç aydır geceleri iki yastık kullanarak yatan hasta paroksismal noktürnal dispne tarifliyordu. Son ...
Bookmarks Related papers MentionsView impact
Anadolu Kardiyoloji Dergisi-the Anatolian Journal of Cardiology, 2003
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PubMed, 2003
Background: The purpose of this study was to use serum markers for myocardial tissue damage to ev... more Background: The purpose of this study was to use serum markers for myocardial tissue damage to evaluate the effect of the severity of left anterior descending artery (LAD) lesions after 1-vessel off-pump coronary artery bypass grafting. Methods: A consecutive series of 20 patients with a totally occluded LAD and only retrograde filling (group T; n = 10) or critical stenosis (70%-99%) and only antegrade filling (group C; n = 10) were included in this study. One patient in group C who displayed no increases in the levels of markers for myocardial ischemia was excluded from the study because of the intraoperative repetition of the anastomosis. Creatine kinase activity (CK), CK-MB activity, and CK-MB mass, myoglobin, lactate, and cardiac troponin I (cTnI) concentrations were determined in venous blood samples taken immediately before and after the anastomosis and at 4, 8, 12, 24, and 48 hours postoperatively. Results: There were no perioperative myocardial infarctions. One patient in group T developed low cardiac output syndrome 48 hours after the operation and died after 1 month. His enzyme levels did not increase in the first 2 days postoperatively. Anastomosis times were similar for the T and C groups (6.85 +/- 0.9 minutes versus 8.4 +/- 2.2 minutes, respectively; P =.069). The levels of all cardiac markers except cTnI increased significantly in the first 24 postoperative hours. CK-MB activity, CK-MB mass concentration, and cTnI concentration were not different between the 2 groups. Four patients in each group were evaluated for the patency of the anastomosis, and all control angiography and myocardial scanning tests showed patent anastomoses and no ischemia. Conclusions: One-vessel off-pump coronary artery bypass grafting can be performed safely in patients with serious LAD stenosis and borderline antegrade blood flow without the need for any coronary collateral circulation support. A short anastomosis time prevents myocardial injury during off-pump coronary surgery.
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PubMed, Sep 1, 2003
Objective: Diagnostic and therapeutic cardiac interventions have being performed in expanding num... more Objective: Diagnostic and therapeutic cardiac interventions have being performed in expanding numbers during last years. Forty-two cases with peripheral vascular injuries requiring surgical therapy after 64.911 cardiac interventions in our center between 1985 and 2002 were evaluated retrospectively. Methods: Thirty-three of vascular injuries (78.6%) occurred after angiography/catheterization, and the remaining vascular injuries (21.4%) occurred after angioplasty/stent procedures. There were 12 female (28.6%) and 30 male (71.4%). The mean age was 51.3+/-4.1 years. The localization of the arterial injuries were femoral region in 37 cases (88.1%) and brachial region in 5 cases (11.9%). The complications were recorded as arterial thrombosis in 19 cases, pseudoaneurysm in 14 cases, hematoma in 5 cases, arteriovenous fistula in 2 cases, deformed stent stuck in 2 cases. Arterial injuries were treated by performing embolectomy in 16 cases, embolectomy and saphenous patch plasty in 3 cases, resection of pseudoaneurysm and PTFE patch plasty in 1 case, draining of hematoma and primary repair in 5 cases, primary repair of femoral arteriovenous fistula in 2 cases and removal of the deformed stent from femoral artery in 2 cases. Results: The incidence of vascular complications was significantly higher in brachial interventions when compared with femoral interventions (p<0.0001). The postoperative morbidity was found as 14.3% in our cases. Conclusion: The early diagnosis and treatment are very important in peripheral vascular complications after cardiac interventions; otherwise, delay can cause loss of related extremity.
Bookmarks Related papers MentionsView impact
PubMed, Jul 1, 2001
Background and aim of the study: Prostheses used to treat heart valve disease improve patient sur... more Background and aim of the study: Prostheses used to treat heart valve disease improve patient survival, but have certain disadvantages. Paravalvular leakage (PVL) is a rare complication after mitral valve replacement (MVR), and can impair cardiac function and reduce the patient's functional capacity, depending on the degree of periprosthetic regurgitation. Methods: Between 1985 and July 1999, 2,502 patients underwent MVR with or without concomitant cardiac procedures. Of these patients, 33 (18 males, 15 females; mean age 39.8+/-15.3 years; range: 12-62 years) had PVL of differing degree. The interval between MVR and observation of PVL was 30.5+/-31.5 months (range: 1-126 months), and the period after diagnosis was 22.6+/-31.5 months (range: 2-114 months). Fourteen patients (42.4%) underwent reoperation (RO group), and 19 (57.6%) were followed medically (ME group). Indications for reoperation were reduction of functional capacity, echocardiographically proven serious mitral regurgitation, and hemolysis. Results: Reoperative mortality was 3.0% (1/33), and late mortality 3.1% (1/32) for all patients. Cumulative survival after PVL was 90.2+/-6.7% at both five and ten years. Annular calcification (33.0%) and infective endocarditis (18.2%) were important predictive factors for development of PVL. Only one patient required second re-do surgery. Univariate and forward stepwise logistic regression analyses showed that there was no predictor for the development of severe PVL requiring a second reoperation. No difference was observed between left ventricular dimensions before and after periprosthetic regurgitation. The only significant finding between groups was an increase in left atrial diameter in RO patients after the development of PVL (p <0.05). Conclusion: Among patients undergoing MVR there are no clinical features to distinguish who will develop severe PVL during follow up. If PVL reduces the patient's functional capacity or causes serious hemolysis, or if severe PVL is evaluated echocardiographically, then reoperation must be performed. Mild or moderate mitral regurgitation without impairment of functional capacity may be followed medically. In asymptomatic patients, enlargement (>5%) of the left atrial diameter following development of moderate PVL may be a valuable criterion for deciding when to reoperate.
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Damar Cerrahi Dergisi, 1998
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Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2009
Amaç: Bu çalışmada, atan kalpte tam revaskülarizasyon uygulanan hastaların perioperatif dönem kar... more Amaç: Bu çalışmada, atan kalpte tam revaskülarizasyon uygulanan hastaların perioperatif dönem karakteristikleri incelendi, erken morbidite ve mortalite nedenleri ortaya konarak, ameliyatlarda kullanılan greftlere ait kısa dönem anjiyografik sonuçlar belirlendi. Çalışma ...
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Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2000
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Turkiye Klinikleri Cardiovascular Surgery - Special Topics, 2012
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Damar Cerrahi Dergisi, 2008
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Asian Cardiovascular and Thoracic Annals, Sep 1, 2001
Partial left atrial resection was performed in 8 males and 12 females, aged 19 to 63 years, with ... more Partial left atrial resection was performed in 8 males and 12 females, aged 19 to 63 years, with giant left atrium and mitral valve disease. Preoperatively, 18 patients had atrial fibrillation, and 2 had normal sinus rhythm. Echocardiography revealed left atrial thrombosis in 3 patients and spontaneous echo contrast in 5. The lateral wall of the left atrium, the region between the pulmonary veins, the roof of the atrium, and the tissue parallel to the mitral annulus were resected. Resection was performed using the cardiac autotransplantation technique in 6 patients. The mitral valve was replaced in 9 patients and reconstructed in 11. Mean aortic crossclamp time was 101 ± 35 minutes and total perfusion time was 135 ± 26 minutes. Mean follow-up was 20.4 ± 1.1 months. There was no operative mortality. One patient (5%) died suddenly in the late postoperative period. Left atrial volume was reduced from 265.3 ± 125 mL to 83 ± 43 mL (p &lt; 0.01). Left atrial diameter decreased from 8.02 ± 1.31 cm to 4.4 ± 1.23 cm (p &lt; 0.01). Sinus rhythm was detected in 13 patients (65%) postoperatively. No left atrial thrombosis or spontaneous echo contrast were found during follow-up. Statistically significant reductions in cardiac size and improvements in functional capacity were observed.
Bookmarks Related papers MentionsView impact
Journal of Cardiac Surgery, Mar 1, 2009
Hypercholesterolemia has been found to be associated with aortic valve stenosis and to resemble t... more Hypercholesterolemia has been found to be associated with aortic valve stenosis and to resemble the inflammatory process of atherosclerosis in many studies. The aim of this study was to investigate the role of hypercholesterolemia in development of aortic valve calcification in different etiologies. The study included 988 patients with rheumatic, congenital, or degenerative aortic stenosis, who underwent aortic valve replacement at Koşuyolu Heart and Research Hospital between 1985 and 2005. Effects of hypercholesterolemia and high low-density lipoprotein level on calcific aortic stenosis or massive aortic valve calcification were analyzed for each etiologic group. Both univariate and multivariate analyses revealed that the high serum cholesterol level (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;200 mg/dL) was related to massive aortic valve calcification in all patients (p = 0.003). Hypercholesterolemia was linked to calcific aortic stenosis and massive calcification in patients with degenerative etiology (p = 0.02 and p = 0.01, respectively) and it was related to massive calcification in patients with congenital bicuspid aorta (p = 0.02). Other independent risk factors for calcific aortic stenosis and massive calcification in the degenerative group were high low-density lipoprotein level (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;130 mg/dL; p = 0.03 and p = 0.05, respectively) and high serum C-reactive protein level (p = 0.04 and p = 0.05, respectively). Hypercholesterolemia is related to increased risk of aortic valve calcification in patients with degenerative and congenital etiology. Preventive treatment of hypercholesterolemia could play an important role to decrease or inhibit development of aortic valve calcification.
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Maltepe tıp dergisi, Dec 1, 2017
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Anadolu Kardiyoloji Dergisi-the Anatolian Journal of Cardiology, 2005
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