Recep Aslan - Academia.edu (original) (raw)

Papers by Recep Aslan

Annals of Thoracic Medicine, 2009

Heart manipulation during off-pump coronary artery bypass surgery may cause hemodynamic instabili... more Heart manipulation during off-pump coronary artery bypass surgery may cause hemodynamic instability, and temporary coronary arterial occlusion may lead to myocardial ischemia. To reduce this, perioperative β-blocking agents or calcium antagonists can be administrated. The effects of perioperative administration of magnesium on myocardial function were studied in patients undergoing coronary artery bypass grafting. The aim of the study was to evaluate the effects of preoperative magnesium administration on perioperative hemodynamia, ventricular arrhythmias and myocardial protection. We reviewed 2 groups of patients undergoing off-pump coronary artery bypass surgery - 24 patients (control group) that had not received preoperative intravenous infusion of magnesium and 23 patients (treatment group) that had received preoperative intravenous magnesium sulfate. The results demonstrated that it had reduced the heart rate, changes of ST segments, the need of β-blocking agents and the use of intra-operative intra-aortic balloon pump and the inotropic usage. This treatment may provide hemodynamic optimization during off-pump coronary artery bypass.

Annals of Thoracic Medicine, 2009

International Journal of Cardiology, 2007

Occlusion of the superior vena cava is a rare but serious complication of transvenous endocardial... more Occlusion of the superior vena cava is a rare but serious complication of transvenous endocardial pacing. We describe an unusual approach for permanent pacemaker implantation using the azygous vein in a patient with occlusion of the bilateral total subclavian and innominate veins after previous bilateral pectoral pacemaker implantation. Endocardial pacing using the azygous vein with minimal invasive thoracotomy may be a good option for patients with inaccessible subclavian route.

Clinical Cardiology, 2004

Background: Atrial fibrillation (AF) is the most common complication following coronary artery by... more Background: Atrial fibrillation (AF) is the most common complication following coronary artery bypass graft (CABG). The mechanism of AF after CABG is not well defined; however, it is suggested that endogenous adenosine, released in response to tissue hypoxia, may play a mechanistic role in these arrhythmias.Hypothesis: The purpose of this study was to examine whether intravenous theophylline, via adenosine A1 receptor antagonism, would correct or modify new-onset early (< 48 h post CABG) atrial fibrillation in patients post CABG, and thereby implicate endogenous adenosine as an inciting agent.Methods: A prospective double-blind, placebo-controlled study design was applied to 385 consecutive patients with coronary artery disease who had undergone CABG. Any patient who developed AF within 48 h of the operative procedure was randomly assigned to receive 5 mg/kg of intravenous theophylline (Group A) or matched intravenous placebo (Group B). The patients who converted to sinus rhythm within 15 min of drug administration were accepted as showing positive responses.Results: Thirty patients comprised the study group. In Group A, 8 of the 15 patients (53%) converted from AF to sinus rhythm within 15 min of theophylline administration. One patient who converted to sinus rhythm 20 min after theophylline administration was accepted as showing a negative response. In the placebo-treated group, no patient converted to sinus rhythm within 15 min (p < 0.007 compared with Group A).Conclusions: The mechanism of AF after CABG is not well defined and is probably multifactorial. However, this study demonstrated that antagonism of the adenosine A1 receptor can promptly convert many of these patients back to sinus rhythm, and thereby implicates endogenously released adenosine in a mechanistic role for inciting early (< 48 h) post-CABG AF.

Cardiovascular Surgery, 1996

This study evaluatedthe effects of aprotinin on plasma levels of elastase,platelet count, fibrino... more This study evaluatedthe effects of aprotinin on plasma levels of elastase,platelet count, fibrinogenlevelsand postoperativebleeding.Thirty cardiacsurgerypatients were randomly for this study.The proteaseinhibitoraprotininwas givenin high dosesto 20 patients beforeand during cardiopulmonary bypass;.10 patients servedas the control group. Mean patientageand bodyweight was similarin both groups.Therewere no significant inter-group differencesin the total cardiopulmonary bypassand cross-clamp times. Mean(s.e.m.) elastase levelswere significantlyraised in the control group [161 .9(2. S7)jfg/1) comparedwith the treated group (148.2 (3.29)pg/1) at 30 min of cardiopulmonary bypass'(P e 0.01) and rose even further at the end of cardiopulmonarybypass, after protarnine'infusion, and 24 h postoperatively (P< 0.00 f). Plateletcountsdecreased morein the controlgroup (P-= 0.001). Serum fibrinogen levels were significantlylower in the controls during and just after cardiopulmonary bypass(P e 0.01). Postoperativeblood loss was significantlyless in the '' aprotinin-treated patients(315(25) ml) comparedwith the controls(S89( 154) ml) (f < .0.05).

Cardiovascular Surgery, 1999

In this study, the authors administered high dose (30 mg/kg body weight i.v.) methylprednisolone ... more In this study, the authors administered high dose (30 mg/kg body weight i.v.) methylprednisolone before cardiopulmonary bypass to observe the effects on complement, immunoglobulins and pulmonary neutrophil sequestration. Fifty patients undergoing valve replacements were included in this study. Patients were divided into two groups: group I (20 patients) served as control and did not receive methylprednisolone, group II (30 patients) received methylprednisolone. Blood samples for complements (C3c and C4) were taken, before cardiopulmonary bypass, at 5, 10 and 30 min intervals from the end of cardiopulmonary bypass, after reversal of heparin with protamine infusion, and after skin closure. Blood samples for immunoglobulins were taken before cardiopulmonary bypass, 30 min after onset of cardiopulmonary bypass and after skin closure. After onset of cardiopulmonary bypass, all C3c and C4 levels decreased in both groups. There was a significant decrease in C4 levels at end of cardiopulmonary bypass and after protamine infusion in group I compared with group II (P Ͻ 0.05). C3c levels in group I decreased significantly compared with group II after 30 min of cardiopulmonary bypass and after protamine infusion (P Ͻ 0.05). All immunoglobulin (IgG, IgM, IgA) levels were decreased in both groups, but the decrease in IgG was statistically significant after skin closure in group I compared with group II (P Ͻ 0.05). Pulmonary neutrophil sequestration was higher in the control group compared with the methyl-prednisolone group (P Ͻ 0.05). In conclusion, methylprednisolone administration before cardiopulmonary bypass may prevent the harmful effects of complement activation, immunoglobulin denaturation and neutrophil sequestration in the pulmonary capillary system.

Of 30 consecutive patients undergoing mitral valve replacement, 15 were randomly assigned to rece... more Of 30 consecutive patients undergoing mitral valve replacement, 15 were randomly assigned to receive pretreatment with glucose-insulin-potassium, while the other 15 received the same volume of normal saline. The characteristics of both groups were similar and all patients ...

Resection of Congenital Intrapericardial Right Atrial Aneurysm--Be< IMG SRC="/math/scedil... more Resection of Congenital Intrapericardial Right Atrial Aneurysm--Be< IMG SRC="/math/scedil. gif" ALT=" s" BORDER=" 0"> o< IMG SRC="/math/gbreve. gif" ALT=" g" BORDER=" 0"> ul et al. 9 (3): 226--Asian Cardiovascular & Thoracic Annals

Annals of Thoracic Surgery, 1999

The aim of the present study was to evaluate potential myocardial protection by trimetazidine by ... more The aim of the present study was to evaluate potential myocardial protection by trimetazidine by measurement of the cardiac marker protein troponin T (TnT) during coronary bypass operations. We conducted a double-blind, placebo-controlled study on 30 randomized patients who had aorta-coronary artery bypass operations. The TMZ group was composed of 15 patients and the placebo group of 15 patients in New York Heart Association class III or IV. Pretreatment was started 3 weeks preoperatively with trimetazidine (60 mg orally per day) or the placebo. In the trimetazidine TMZ group, there were 2 women and 13 men with a mean age of 57.1+/-2.2 years and mean cross-clamp time of 44+/-1.8 minutes. In the placebo group, there were 5 women and 10 men with a mean age of 58.4+/-1.2 years and a mean cross-clamp time of 42+/-2.4 minutes. Serial blood samples were collected before and after the operation, and serum concentrations of cardiac TnT were measured. The preoperative serum concentration of TnT was 0 to 0.39 ng/mL in all patients. The mean TnT levels were measured 5 minutes after completion of cardiopulmonary bypass (1.5+/-0.3 ng/mL) and 12 (1.4+/-0.1 ng/mL), 24 (0.9+/-0.1 ng/mL), and 48 hours postoperatively (0.1+/-0.1 ng/mL) in the trimetazidine group. Troponin T levels in the placebo group measured at the same time periods were 4.4+/-0.4, 4.8+/-0.7, 2.8+/-0.4, and 0.7+/-0.1 ng/mL. In the trimetazidine group, TnT levels were significantly less than those of the placebo group (p < 0.001). The levels of TnT were tested by creatine kinase-MB levels of both groups. Mean cardiac index was evaluated in all patients preoperatively and postoperatively. There was no significant difference in perioperative hemodynamics (blood pressure and cardiac index) between groups. These results obtained by measurement of cardiac TnT suggested that pretreatment with trimetazidine reduces ischemic-reperfusion damage during coronary bypass operations but did not affect postoperative hemodynamics.

Cardiovascular Surgery, 1999

In this study, the potentially beneficial effects of preoperative treatment with glucose, insulin... more In this study, the potentially beneficial effects of preoperative treatment with glucose, insulin and potassium in a randomized series of 30 consecutive patients undergoing mitral valve replacement, who were in the third and fourth functional groups of the New York Heart Association scale, were investigated. Fifteen patients received glucose, insulin and potassium, and 15 patients received the same volume of normal saline. The characteristics of the groups did not differ. Papillary muscle-biopsy samples were obtained at the time of surgery and analysed for glycogen, both biochemically and histochemically. The clinical course of all patients was monitored closely during the first 24 hours after surgery. The patients receiving glucose, insulin and potassium had higher glycogen levels (43 Ϯ 13.54 mol/g) (P Ͻ 0.001). In addition, they required less inotropic pharmacological support (scored by the Gradinac method), had fewer ventricular arrhythmias and exhibited improved haemodynamic indices: cardiac output increased (P Ͻ 0.025 to P Ͻ 0.005), while systemic vascular resistance decreased (P Ͻ 0.001). Pretreatment with glucose, insulin and potassium did not, however, affect the patients' postoperative wedge pressure and mortality. The results of this study suggest that glucose, insulin and potassium pretreatment may be beneficial in unfit patients undergoing mitral valve replacement.

International Journal of Cardiology, 2007