Mehmet Erdem Toker - Academia.edu (original) (raw)
Papers by Mehmet Erdem Toker
Koşuyolu Heart Journal, 2020
Introduction: No exact consensus exists on the timing of the placement of an intraaortic balloon ... more Introduction: No exact consensus exists on the timing of the placement of an intraaortic balloon pump (IABP), yet still, it is the most common mechanical support device used in patients requiring open heart surgery. The purpose of this study was to investigate the results of the implantation of IABP in three different periods as preoperative, intraoperative, and postoperative and to compare the results obtained in these periods. Patients and Methods: This study included 193 patients undergoing open-heart surgery with IABP support between January 2014 and December 2016. The patients were divided into three groups as preoperative period, intraoperative period and postoperative period, based on the beginning of IABP support. The patients were compared in terms of preoperative characteristics, surgical data and postoperative results. Results: Of the 193 patients, 32 (16.5%) received preoperative, 64 (33.1%) intraoperative, and 97 (50.2%) postoperative IABP support. The length of ICU stay (20.15 ± 23 days) was longer for the postoperative group compared with the preoperative (7.63 ± 9.8 days) and intraoperative (12.98 ± 25 days) groups (p1: 0.005; p2: 0.007 respectively, p< 0.05). The new dialysis incidence rate in the pre-, intra-, and postoperative periods was 9.4%, 23.4%, and 33.0%, respectively. The veno-arterial extracorporeal membrane oxygenation implantation rate in the preoperative, intraoperative, and postoperative groups was 3.1%, 23.4%, and 22.7%, respectively. The incidence of hospital mortality was 25.0% in the preoperative group, which was significantly lower compared to the intraoperative (54.7%) and the postoperative groups (70.1%) (p1: 0.011; p2: 0.000 respectively, p< 0.05). Conclusion: Any delay in insertion of IABP may cause progressive hemodinamic deteoriation. Determining the indication of implantation may even be difficult in some clinical scenarios. IABP support should be started without delay in the intraoperative period when a second inotropic support is needed and the patient has difficulty in weaning from CPB.
The Journal of heart valve disease, 2016
The study aim was to identify factors affecting early mortality in valvular reoperations. Between... more The study aim was to identify factors affecting early mortality in valvular reoperations. Between January 1993 and December 2011, a total of 693 patients who had undergone valvular reoperations due to problems with previously implanted mechanical and biological valves, new valve degeneration or valve failure after a reconstructive procedure was included in the study. Factors affecting early mortality were identified by the examination of preoperative and perioperative data, using multivariate analysis. The average age of the patients was 44.9 years. For all patients, overall hospital mortality was 15.9%, while hospital mortality rates were 12.9% and 35.3% for elective operation and urgent/emergency treatment, respectively. Factors affecting early mortality in the multivariate analysis were longer total perfusion time (>120 min, p = 0.001), emergency or urgent treatment (p = 0.001), and the presence of preoperative renal failure (p = 0.001). Mortality for elective patients in valv...
Cardiovascular Surgery and Interventions
Heparin-induced thrombocytopenia is a complication associated with increased early mortality and ... more Heparin-induced thrombocytopenia is a complication associated with increased early mortality and major morbidity rates after open heart surgery. Herein, we present a case of heparin-induced thrombocytopenia with major hemodynamic deterioration following elective aortic and mitral valve replacement who was successfully treated with plasmapheresis, intravenous immunoglobulin, and fondaparinux.
Turkiye Klinikleri Cardiovascular Sciences, 2013
Texas Heart Institute Journal from the Texas Heart Institute of St Luke S Episcopal Hospital Texas Children S Hospital, Feb 1, 2005
We report 4 consecutive cases in which the double-patch technique was used to repair an inferior ... more We report 4 consecutive cases in which the double-patch technique was used to repair an inferior postinfarction ventricular septal rupture. The ventricular septal perforation was closed directly by stitching, with the same sutures, 2 autologous pericardial patches onto both sides of the affected septum, through only a left ventriculotomy. Complete closure of the defect was accomplished, and no residual shunt was observed in any patient. This technique appears to be useful in selected cases, such as ventricular septal perforation with myocardial infarction in the subacute or chronic phase, especially in instances of inferoposterior infarction. Further experience is needed to verify its safety and efficacy.
Surgically important coronary artery anomalies may be seen uncommonly in tetralogy of Fallot. The... more Surgically important coronary artery anomalies may be seen uncommonly in tetralogy of Fallot. The most commonly encountered anomaly is the abnormal origin of the left anterior descending coronary artery from the right coronary artery crossing the right ventricular outflow tract. ...
Texas Heart Institute Journal from the Texas Heart Institute of St Luke S Episcopal Hospital Texas Children S Hospital, Feb 1, 2005
We present a review of our single-institution experience, over 19 years, with aortobronchial and ... more We present a review of our single-institution experience, over 19 years, with aortobronchial and aortoesophageal fistulae due to descending thoracic aortic aneurysm. We conducted a retrospective chart review of 10 cases involving surgery for aortobronchial and aortoesophageal fistulae in our clinic from February 1985 through October 2004. Pathologic or predisposing conditions associated with aortobronchial fistula were descending thoracic aortic aneurysm (n=8), previous aortic surgery (n=1), and concomitant aortoesophageal fistula (n=1). Three patients presented emergently with aortobronchial fistula (n=2) and aortoesophageal fistula (n=1). Ages of the 10 patients ranged from 42 to 74 years (median, 63 years). The median cross-clamp time was 34 minutes (range, 27-41 min). Repairs, in 9 patients, involved an inlay of prosthetic tube graft using the clamp-and-sew technique, and in 1 patient repair involved patch aortoplasty. The operative mortality rate was 20%: 1 patient had acute concomitant aortoesophageal and aortobronchial fistulae, and another had chronic aortobronchial fistula. There was no embolic stroke or paraplegia. During follow-up (median, 2.5 years), there were no deaths or postoperative morbidity. We conclude that repair of aortobronchial and aortoesophageal fistulae using the clamp-and-sew technique can be performed with acceptable operative mortality and long-term results. However, the mortality rate continues to be highly significant in patients with acute bleeding aortobronchial fistula or with aortoesophageal fistula, despite rapid surgical intervention.
Turkiye Klinikleri Journal of Surgical Medical Sciences, 2006
Turkiye Klinikleri Journal of Cardiovascular Surgery, 2004
... (13:32) Bakanlık: Å eker ve INR ölçüm stripleri hastanelerde ücretsiz. Devamı... Kalp Damar C... more ... (13:32) Bakanlık: Å eker ve INR ölçüm stripleri hastanelerde ücretsiz. Devamı... Kalp Damar Cerrahisi Dergisi Yıl: 2004 / Cilt: 5 / Sayı: 2. Mekanik Miyokardiyal Destek Sistemleri Vedat ERENTUĞ * , Mehmet Erdem TOKER * , Cevat YAKUT ** * Uz.Dr., Koşuyolu Kalp Eğitim ve ...
... Search result page. Title: A Case of Tetralogy of Fallot in Mirror-image Dextrocardia and Tot... more ... Search result page. Title: A Case of Tetralogy of Fallot in Mirror-image Dextrocardia and Total Situs Inversus. Author: Mehmet Balkanay ; Ercan Eren ; Hakan Akbayrak ; Mehmet Erdem Toker ; Mustafa G?ler ; Cevat Yakut. Abstract ...
Turkiye Klinikleri Kalp Damar Cerrahisi Dergisi, 2000
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2013
This retrospective study analyzes short- and long-term outcomes in 18 patients who underwent repa... more This retrospective study analyzes short- and long-term outcomes in 18 patients who underwent repair of posterobasal left ventricular aneurysm from January 1993 through December 2009. As concomitant procedures, mitral reconstruction was performed in 4 patients, ventricular septal defect repair in 2 patients, and coronary artery bypass grafting in 17 patients. In regard to surgical technique, 10 patients underwent patch repair and 8 underwent closure by linear suture. The in-hospital mortality rate was 11% (2 patients). An intra-aortic balloon pump was placed postoperatively in 1 patient. One patient underwent reoperation for mediastinitis and 2 for bleeding. The 1-, 5-, and 10-year survival rates were 82%, 76%, and 52%, respectively. Posterobasal left ventricular aneurysm repair can be performed with low short-term mortality rates and good long-term outcomes. It must be judged whether a linear repair or patch repair is better, in accordance with aneurysm size and the concomitant oper...
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2009
The aim of this study was to assess the effects of aortic valve replacement (AVR) on the recovery... more The aim of this study was to assess the effects of aortic valve replacement (AVR) on the recovery of left ventricular function and the predictors for long-term survival in patients suffering from isolated severe aortic stenosis (AS) with a significant left ventricular dysfunction (LVD). This retrospective study was conducted on 46 patients with isolated severe AS and LVD [left ventricular ejection fraction (LVEF) = or < 40%] who underwent AVR in our clinic between January 1993 and March 2006. Patients with coronary artery disease, with more than moderate aortic regurgitation (>2), with previous valve replacement or repair, and with other valve pathologies were excluded. The mean aortic valve area was 0.7+/- 0.09 cm2. The following fourteen variables were analyzed: etiology, age (= or >70 years), sex, preoperative New York Heart Association (NYHA) functional class, chronic obstructive pulmonary disease, hypertension, diabetes, peripheral arterial disease, chronic renal insuf...
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2005
We report 4 consecutive cases in which the double-patch technique was used to repair an inferior ... more We report 4 consecutive cases in which the double-patch technique was used to repair an inferior postinfarction ventricular septal rupture. The ventricular septal perforation was closed directly by stitching, with the same sutures, 2 autologous pericardial patches onto both sides of the affected septum, through only a left ventriculotomy. Complete closure of the defect was accomplished, and no residual shunt was observed in any patient. This technique appears to be useful in selected cases, such as ventricular septal perforation with myocardial infarction in the subacute or chronic phase, especially in instances of inferoposterior infarction. Further experience is needed to verify its safety and efficacy.
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2004
A retrospective evaluation was made on iatrogenic cardiac traumas requiring surgical treatment, t... more A retrospective evaluation was made on iatrogenic cardiac traumas requiring surgical treatment, that were induced by cardiac catheterizations and interventions performed within a 17-year period. A total of 64,911 patients underwent cardiac catheterizations and interventions from 1985 to 2002. Complications of iatrogenic cardiac traumas induced by these interventions were examined together with the surgical treatment performed within 24 hours after catheterization. Iatrogenic cardiac trauma requiring prompt surgical intervention was documented in 20 patients (6 females, 14 males; mean age 51 years; range 31 to 69 years). These were due to coronary angiography/balloon angioplasty-stenting in 14 (70%), percutaneous mitral balloon valvuloplasty in four (20%), and to heart catheterization in two patients (10%). Acute cardiac tamponade was detected in 10 patients (50%) resulting from perforations to the cardiac chambers in six, coronary arteries in two, and major vessels in two patients. ...
The heart surgery forum, 2002
The adverse effects of extracorporeal circulation increase the morbidity and mortality risk of co... more The adverse effects of extracorporeal circulation increase the morbidity and mortality risk of coronary bypass surgery, especially in patients with left ventricular dysfunction. The purpose of this study was to provide a comparison of the early and long-term outcome between patient groups with left ventricular dysfunction (LVEF<40% or LVPS>or=15) operated with or without using cardiopulmonary bypass. Fifty-one patients with left ventricular dysfunction, who were operated on between October 1992 and March 1994, were investigated retrospectively. They were divided into two groups: BH-group included 26 patients and cardiopulmonary bypass group had 25 patients. Mean age and risk factors were identical. All patients received one vessel bypass left internal mammary artery to left descending artery. There was no early mortality and perioperative myocardial infarction in either group. In the early postoperative period the need of cardiac support therapy was significantly higher in the...
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2005
We present a review of our single-institution experience, over 19 years, with aortobronchial and ... more We present a review of our single-institution experience, over 19 years, with aortobronchial and aortoesophageal fistulae due to descending thoracic aortic aneurysm. We conducted a retrospective chart review of 10 cases involving surgery for aortobronchial and aortoesophageal fistulae in our clinic from February 1985 through October 2004. Pathologic or predisposing conditions associated with aortobronchial fistula were descending thoracic aortic aneurysm (n=8), previous aortic surgery (n=1), and concomitant aortoesophageal fistula (n=1). Three patients presented emergently with aortobronchial fistula (n=2) and aortoesophageal fistula (n=1). Ages of the 10 patients ranged from 42 to 74 years (median, 63 years). The median cross-clamp time was 34 minutes (range, 27-41 min). Repairs, in 9 patients, involved an inlay of prosthetic tube graft using the clamp-and-sew technique, and in 1 patient repair involved patch aortoplasty. The operative mortality rate was 20%:1 patient had acute con...
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2006
In situ right internal mammary artery is the graft of choice in reoperative off-pump coronary art... more In situ right internal mammary artery is the graft of choice in reoperative off-pump coronary artery bypass grafting, as well as in primary on-pump coronary artery bypass grafting, unless the vessel has been used previously. However, there are not enough data about postoperative angiographic findings of the in situ right internal mammary artery in reoperative coronary artery bypass grafting with the off-pump technique. From September 1993 through January 2004, we reviewed the postoperative course and the graft patency of 12 selected patients who underwent off-pump coronary artery bypass grafting reoperation only for revascularization of the left anterior descending artery, by means of a pedicled right internal mammary artery graft. All patients were evaluated clinically and by postoperative coronary angiography. There were no early or late deaths during the mean follow-up period of 33.08 +/- 30.05 months (range, 1-77 months). The mean interval from the 1st operation to the 2nd opera...
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2009
We retrospectively investigated preoperative and postoperative characteristics in order to determ... more We retrospectively investigated preoperative and postoperative characteristics in order to determine factors that affected hospital death in patients who underwent 3 or 4 separate cardiac valvular surgeries. The hospital records of 53 such patients who were operated upon from 1985 through 2006 were obtained. The patients were divided into 2 groups according to whether their initial operation was a closed mitral commissurotomy (group C, n = 33) or open-heart surgery with cardiopulmonary bypass (group O, n = 20). In group C, all patients who had initially undergone 1 or 2 closed mitral commissurotomy procedures underwent subsequent reoperations that entailed median sternotomy and cardiopulmonary bypass. Sternotomy and cardiopulmonary bypass had been used in valvular operations of all group O patients. The total early mortality rate was 11.3% (6 of 53 patients). Multivariate analysis revealed that longer aortic cross-clamp times and double valve replacement at last operation significan...
Turkiye Klinikleri Journal of Medical Sciences, 2010
To re vi ew early and la te re sults of sup ra com mis su ral aor tic rep la ce ment in pa ti ent... more To re vi ew early and la te re sults of sup ra com mis su ral aor tic rep la ce ment in pa ti ents with acu te and chro nic type A dis sec ti on. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : From Feb ru ary 1985 to Oc to ber 2005, 162 pa ti ents with acu te and chro nic aor tic dis sec ti on un der went sup ra com mis su ral aor tic graft rep la ce ment. A ret ros pec ti ve cli ni cal re vi ew was un der ta ken using hos pi tal re cords, clini cal and ec ho car di og rap hic da ta, and te lep ho ne in ter vi ews with pa ti ents. R Re e s su ul lt ts s: : The re we re 23 (14.1 %) ope ra ti ve and eight (6.4 %) la te de aths. The most com mon ca u ses of hos pi tal de ath we re in tra o pe ra ti ve comp li ca ti ons re la ted to he morr ha ge (n= 9), and res pi ra tory fa i lu re (n = 6), and the ot her ca u se was mul ti or gan fa i lu re (n= 5). The hos pi tal mor ta lity ra te for pa ti ents with chro nic type A dis sec ti on was 6.25% (3/48). The ca u ses of de ath we re res pi ra tory fa i lu re (n= 2) and mul ti or gan fa i lu re (n= 1). The mo des of hos pi tal de aths we re not re la ted to re si du al aor tic in suf fi ci ency (AR) in any ca se sin ce early pos to pe ra ti ve trans tho ra cic ec ho car di og raphy did not show gra ter than grade II in the se pa ti ents in early pos to pe ra ti ve or fol low-up pe ri od, trans tho ra cic ec ho car di og raphy did not show aor tic re gur gi ta ti on gra ter than gra de II in any ca se. All sur vi vors we re in New York He art As so ci a ti on class I or II at the last vi sit. C Co on nc c l lu u s si i o on n: : Sup ra com mis su ral aor tic graft rep la cement pro vi des sa tis fac tory re sults for many pa ti ents with as cen ding aor tic dis sec ti on. The func ti on of the pre ser ved aor tic val ves re ma i ned unc han ged in the ma jo rity of the pa ti ents du ring the first fi ve ye ars of fol low-up. K Ke ey y W Wo or rd ds s: : Aor ta; aor tic val ve in suf fi ci ency; aor tic val ve Ö ÖZ ZE ET T A Am ma aç ç: : Sup ra ko mis su ral aort rep las ma nı uy gu la nan akut ve kro nik Tip A aort dis sek si yon lu ol gu la rın er ken ve geç dö nem so nuç la rı nın göz den ge çi ril me si. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Şubat 1985 ile Ekim 2005 ta rih le ri ara sın da akut ve kro nik dis sek si yo nu olan 162 ol gu ya sup ra kom mis su ral aort gretf rep las ma nı uy gu lan dı. Kli nik bul gu lar ret ros pek tif ola rak has ta ka yıt la rı, kli nik ve eko kar diyog ra fik bul gu lar ve has ta lar la te le fon gö rüş me le ri ile sağ lan dı. B Bu ul l g gu u l la ar r: : Yir mi üç (%14.1) ope ratif, se kiz (%5.8) geç dö nem mor ta li te si mev cut tu. En sık ölüm ne den le ri, in tra o pe ra tif komp li kasyon la ra bağ lı ola rak, ka na ma (n=9), so lu num yet mez li ği (n= 6) ve di ğer se bep ola rak da mul ti or gan yet mez li ği (n= 5) idi. Kro nik tip A dis sek si yon ol gu la rın da has ta ne mor ta li te si 6.25% (3/48) idi. Ölüm se bep le ri; so lu num yet mez li ği (n=2) ve mul ti or gan yet mez li ği (n= 1) idi. Ölüm le rin hiç bi ri re zi dü el aort yet mez li ği ne bağ lı de ğil di. Ya şa yan ol gu la rın er ken pos to pe ra tif ve uzun dö nem ta kip sü re sin ce trans to ra sik eko kar di yog ra fi ler de ikin ci de re ce den da ha faz la re zi dü el aort yet mez li ği ne rast lan ma dı. S So o n nu uç ç: : Sup ra kom mis su ral aort greft rep las ma nı bir çok asen dan aort dis sek si yon lu olgu lar da tat min edi ci so nuç lar sağ lar. Beş yıl lık bir iz lem de ol gu la rın ço ğun da ko ru nan aort ka paklar da her han gi bir pa to lo ji tes pit edil me miş tir.
Koşuyolu Heart Journal, 2020
Introduction: No exact consensus exists on the timing of the placement of an intraaortic balloon ... more Introduction: No exact consensus exists on the timing of the placement of an intraaortic balloon pump (IABP), yet still, it is the most common mechanical support device used in patients requiring open heart surgery. The purpose of this study was to investigate the results of the implantation of IABP in three different periods as preoperative, intraoperative, and postoperative and to compare the results obtained in these periods. Patients and Methods: This study included 193 patients undergoing open-heart surgery with IABP support between January 2014 and December 2016. The patients were divided into three groups as preoperative period, intraoperative period and postoperative period, based on the beginning of IABP support. The patients were compared in terms of preoperative characteristics, surgical data and postoperative results. Results: Of the 193 patients, 32 (16.5%) received preoperative, 64 (33.1%) intraoperative, and 97 (50.2%) postoperative IABP support. The length of ICU stay (20.15 ± 23 days) was longer for the postoperative group compared with the preoperative (7.63 ± 9.8 days) and intraoperative (12.98 ± 25 days) groups (p1: 0.005; p2: 0.007 respectively, p< 0.05). The new dialysis incidence rate in the pre-, intra-, and postoperative periods was 9.4%, 23.4%, and 33.0%, respectively. The veno-arterial extracorporeal membrane oxygenation implantation rate in the preoperative, intraoperative, and postoperative groups was 3.1%, 23.4%, and 22.7%, respectively. The incidence of hospital mortality was 25.0% in the preoperative group, which was significantly lower compared to the intraoperative (54.7%) and the postoperative groups (70.1%) (p1: 0.011; p2: 0.000 respectively, p< 0.05). Conclusion: Any delay in insertion of IABP may cause progressive hemodinamic deteoriation. Determining the indication of implantation may even be difficult in some clinical scenarios. IABP support should be started without delay in the intraoperative period when a second inotropic support is needed and the patient has difficulty in weaning from CPB.
The Journal of heart valve disease, 2016
The study aim was to identify factors affecting early mortality in valvular reoperations. Between... more The study aim was to identify factors affecting early mortality in valvular reoperations. Between January 1993 and December 2011, a total of 693 patients who had undergone valvular reoperations due to problems with previously implanted mechanical and biological valves, new valve degeneration or valve failure after a reconstructive procedure was included in the study. Factors affecting early mortality were identified by the examination of preoperative and perioperative data, using multivariate analysis. The average age of the patients was 44.9 years. For all patients, overall hospital mortality was 15.9%, while hospital mortality rates were 12.9% and 35.3% for elective operation and urgent/emergency treatment, respectively. Factors affecting early mortality in the multivariate analysis were longer total perfusion time (>120 min, p = 0.001), emergency or urgent treatment (p = 0.001), and the presence of preoperative renal failure (p = 0.001). Mortality for elective patients in valv...
Cardiovascular Surgery and Interventions
Heparin-induced thrombocytopenia is a complication associated with increased early mortality and ... more Heparin-induced thrombocytopenia is a complication associated with increased early mortality and major morbidity rates after open heart surgery. Herein, we present a case of heparin-induced thrombocytopenia with major hemodynamic deterioration following elective aortic and mitral valve replacement who was successfully treated with plasmapheresis, intravenous immunoglobulin, and fondaparinux.
Turkiye Klinikleri Cardiovascular Sciences, 2013
Texas Heart Institute Journal from the Texas Heart Institute of St Luke S Episcopal Hospital Texas Children S Hospital, Feb 1, 2005
We report 4 consecutive cases in which the double-patch technique was used to repair an inferior ... more We report 4 consecutive cases in which the double-patch technique was used to repair an inferior postinfarction ventricular septal rupture. The ventricular septal perforation was closed directly by stitching, with the same sutures, 2 autologous pericardial patches onto both sides of the affected septum, through only a left ventriculotomy. Complete closure of the defect was accomplished, and no residual shunt was observed in any patient. This technique appears to be useful in selected cases, such as ventricular septal perforation with myocardial infarction in the subacute or chronic phase, especially in instances of inferoposterior infarction. Further experience is needed to verify its safety and efficacy.
Surgically important coronary artery anomalies may be seen uncommonly in tetralogy of Fallot. The... more Surgically important coronary artery anomalies may be seen uncommonly in tetralogy of Fallot. The most commonly encountered anomaly is the abnormal origin of the left anterior descending coronary artery from the right coronary artery crossing the right ventricular outflow tract. ...
Texas Heart Institute Journal from the Texas Heart Institute of St Luke S Episcopal Hospital Texas Children S Hospital, Feb 1, 2005
We present a review of our single-institution experience, over 19 years, with aortobronchial and ... more We present a review of our single-institution experience, over 19 years, with aortobronchial and aortoesophageal fistulae due to descending thoracic aortic aneurysm. We conducted a retrospective chart review of 10 cases involving surgery for aortobronchial and aortoesophageal fistulae in our clinic from February 1985 through October 2004. Pathologic or predisposing conditions associated with aortobronchial fistula were descending thoracic aortic aneurysm (n=8), previous aortic surgery (n=1), and concomitant aortoesophageal fistula (n=1). Three patients presented emergently with aortobronchial fistula (n=2) and aortoesophageal fistula (n=1). Ages of the 10 patients ranged from 42 to 74 years (median, 63 years). The median cross-clamp time was 34 minutes (range, 27-41 min). Repairs, in 9 patients, involved an inlay of prosthetic tube graft using the clamp-and-sew technique, and in 1 patient repair involved patch aortoplasty. The operative mortality rate was 20%: 1 patient had acute concomitant aortoesophageal and aortobronchial fistulae, and another had chronic aortobronchial fistula. There was no embolic stroke or paraplegia. During follow-up (median, 2.5 years), there were no deaths or postoperative morbidity. We conclude that repair of aortobronchial and aortoesophageal fistulae using the clamp-and-sew technique can be performed with acceptable operative mortality and long-term results. However, the mortality rate continues to be highly significant in patients with acute bleeding aortobronchial fistula or with aortoesophageal fistula, despite rapid surgical intervention.
Turkiye Klinikleri Journal of Surgical Medical Sciences, 2006
Turkiye Klinikleri Journal of Cardiovascular Surgery, 2004
... (13:32) Bakanlık: Å eker ve INR ölçüm stripleri hastanelerde ücretsiz. Devamı... Kalp Damar C... more ... (13:32) Bakanlık: Å eker ve INR ölçüm stripleri hastanelerde ücretsiz. Devamı... Kalp Damar Cerrahisi Dergisi Yıl: 2004 / Cilt: 5 / Sayı: 2. Mekanik Miyokardiyal Destek Sistemleri Vedat ERENTUĞ * , Mehmet Erdem TOKER * , Cevat YAKUT ** * Uz.Dr., Koşuyolu Kalp Eğitim ve ...
... Search result page. Title: A Case of Tetralogy of Fallot in Mirror-image Dextrocardia and Tot... more ... Search result page. Title: A Case of Tetralogy of Fallot in Mirror-image Dextrocardia and Total Situs Inversus. Author: Mehmet Balkanay ; Ercan Eren ; Hakan Akbayrak ; Mehmet Erdem Toker ; Mustafa G?ler ; Cevat Yakut. Abstract ...
Turkiye Klinikleri Kalp Damar Cerrahisi Dergisi, 2000
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2013
This retrospective study analyzes short- and long-term outcomes in 18 patients who underwent repa... more This retrospective study analyzes short- and long-term outcomes in 18 patients who underwent repair of posterobasal left ventricular aneurysm from January 1993 through December 2009. As concomitant procedures, mitral reconstruction was performed in 4 patients, ventricular septal defect repair in 2 patients, and coronary artery bypass grafting in 17 patients. In regard to surgical technique, 10 patients underwent patch repair and 8 underwent closure by linear suture. The in-hospital mortality rate was 11% (2 patients). An intra-aortic balloon pump was placed postoperatively in 1 patient. One patient underwent reoperation for mediastinitis and 2 for bleeding. The 1-, 5-, and 10-year survival rates were 82%, 76%, and 52%, respectively. Posterobasal left ventricular aneurysm repair can be performed with low short-term mortality rates and good long-term outcomes. It must be judged whether a linear repair or patch repair is better, in accordance with aneurysm size and the concomitant oper...
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2009
The aim of this study was to assess the effects of aortic valve replacement (AVR) on the recovery... more The aim of this study was to assess the effects of aortic valve replacement (AVR) on the recovery of left ventricular function and the predictors for long-term survival in patients suffering from isolated severe aortic stenosis (AS) with a significant left ventricular dysfunction (LVD). This retrospective study was conducted on 46 patients with isolated severe AS and LVD [left ventricular ejection fraction (LVEF) = or < 40%] who underwent AVR in our clinic between January 1993 and March 2006. Patients with coronary artery disease, with more than moderate aortic regurgitation (>2), with previous valve replacement or repair, and with other valve pathologies were excluded. The mean aortic valve area was 0.7+/- 0.09 cm2. The following fourteen variables were analyzed: etiology, age (= or >70 years), sex, preoperative New York Heart Association (NYHA) functional class, chronic obstructive pulmonary disease, hypertension, diabetes, peripheral arterial disease, chronic renal insuf...
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2005
We report 4 consecutive cases in which the double-patch technique was used to repair an inferior ... more We report 4 consecutive cases in which the double-patch technique was used to repair an inferior postinfarction ventricular septal rupture. The ventricular septal perforation was closed directly by stitching, with the same sutures, 2 autologous pericardial patches onto both sides of the affected septum, through only a left ventriculotomy. Complete closure of the defect was accomplished, and no residual shunt was observed in any patient. This technique appears to be useful in selected cases, such as ventricular septal perforation with myocardial infarction in the subacute or chronic phase, especially in instances of inferoposterior infarction. Further experience is needed to verify its safety and efficacy.
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2004
A retrospective evaluation was made on iatrogenic cardiac traumas requiring surgical treatment, t... more A retrospective evaluation was made on iatrogenic cardiac traumas requiring surgical treatment, that were induced by cardiac catheterizations and interventions performed within a 17-year period. A total of 64,911 patients underwent cardiac catheterizations and interventions from 1985 to 2002. Complications of iatrogenic cardiac traumas induced by these interventions were examined together with the surgical treatment performed within 24 hours after catheterization. Iatrogenic cardiac trauma requiring prompt surgical intervention was documented in 20 patients (6 females, 14 males; mean age 51 years; range 31 to 69 years). These were due to coronary angiography/balloon angioplasty-stenting in 14 (70%), percutaneous mitral balloon valvuloplasty in four (20%), and to heart catheterization in two patients (10%). Acute cardiac tamponade was detected in 10 patients (50%) resulting from perforations to the cardiac chambers in six, coronary arteries in two, and major vessels in two patients. ...
The heart surgery forum, 2002
The adverse effects of extracorporeal circulation increase the morbidity and mortality risk of co... more The adverse effects of extracorporeal circulation increase the morbidity and mortality risk of coronary bypass surgery, especially in patients with left ventricular dysfunction. The purpose of this study was to provide a comparison of the early and long-term outcome between patient groups with left ventricular dysfunction (LVEF<40% or LVPS>or=15) operated with or without using cardiopulmonary bypass. Fifty-one patients with left ventricular dysfunction, who were operated on between October 1992 and March 1994, were investigated retrospectively. They were divided into two groups: BH-group included 26 patients and cardiopulmonary bypass group had 25 patients. Mean age and risk factors were identical. All patients received one vessel bypass left internal mammary artery to left descending artery. There was no early mortality and perioperative myocardial infarction in either group. In the early postoperative period the need of cardiac support therapy was significantly higher in the...
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2005
We present a review of our single-institution experience, over 19 years, with aortobronchial and ... more We present a review of our single-institution experience, over 19 years, with aortobronchial and aortoesophageal fistulae due to descending thoracic aortic aneurysm. We conducted a retrospective chart review of 10 cases involving surgery for aortobronchial and aortoesophageal fistulae in our clinic from February 1985 through October 2004. Pathologic or predisposing conditions associated with aortobronchial fistula were descending thoracic aortic aneurysm (n=8), previous aortic surgery (n=1), and concomitant aortoesophageal fistula (n=1). Three patients presented emergently with aortobronchial fistula (n=2) and aortoesophageal fistula (n=1). Ages of the 10 patients ranged from 42 to 74 years (median, 63 years). The median cross-clamp time was 34 minutes (range, 27-41 min). Repairs, in 9 patients, involved an inlay of prosthetic tube graft using the clamp-and-sew technique, and in 1 patient repair involved patch aortoplasty. The operative mortality rate was 20%:1 patient had acute con...
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2006
In situ right internal mammary artery is the graft of choice in reoperative off-pump coronary art... more In situ right internal mammary artery is the graft of choice in reoperative off-pump coronary artery bypass grafting, as well as in primary on-pump coronary artery bypass grafting, unless the vessel has been used previously. However, there are not enough data about postoperative angiographic findings of the in situ right internal mammary artery in reoperative coronary artery bypass grafting with the off-pump technique. From September 1993 through January 2004, we reviewed the postoperative course and the graft patency of 12 selected patients who underwent off-pump coronary artery bypass grafting reoperation only for revascularization of the left anterior descending artery, by means of a pedicled right internal mammary artery graft. All patients were evaluated clinically and by postoperative coronary angiography. There were no early or late deaths during the mean follow-up period of 33.08 +/- 30.05 months (range, 1-77 months). The mean interval from the 1st operation to the 2nd opera...
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2009
We retrospectively investigated preoperative and postoperative characteristics in order to determ... more We retrospectively investigated preoperative and postoperative characteristics in order to determine factors that affected hospital death in patients who underwent 3 or 4 separate cardiac valvular surgeries. The hospital records of 53 such patients who were operated upon from 1985 through 2006 were obtained. The patients were divided into 2 groups according to whether their initial operation was a closed mitral commissurotomy (group C, n = 33) or open-heart surgery with cardiopulmonary bypass (group O, n = 20). In group C, all patients who had initially undergone 1 or 2 closed mitral commissurotomy procedures underwent subsequent reoperations that entailed median sternotomy and cardiopulmonary bypass. Sternotomy and cardiopulmonary bypass had been used in valvular operations of all group O patients. The total early mortality rate was 11.3% (6 of 53 patients). Multivariate analysis revealed that longer aortic cross-clamp times and double valve replacement at last operation significan...
Turkiye Klinikleri Journal of Medical Sciences, 2010
To re vi ew early and la te re sults of sup ra com mis su ral aor tic rep la ce ment in pa ti ent... more To re vi ew early and la te re sults of sup ra com mis su ral aor tic rep la ce ment in pa ti ents with acu te and chro nic type A dis sec ti on. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : From Feb ru ary 1985 to Oc to ber 2005, 162 pa ti ents with acu te and chro nic aor tic dis sec ti on un der went sup ra com mis su ral aor tic graft rep la ce ment. A ret ros pec ti ve cli ni cal re vi ew was un der ta ken using hos pi tal re cords, clini cal and ec ho car di og rap hic da ta, and te lep ho ne in ter vi ews with pa ti ents. R Re e s su ul lt ts s: : The re we re 23 (14.1 %) ope ra ti ve and eight (6.4 %) la te de aths. The most com mon ca u ses of hos pi tal de ath we re in tra o pe ra ti ve comp li ca ti ons re la ted to he morr ha ge (n= 9), and res pi ra tory fa i lu re (n = 6), and the ot her ca u se was mul ti or gan fa i lu re (n= 5). The hos pi tal mor ta lity ra te for pa ti ents with chro nic type A dis sec ti on was 6.25% (3/48). The ca u ses of de ath we re res pi ra tory fa i lu re (n= 2) and mul ti or gan fa i lu re (n= 1). The mo des of hos pi tal de aths we re not re la ted to re si du al aor tic in suf fi ci ency (AR) in any ca se sin ce early pos to pe ra ti ve trans tho ra cic ec ho car di og raphy did not show gra ter than grade II in the se pa ti ents in early pos to pe ra ti ve or fol low-up pe ri od, trans tho ra cic ec ho car di og raphy did not show aor tic re gur gi ta ti on gra ter than gra de II in any ca se. All sur vi vors we re in New York He art As so ci a ti on class I or II at the last vi sit. C Co on nc c l lu u s si i o on n: : Sup ra com mis su ral aor tic graft rep la cement pro vi des sa tis fac tory re sults for many pa ti ents with as cen ding aor tic dis sec ti on. The func ti on of the pre ser ved aor tic val ves re ma i ned unc han ged in the ma jo rity of the pa ti ents du ring the first fi ve ye ars of fol low-up. K Ke ey y W Wo or rd ds s: : Aor ta; aor tic val ve in suf fi ci ency; aor tic val ve Ö ÖZ ZE ET T A Am ma aç ç: : Sup ra ko mis su ral aort rep las ma nı uy gu la nan akut ve kro nik Tip A aort dis sek si yon lu ol gu la rın er ken ve geç dö nem so nuç la rı nın göz den ge çi ril me si. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Şubat 1985 ile Ekim 2005 ta rih le ri ara sın da akut ve kro nik dis sek si yo nu olan 162 ol gu ya sup ra kom mis su ral aort gretf rep las ma nı uy gu lan dı. Kli nik bul gu lar ret ros pek tif ola rak has ta ka yıt la rı, kli nik ve eko kar diyog ra fik bul gu lar ve has ta lar la te le fon gö rüş me le ri ile sağ lan dı. B Bu ul l g gu u l la ar r: : Yir mi üç (%14.1) ope ratif, se kiz (%5.8) geç dö nem mor ta li te si mev cut tu. En sık ölüm ne den le ri, in tra o pe ra tif komp li kasyon la ra bağ lı ola rak, ka na ma (n=9), so lu num yet mez li ği (n= 6) ve di ğer se bep ola rak da mul ti or gan yet mez li ği (n= 5) idi. Kro nik tip A dis sek si yon ol gu la rın da has ta ne mor ta li te si 6.25% (3/48) idi. Ölüm se bep le ri; so lu num yet mez li ği (n=2) ve mul ti or gan yet mez li ği (n= 1) idi. Ölüm le rin hiç bi ri re zi dü el aort yet mez li ği ne bağ lı de ğil di. Ya şa yan ol gu la rın er ken pos to pe ra tif ve uzun dö nem ta kip sü re sin ce trans to ra sik eko kar di yog ra fi ler de ikin ci de re ce den da ha faz la re zi dü el aort yet mez li ği ne rast lan ma dı. S So o n nu uç ç: : Sup ra kom mis su ral aort greft rep las ma nı bir çok asen dan aort dis sek si yon lu olgu lar da tat min edi ci so nuç lar sağ lar. Beş yıl lık bir iz lem de ol gu la rın ço ğun da ko ru nan aort ka paklar da her han gi bir pa to lo ji tes pit edil me miş tir.