Noyan Ogus - Academia.edu (original) (raw)

Papers by Noyan Ogus

Turkiye Klinikleri Kalp Damar Cerrahisi Dergisi, 2001

Use of Alfieri stitch technique in a patient with hypertrophic obstructive cardiomyopathy

Objective: We aimed to evaluate the etiology and frequency of thrombocytopenia in postoperative c... more Objective: We aimed to evaluate the etiology and frequency of thrombocytopenia in postoperative cardiovascular surgery patients and the complications secondary to thrombocytopenia in this patient group. Material and Methods: We retrospectively reviewed the postoperative data of 167 patients followed and treated at the cardiovascular surgery intensive care unit. The presence of thrombocytopenia was detected from blood count results in patients' files. Etiologic factors and complications were assessed in patients possessing thrombocytopenia. Results: A thrombocyte level lower than 150,000/mm3 was accepted as thrombocytopenia. It was detected in 64 patients (%38.32). Etiologies for thrombocytopenia were the usage of low molecular weight heparin, disseminated intravascular coagulation, sepsis and septicemia, drugs other than heparin, and systemic diseases. Among these, low molecular weight heparin was the most common reason (n=34, %53.1) and in that particular patient group thromboc...

The Journal of cardiovascular surgery, 2002

It is crucial to determine stability, histocompatibility and antibacterial properties of the cyan... more It is crucial to determine stability, histocompatibility and antibacterial properties of the cyanoacrylate used for sternal fixation. Clinical study: in 17 cases of mediastinitis, debridement and rewiring the sternum, was applied as the treatment method (Group I). Eighteen cases of mediastinitis were treated with the same method added sternal cyanoacrylate gluing (Group II). A comparative study was done; the follow-up period was 36.7+/-4 and 18.5+/-6.9 months in Group I and II, respectively. Animal study: in 10 rats, upper sternotomy was done and the sternal bone was contaminated. Direct wound closure was done in 4 rats (Group A), in 6 animals, wounds were closed after applying cyanoacrylate in sternal split (Group B). In this prospective study, all rats alive were sacrificed at the 3rd and 8th weeks and sternums were examined histologically. Clinical study: in Group I, 6 patients required additional interventions due to recurrent sternal detachment and osteomyelitis (35.3%). In Gro...

Journal of International Medical Research, 2004

We investigated the effects of pressure, temperature and additives on aortic root reperfusion suc... more We investigated the effects of pressure, temperature and additives on aortic root reperfusion success. Cardiopulmonary bypass and heart arrest were initiated in mongrel dogs and sudden uncontrolled normothermic (group 1), pressure controlled substrate enriched normothermic (group 2a), pressure controlled unmodified normothermic (group 2b) and pressure controlled unmodified tepid (group 3) reperfusion compared. In group 1, the first cardiac rhythm was ventricular fibrillation, but dogs in the other groups showed spontaneous sinus rhythm. Recovery times were significantly longer and cardiac output levels significantly decreased in group 1 compared with the other groups. Prolonged lactate production and oxygen uptake failure were observed in group 1 compared with the other groups; oxidative stress markers and microscopic studies confirmed significant tissue injury in group 1. All parameters were similar between groups 2a, 2b and 3, indicating that low reperfusion pressure in the first ...

European Journal of Cardio-Thoracic Surgery, 2005

Complex surgical procedures are associated with a major risk of peri-operative bleeding. Jehova's... more Complex surgical procedures are associated with a major risk of peri-operative bleeding. Jehova's witnesses (JW) necessitate a tailored strategy warranting the optimal surgical management, in observance to their religion principles. In this report, we present a JW female patient, who underwent combined coronary artery bypass grafting and carotid endarterectomy, with neither endotracheal intubation nor general anaesthesia. Patient had previously undergone bilateral endarterectomy and required a reoperation on the left side. She was also scheduled for revascularization of left anterior descending coronary artery. After an extensive evaluation of all the possible operative strategies, we planned to perform CABG via a mid-line sternotomy, followed by CEA, in the awake patient. There were no intra-operative complications. Hb level, monitored by blood gases controls, mantained above 10 g/dl. The post-operative course was uneventful. In this patient, for the first time, a high-risk CABG procedure and a high-risk CEA were carried out simultaneously, in the awake setting. This approach represented a meeting point between surgical requirements and specific patient's needs. We believe it could be a safe alternative management applicable to high risk candidates to combined carotid and coronary artery surgery, presenting with bleeding-related issues.

The Annals of Thoracic Surgery, 2007

able outcomes are reported more frequently, it may affect the perioperative counselling. This rep... more able outcomes are reported more frequently, it may affect the perioperative counselling. This report should also underline the importance of counselling of all Marfan patients in pregnancy to avoid life-threatening complications such as acute type A dissection. Marfan syndrome, pregnancy, and aortic dissection is a very rare but highly challenging coincidence with no standardized therapeutic concept. In our opinion, surgical repair of acute type A dissection in pregnant patients using CPB and deep hypothermia with the fetus in utero seems to be an adequate therapeutic regime, even in Marfan patients. We suggest that a more aggressive approach in selected cases, maybe elective treatment, will lead to favorable results at a reasonable risk. References 1. Immer FF, Bansi AG, Immer-Bansi AS, et al. Aortic dissection in pregnancy: analysis of risk factors and outcome. Ann

Acta Cardiologica, 2008

The purpose of this study was to assess the viability and dilator response of the saphenous vein ... more The purpose of this study was to assess the viability and dilator response of the saphenous vein segments harvested during cardiac surgery. The saphenous veins were incubated with either normal saline (group A) or papaverine solutions (group B). The viability of saphenous vein endothelial cells was assessed by counting the number of total cells. Maximal endothelium-dependent vasodilator response to acetylcholine was also investigated. Cell viability of vein samples was decreased after 4 hours of incubation with normal saline (34 +/- 6.5%) as compared to solution containing papaverine (92 +/- 3.7%). By 24 hours, the viabilities of the endothelial cells incubated with saline and papaverine solutions were 22 +/- 4.5% and 87 +/- 5%, respectively.There was significant difference in vasodilatation responses to acetylcholine between saline-incubated and papaverine-incubated groups. By 4 hours of incubation, the relaxation response to acetylcholine significantly deteriorated in group A when compared to the initial value (P < 0.001). Furthermore, the decrease in this vasorelaxation response has also continued throughout the observation period and the values obtained by 24 hours were observed to be significantly lower than those obtained at the end of 4 hours (P < 0.01). In contrast, although a decrease was noticed in group B over time, this decrease was not statistically significant (P, not significant). We thus conclude that the use of papaverine solution improves endothelial cell viability and is associated with preservation of the maximal endothelial-dependent vasodilator response of a vein segment.

Angiology, 2001

A 60-year-old woman with no recent symptoms was admitted to a local hospital for unstable angina,... more A 60-year-old woman with no recent symptoms was admitted to a local hospital for unstable angina, and coronary angiography was performed. A coronary angiogram revealed normal origin of the coronary arteries and critical stenosis of the high lateral (HL), circumflex (Cx), and right coronary (RC) arteries proximal to the posterior descending (PD) artery (Figure 1). No LAD could be visualized even with aortography. The patient was scheduled for coronary artery bypass grafting. At exploration, there was no fat tissue in the interventricular groove, and no LAD could be visualized externally (Figure 2). Attempts at isolating an LAD intramurally failed, so a decision was made to explore the left coronary ostium. A transverse aortotomy was made and coronary ostia

Turkiye Klinikleri Journal of Cardiovascular Surgery, 2001

Folia Neuropathologica, Feb 1, 2008

We aimed to determine the efficacy of remote ischaemic preconditioning in the hind limb of rats f... more We aimed to determine the efficacy of remote ischaemic preconditioning in the hind limb of rats for ischaemic damage of the spinal cord through neurological and histological investigation and examination of heat shock proteins (HSP). Thirty male Sprague-Dawley rats were divided into three groups as Group 1 (control group, n=10), Group 2 (ischaemia control group, n=10), and Group 3 (remote ischaemia preconditioning group, n=10). The right lower limb of the rats in the study group was compressed with a tourniquet for three cycles of ten-minute ischaemia followed by ten-minute reperfusion. After a period of 8 hours, the peritoneal cavity was accessed through a midline vertical incision. The abdominal aorta was clamped between the origin of the renal arteries and the iliac arteries for 45 minutes and spinal cord ischaemia was induced. The same procedure of abdominal aorta clamping was performed in the control group without creating leg ischaemia. The rats were evaluated for neurological parameters at 24 and 48 hours. At the end of this time period, all rats were sacrificed and the spinal cords were stained for determination of HSP and histopathological classification. For immunohistochemical evaluation, the samples were analyzed according to the degree of staining with HSP70 rabbit antibody. After completing the neurological examinations and histological evaluations, we determined the spinal cords of the animals in the sham group to be completely normal. The post-operative neurological examination scores of Group 3 at 24 and 48 hours were significantly higher than scores measured in the other two groups. There were seven rats with HSP expression and this was detected in animals pretreated with remote ischaemic preconditioning. There were also two rats in Group 2 with HSP expression. Our results show that production of transient remote ischaemia preconditioning in the lower extremities reduces damage in the spinal cord secondary to ischaemia probably by the increase of HSP.

Angiology, Feb 1, 2009

Drug-induced myopathy, also named Nicolau syndrome, is a well-known phenomenon following intramus... more Drug-induced myopathy, also named Nicolau syndrome, is a well-known phenomenon following intramuscular injection of certain agents, most commonly reported with penicillin or diclofenac. The mechanism responsible for the pathology is proposed to be incidental administration of the drug into the small arterioles. In this report, we present a Nicolau syndrome-like case that developed following accidental injection of a local anesthetic agent into the femoral artery during coronary angiography.

Anadolu Kardiyoloji Dergisi Akd the Anatolian Journal of Cardiology, Oct 1, 2006

Systolic anterior motion of the anterior mitral leaflet plays an important role in the dynamic ou... more Systolic anterior motion of the anterior mitral leaflet plays an important role in the dynamic outflow tract obstruction encountered in patients with hypertrophic obstructive cardiomyopathy. Here we present a 58-year-old male patient who was successfully treated with a myectomy procedure applied along with the edge-to-edge Alfieri stitch technique. The use of the Alfieri technique provides satisfactory short-term results and can

Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2004

In 31 consecutive patients with ischemic left ventricular dysfunction and mitral regurgitation ra... more In 31 consecutive patients with ischemic left ventricular dysfunction and mitral regurgitation ranging from 2/4 to 3/4 (mean, 2.87 +/- 0.34), we performed coronary bypass grafting alone and assessed early and midterm outcomes. Our patients' mean preoperative New York Heart Association functional class was 3.64 +/- 0.48, and their mean left ventricular ejection fraction was 0.25 +/- 0.05. Preoperative thallium imaging revealed that all patients had at minimum a partially reversible defect in the anterior wall. All patients survived the operation. Hospital length of stay ranged from 5 to 21 days (mean, 8.35 +/- 4.07 days), and mean length of follow-up was 21.35 +/- 13.24 months. Postoperatively, patients' functional classification improved to a mean of 1.32 +/- 0.6; left ventricular ejection fraction improved to a mean of 0.43 +/- 0.09; and severity of mitral regurgitation decreased to a mean of 1.35 +/- 0.96. Statistical analysis showed that all improvements were significant....

Turkiye Klinikleri Kalp Damar Cerrahisi Dergisi, 2001

Use of Alfieri stitch technique in a patient with hypertrophic obstructive cardiomyopathy

Objective: We aimed to evaluate the etiology and frequency of thrombocytopenia in postoperative c... more Objective: We aimed to evaluate the etiology and frequency of thrombocytopenia in postoperative cardiovascular surgery patients and the complications secondary to thrombocytopenia in this patient group. Material and Methods: We retrospectively reviewed the postoperative data of 167 patients followed and treated at the cardiovascular surgery intensive care unit. The presence of thrombocytopenia was detected from blood count results in patients' files. Etiologic factors and complications were assessed in patients possessing thrombocytopenia. Results: A thrombocyte level lower than 150,000/mm3 was accepted as thrombocytopenia. It was detected in 64 patients (%38.32). Etiologies for thrombocytopenia were the usage of low molecular weight heparin, disseminated intravascular coagulation, sepsis and septicemia, drugs other than heparin, and systemic diseases. Among these, low molecular weight heparin was the most common reason (n=34, %53.1) and in that particular patient group thromboc...

The Journal of cardiovascular surgery, 2002

It is crucial to determine stability, histocompatibility and antibacterial properties of the cyan... more It is crucial to determine stability, histocompatibility and antibacterial properties of the cyanoacrylate used for sternal fixation. Clinical study: in 17 cases of mediastinitis, debridement and rewiring the sternum, was applied as the treatment method (Group I). Eighteen cases of mediastinitis were treated with the same method added sternal cyanoacrylate gluing (Group II). A comparative study was done; the follow-up period was 36.7+/-4 and 18.5+/-6.9 months in Group I and II, respectively. Animal study: in 10 rats, upper sternotomy was done and the sternal bone was contaminated. Direct wound closure was done in 4 rats (Group A), in 6 animals, wounds were closed after applying cyanoacrylate in sternal split (Group B). In this prospective study, all rats alive were sacrificed at the 3rd and 8th weeks and sternums were examined histologically. Clinical study: in Group I, 6 patients required additional interventions due to recurrent sternal detachment and osteomyelitis (35.3%). In Gro...

Journal of International Medical Research, 2004

We investigated the effects of pressure, temperature and additives on aortic root reperfusion suc... more We investigated the effects of pressure, temperature and additives on aortic root reperfusion success. Cardiopulmonary bypass and heart arrest were initiated in mongrel dogs and sudden uncontrolled normothermic (group 1), pressure controlled substrate enriched normothermic (group 2a), pressure controlled unmodified normothermic (group 2b) and pressure controlled unmodified tepid (group 3) reperfusion compared. In group 1, the first cardiac rhythm was ventricular fibrillation, but dogs in the other groups showed spontaneous sinus rhythm. Recovery times were significantly longer and cardiac output levels significantly decreased in group 1 compared with the other groups. Prolonged lactate production and oxygen uptake failure were observed in group 1 compared with the other groups; oxidative stress markers and microscopic studies confirmed significant tissue injury in group 1. All parameters were similar between groups 2a, 2b and 3, indicating that low reperfusion pressure in the first ...

European Journal of Cardio-Thoracic Surgery, 2005

Complex surgical procedures are associated with a major risk of peri-operative bleeding. Jehova's... more Complex surgical procedures are associated with a major risk of peri-operative bleeding. Jehova's witnesses (JW) necessitate a tailored strategy warranting the optimal surgical management, in observance to their religion principles. In this report, we present a JW female patient, who underwent combined coronary artery bypass grafting and carotid endarterectomy, with neither endotracheal intubation nor general anaesthesia. Patient had previously undergone bilateral endarterectomy and required a reoperation on the left side. She was also scheduled for revascularization of left anterior descending coronary artery. After an extensive evaluation of all the possible operative strategies, we planned to perform CABG via a mid-line sternotomy, followed by CEA, in the awake patient. There were no intra-operative complications. Hb level, monitored by blood gases controls, mantained above 10 g/dl. The post-operative course was uneventful. In this patient, for the first time, a high-risk CABG procedure and a high-risk CEA were carried out simultaneously, in the awake setting. This approach represented a meeting point between surgical requirements and specific patient's needs. We believe it could be a safe alternative management applicable to high risk candidates to combined carotid and coronary artery surgery, presenting with bleeding-related issues.

The Annals of Thoracic Surgery, 2007

able outcomes are reported more frequently, it may affect the perioperative counselling. This rep... more able outcomes are reported more frequently, it may affect the perioperative counselling. This report should also underline the importance of counselling of all Marfan patients in pregnancy to avoid life-threatening complications such as acute type A dissection. Marfan syndrome, pregnancy, and aortic dissection is a very rare but highly challenging coincidence with no standardized therapeutic concept. In our opinion, surgical repair of acute type A dissection in pregnant patients using CPB and deep hypothermia with the fetus in utero seems to be an adequate therapeutic regime, even in Marfan patients. We suggest that a more aggressive approach in selected cases, maybe elective treatment, will lead to favorable results at a reasonable risk. References 1. Immer FF, Bansi AG, Immer-Bansi AS, et al. Aortic dissection in pregnancy: analysis of risk factors and outcome. Ann

Acta Cardiologica, 2008

The purpose of this study was to assess the viability and dilator response of the saphenous vein ... more The purpose of this study was to assess the viability and dilator response of the saphenous vein segments harvested during cardiac surgery. The saphenous veins were incubated with either normal saline (group A) or papaverine solutions (group B). The viability of saphenous vein endothelial cells was assessed by counting the number of total cells. Maximal endothelium-dependent vasodilator response to acetylcholine was also investigated. Cell viability of vein samples was decreased after 4 hours of incubation with normal saline (34 +/- 6.5%) as compared to solution containing papaverine (92 +/- 3.7%). By 24 hours, the viabilities of the endothelial cells incubated with saline and papaverine solutions were 22 +/- 4.5% and 87 +/- 5%, respectively.There was significant difference in vasodilatation responses to acetylcholine between saline-incubated and papaverine-incubated groups. By 4 hours of incubation, the relaxation response to acetylcholine significantly deteriorated in group A when compared to the initial value (P < 0.001). Furthermore, the decrease in this vasorelaxation response has also continued throughout the observation period and the values obtained by 24 hours were observed to be significantly lower than those obtained at the end of 4 hours (P < 0.01). In contrast, although a decrease was noticed in group B over time, this decrease was not statistically significant (P, not significant). We thus conclude that the use of papaverine solution improves endothelial cell viability and is associated with preservation of the maximal endothelial-dependent vasodilator response of a vein segment.

Angiology, 2001

A 60-year-old woman with no recent symptoms was admitted to a local hospital for unstable angina,... more A 60-year-old woman with no recent symptoms was admitted to a local hospital for unstable angina, and coronary angiography was performed. A coronary angiogram revealed normal origin of the coronary arteries and critical stenosis of the high lateral (HL), circumflex (Cx), and right coronary (RC) arteries proximal to the posterior descending (PD) artery (Figure 1). No LAD could be visualized even with aortography. The patient was scheduled for coronary artery bypass grafting. At exploration, there was no fat tissue in the interventricular groove, and no LAD could be visualized externally (Figure 2). Attempts at isolating an LAD intramurally failed, so a decision was made to explore the left coronary ostium. A transverse aortotomy was made and coronary ostia

Turkiye Klinikleri Journal of Cardiovascular Surgery, 2001

Folia Neuropathologica, Feb 1, 2008

We aimed to determine the efficacy of remote ischaemic preconditioning in the hind limb of rats f... more We aimed to determine the efficacy of remote ischaemic preconditioning in the hind limb of rats for ischaemic damage of the spinal cord through neurological and histological investigation and examination of heat shock proteins (HSP). Thirty male Sprague-Dawley rats were divided into three groups as Group 1 (control group, n=10), Group 2 (ischaemia control group, n=10), and Group 3 (remote ischaemia preconditioning group, n=10). The right lower limb of the rats in the study group was compressed with a tourniquet for three cycles of ten-minute ischaemia followed by ten-minute reperfusion. After a period of 8 hours, the peritoneal cavity was accessed through a midline vertical incision. The abdominal aorta was clamped between the origin of the renal arteries and the iliac arteries for 45 minutes and spinal cord ischaemia was induced. The same procedure of abdominal aorta clamping was performed in the control group without creating leg ischaemia. The rats were evaluated for neurological parameters at 24 and 48 hours. At the end of this time period, all rats were sacrificed and the spinal cords were stained for determination of HSP and histopathological classification. For immunohistochemical evaluation, the samples were analyzed according to the degree of staining with HSP70 rabbit antibody. After completing the neurological examinations and histological evaluations, we determined the spinal cords of the animals in the sham group to be completely normal. The post-operative neurological examination scores of Group 3 at 24 and 48 hours were significantly higher than scores measured in the other two groups. There were seven rats with HSP expression and this was detected in animals pretreated with remote ischaemic preconditioning. There were also two rats in Group 2 with HSP expression. Our results show that production of transient remote ischaemia preconditioning in the lower extremities reduces damage in the spinal cord secondary to ischaemia probably by the increase of HSP.

Angiology, Feb 1, 2009

Drug-induced myopathy, also named Nicolau syndrome, is a well-known phenomenon following intramus... more Drug-induced myopathy, also named Nicolau syndrome, is a well-known phenomenon following intramuscular injection of certain agents, most commonly reported with penicillin or diclofenac. The mechanism responsible for the pathology is proposed to be incidental administration of the drug into the small arterioles. In this report, we present a Nicolau syndrome-like case that developed following accidental injection of a local anesthetic agent into the femoral artery during coronary angiography.

Anadolu Kardiyoloji Dergisi Akd the Anatolian Journal of Cardiology, Oct 1, 2006

Systolic anterior motion of the anterior mitral leaflet plays an important role in the dynamic ou... more Systolic anterior motion of the anterior mitral leaflet plays an important role in the dynamic outflow tract obstruction encountered in patients with hypertrophic obstructive cardiomyopathy. Here we present a 58-year-old male patient who was successfully treated with a myectomy procedure applied along with the edge-to-edge Alfieri stitch technique. The use of the Alfieri technique provides satisfactory short-term results and can

Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2004

In 31 consecutive patients with ischemic left ventricular dysfunction and mitral regurgitation ra... more In 31 consecutive patients with ischemic left ventricular dysfunction and mitral regurgitation ranging from 2/4 to 3/4 (mean, 2.87 +/- 0.34), we performed coronary bypass grafting alone and assessed early and midterm outcomes. Our patients' mean preoperative New York Heart Association functional class was 3.64 +/- 0.48, and their mean left ventricular ejection fraction was 0.25 +/- 0.05. Preoperative thallium imaging revealed that all patients had at minimum a partially reversible defect in the anterior wall. All patients survived the operation. Hospital length of stay ranged from 5 to 21 days (mean, 8.35 +/- 4.07 days), and mean length of follow-up was 21.35 +/- 13.24 months. Postoperatively, patients' functional classification improved to a mean of 1.32 +/- 0.6; left ventricular ejection fraction improved to a mean of 0.43 +/- 0.09; and severity of mitral regurgitation decreased to a mean of 1.35 +/- 0.96. Statistical analysis showed that all improvements were significant....