Ozerdem Ozcaliskan - Academia.edu (original) (raw)

Papers by Ozerdem Ozcaliskan

Damar Cerrahi Dergisi, 2015

The Heart Surgery Forum, 2007

Visceral artery aneurysms are rare vascular malformations and the literature lacks satisfactory g... more Visceral artery aneurysms are rare vascular malformations and the literature lacks satisfactory general information about the pathology. The aim of this study was to review our experiences in the diagnosis and treatment of visceral artery aneurysms. We retrospectively reviewed data on 10 patients who were diagnosed with visceral artery aneurysms at our institution between June 2002 and September 2005. All available clinical, pathologic, and postoperative data were reviewed and analyzed for postoperative outcome. Four splenic artery aneurysms, 2 hepatic artery aneurysms, 5 renal artery aneurysms, 1 superior mesenteric artery aneurysm, and 1 inferior mesenteric artery aneurysm (13 total visceral artery aneurysms) were diagnosed in 10 patients. All the patients were treated except 1 patient with bilateral renal artery aneurysms. One patient required emergent surgical treatment due to splenic artery aneurysm rupture. Only 1 patient underwent endovascular treatment (ie, coil embolization for a superior mesenteric artery aneurysm); otherwise all the patients were treated surgically on an elective basis. Surgical treatment modalities included ligation with exclusion in 4 patients (2 splenic artery aneurysms, 1 renal artery aneurysm, 1 hepatic artery aneurysm) and resection with revascularization in 4 patients (1 splenic artery aneurysm, 2 renal artery aneurysms, 1 hepatic artery aneurysm, 1 inferior mesenteric artery aneurysm). Histopathologic examination of the vascular materials revealed major atherosclerotic changes except one that showed inflammatory vasculitic changes. One patient required bleeding revision, and mortality did not occur in any of the patients. Visceral artery aneurysms are rare and potentially life-threatening vascular disorders. The number of cases diagnosed every year increases because of advanced radiologic diagnostic methods and screening programs. Careful consideration and early management of these malformations can be life saving.

Annals of Thoracic and Cardiovascular Surgery, 2013

Purpose: Surgical correction of the partial anomalous pulmonary venous connection (PAPVC) drainin... more Purpose: Surgical correction of the partial anomalous pulmonary venous connection (PAPVC) draining into the superior vena cava (SVC) has been associated with sinus node dysfunction and venous return obstruction, postoperatively. We present the results of our lateral cavoatriotomy approach with little modifications to avoid injury to the sinus node and its artery. Methods: 32 patients who underwent surgical repair of PAPVC to SVC with modified lateral cavoatriotomy in our clinic between January 2003 and January 2009 were evaluated retrospectively. Results: Median age was 6 years (2-32 years). The mean follow-up time was 65.8 ± 23.7 months (36-111 months). There were no early or late deaths. No patients required reoperation. New onset of arrhythmia had developed in two patients and resolved before hospital discharge. Stenosis of the SVC in one patient had developed 11 months after the operation and was treated with balloon angioplasty, successfully. No sinus node dysfunction or venous return obstruction was detected in their last follow-up. Conclusion: Cavoatrial incision for repair of PAPVC to SVC may become a safer surgical technique with some modifications.

Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2012

Amaç: Çalışmamızda Fallot tetralojisi (TOF) olan hastalara uygulanan tam düzeltme ameliyatının or... more Amaç: Çalışmamızda Fallot tetralojisi (TOF) olan hastalara uygulanan tam düzeltme ameliyatının orta dönem sonuçları sunuldu. Ça lış ma pla nı: Ocak 2006-Ağustos 2011 tarihleri arasında toplam 104 TOF hastasına (60 erkek, 44 kadın; ort. yaş 4.1 yıl; dağıtım 1-24 yıl) tam düzeltme uygulandı. Sağ ventrikül çıkım yolu genişletilmesi 89 hastada transanüler yama ile (10 hastada V-Plasti tekniği ile), 12 hastada sadece sağ atriyotomiden kas rezeksiyonu ile üç hastada ise Contegra greft ile yapıldı. Hastalar pulmoner yetmezlik, transpulmoner gradyan, ventrikül fonksiyonları ve rezidüel ventriküler septal defekt (VSD) varlığını tespit etmek amacıyla ekokardiyografi ile takip edildi. Ortalama takip süresi 26.4 ay (dağılım, 6-62 ay) idi. Bul gu lar: Yedi hastada erken dönem mortalite izlenirken, geç dönem mortalite gözlenmedi. Olguların ikisine tam atriyoventriküler (AV) blok, birine Mobitz tip-2 AV blok nedeni ile kalıcı pacemaker implante edildi. Kontrol ekokardiyografilerde rezidüel VSD görülmedi. On üç hasta hafif pulmoner yetmezlik ile takip edilmekte iken, takip sırasında ileri pulmoner yetmezlik saptanan yedi olguya pompasız injektabl pulmoner kapak replasmanı uygulandı. So nuç: Ameliyat sonrası dönemde pulmoner yetmezliği gelişen hastalarda pompasız injektable pulmoner kapak replasmanı göz önünde bulundurulmalıdır. Anah tar söz cük ler: Pulmoner yetmezlik; Fallot tetralojisi; tam düzeltme. Background: We aimed to present midterm results of total correction surgery in patients with tetralogy of Fallot (TOF). Methods: A total of 104 patients with TOF (60 males, 44 females; mean age 4.1 years; range 1 to 24 years) underwent total correction between January 2006 and August 2011. Right ventricular outflow tract reconstruction was performed by transannular patching in 89 (V-Plasty technique in 10), by muscular resection from only right atriotomy in 12, and by Contegra graft in three patients. Patients were followedup by echocardiography to detect the presence of pulmonary insufficiency, transpulmonary gradient, ventricle functions, and residual ventricular septal defect (VSD). The mean follow-up was 26.4 months (range, 6-62). Results:Early-term mortality was seen in seven patients, while no late-term mortality was observed. A permanent pacemaker was implanted to two patients with complete atrioventricular (AV) block and one patient with Mobitz type-2 AV block. Repeated echocardiography showed no residual VSD. Of 13 patients with mild pulmonary insufficiency, seven with severe pulmonary insufficiency during the follow-up period underwent off-pump injectable pulmonary valve replacement. Conclusion: Off-pump injectable pulmonary valve replacement should be considered in patients with postoperative pulmonary insufficiency.

The Heart Surgery …, 2007

Visceral artery aneurysms are rare vascular pathologies with an incidence detected in autopsy ser... more Visceral artery aneurysms are rare vascular pathologies with an incidence detected in autopsy series ranging between 0.1% to 0.2% among all vascular aneurysms [Drescher 2006]. The natural history and clinical course of the pathology are uncer-tain, and the indications for surgical ...

Background: We investigated the efficacy, preoperative, postoperative and early stage outcomes of... more Background: We investigated the efficacy, preoperative, postoperative and early stage outcomes of Anaconda type endovascular stent-grafts in patients who had intervention in our clinic with the diagnosis of abdominal aortic aneurysm. Material – Methods: During the years of 2010 and 2013, 23 patients (19 male, 4 female) had endovascular stent-graft procedure with the diagnosis of infrarenal abdominal aortic aneurysm. The mean age was 76.1 (67-82). All patients had Anaconda endovascular stent graft procedure. Results: The intervention was performed to all patients in angiology laboratory under the sterilization and technical conditions of a surgery room. Aortoiliac stenting was done for all patients. The mean procedural time was 70.5 (55-97) minutes. No patient required open surgery. Graft placement was successful in all patients. None of the patients died during the procedure. One patient died in early stage due to congestive heart failure and pulmonary edema. None of the patients ha...

Turkish Journal of Vascular Surgery, 2014

Objective: Takayasu’s arteritis (TA) is first described by a Japanese ophthalmologist, Mikito Ta... more Objective: Takayasu’s arteritis (TA) is first described by a Japanese ophthalmologist,
Mikito Takayasu, in 1908. It is a disease of unknown etiology, primarily affecting aorta and its branches. We present mid-term results of 20 patients who underwent surgery or endovascular intervention due to TA.
Material and Methods: Between January 2003 and January 2013, 20 patients with TA underwent surgery or endovascular intervention in our clinic. Their symptoms and findings were upper extremity ischemia (n=10), upper extremity hypertension (n=7), lower extremity claudication (n=5), subclavian steal (n=5), syncope (n=2), vertebro-basillary insufficiency (n=2), and visual disturbances (n=1). Of 20 patients, 13 underwent surgery, 6 underwent endovascular intervention, and 1 underwent a hybrid approach.
Results: Restenosis was observed in 6 patients. Aneurysm occurred at right distal anastomotic site of the aorto-bifemoral graft in 1 patient who underwent surgery due to atypical coarctation of the aorta. Transient ischemic attack occurred in 1 patient on 48th day after endovascular intervention to the left carotid artery. There was no mortality in our series.
Conclusion: Both surgical and endovascular approaches are commonly used techniques in TA. Restenosis rates of these interventions are similar. Treatment depends on the on the characteristics of the lesion, and the experience of the surgeon.

Journal of Cardiothoracic Surgery, Jul 11, 2012

Background: The aim of the present study is to compare negative pressure wound therapy versus con... more Background: The aim of the present study is to compare negative pressure wound therapy versus conventional treatment outcomes at postoperative mediastinitis after cardiac surgery. Methods: Between January 2000 and December 2011, after 9972 sternotomies, postoperative mediastinitis was diagnosed in 90 patients. The treatment modalities divided the patients into two groups: group 1 patients (n = 47) were initially treated with the negative pressure wound therapy and group 2 patients (n = 43) were underwent conventional treatment protocols. The outcomes were investigated with Kaplan-Meier method, log-rank test, Student's test and Fisher's exact test. Results: The 90-days mortality was found significantly lower in the negative pressure wound group than in the conventionally treated group. Overall survival was significantly better in the negative pressure wound group than in the conventionally treated group. Conclusion: Negative pressure wound therapy is safe and reliable option in mediastinitis after cardiac surgery, with excellent survival and low failure rate when compared with conventional treatments.

Background: In this study, we sought to analyze our experience in urgent surgical management for ... more Background: In this study, we sought to analyze our experience in urgent surgical management for embolized cardiac septal and ductal occluder devices resulting from trans-catheter closure of atrial septal defect, ventricular septal defect and patent ductus arteriosus in childhood patient group. Methods: We retrospectively reviewed 9 patients (aged 2-15 years) who underwent urgent surgery due to cardiac septal and ductal occluder embolization between January 2007 and December 2010. Congenital defects were atrial septal defect (n = 6), ventricular septal defect (n = 1), and patent ductus arteriosus (n = 2). Risk factors for device embolization and urgent surgical management techniques for embolized device removal were discussed. Results: Removal of embolized devices in all cases and repair of damaged tricuspid valve in 2 patients were performed. Inevitably, all congenital defects were closed or ligated up to the primary defect. Total circulator arrest necessitated in 1 patient with ascending aortic device embolization. All operations were completed successfully and no hospital mortality or morbidity was encountered. Conclusions: Although closure of left to right shunting defects by percutaneous occluder devices has a lot of advantages, device embolization is still a major complication. If embolized device retrieval fails with percutaneous intervention attempts, surgical management is the only method to remove embolized devices. In this circumstance, to provide an uneventful perioperative course, urgent management strategies should be well planned.

The Journal of Heart Valve Disease, Mar 1, 2013

The study aim was to present the short- and mid-term results for patients who underwent aortic va... more The study aim was to present the short- and mid-term results for patients who underwent aortic valve replacement (AVR) with the Sorin Freedom Solo third-generation stentless prosthetic valve. AVR with a Sorin Freedom Solo valve was performed in 14 patients between March 2006 and March 2011. Patients aged 60 years (male:female ratio 6:8; mean age 73.28 +/- 5.42 years) who required AVR with the Sorin Freedom Solo valve according to the surgeon's choice were included in the study. The valvular prosthesis was implanted in the supra-annular position, using a single suture line. Eight patients underwent an isolated AVR; combined interventions were carried out in the other patients due to concomitant cardiac disease. One patient died during the immediate perioperative period, and two more during the follow up, from non-cardiac causes. The mean maximum transvalvular gradient of patients with aortic stenosis was 88.1 +/- 20.2 mmHg, and this fell to 26.4 +/- 7.6 mmHg during the early postoperative period. The mean gradient at one year of follow up was further decreased to 19.4 +/- 5.3 mmHg. The left ventricular end-diastolic and end-systolic diameters were also significantly reduced, from 4.8 +/- 0.9 to 4.3 +/- 0.6 cm and from 3.2 +/- 0.6 to 2.8 +/- 5.3 cm, respectively. The average left ventricular ejection fraction was 60.2 +/- 4.9% preoperatively, and 63.2 +/- 2.1% at one year after surgery (p = NS). No paravalvular leakage, endocarditis, prosthesis failure or neurologic events were reported among patients. The Sorin Freedom Solo stentless valve has provided good early and intermediate-term results. Implantation of the prosthesis is straightforward, with low rates of morbidity and mortality. However, these data require further support from larger patient series and long-term follow up.

Journal of Cardiac Surgery, 2011

A case of pulmonary valve endocarditis in a patient with a ductus arteriosus (PDA) is reported. T... more A case of pulmonary valve endocarditis in a patient with a ductus arteriosus (PDA) is reported. The PDA was ligated, the septal leaflet of the pulmonary valve was excised, and a pericardial monocusp reconstruction was performed.

The heart surgery forum, 2011

Cardiac leiomyosarcoma is a rare tumor with poor survival prospects. Surgery prolongs survival, b... more Cardiac leiomyosarcoma is a rare tumor with poor survival prospects. Surgery prolongs survival, but the tumor often recurs early after surgery. The diagnosis is often made by transthoracic echocardiography. Magnetic resonance imaging and computed tomography are required to characterize the location and extent of cardiac masses. In this report, we present a patient with a leiomyosarcoma that was resected completely. The tumor was located in the left atrium, mimicked a myxoma, and protruded into the left ventricle during diastole.

Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2008

Spontaneous dissection of the abdominal aorta should be considered as a vascular surgical emergen... more Spontaneous dissection of the abdominal aorta should be considered as a vascular surgical emergency. We report here our experience with this rare pathology. At our hospital, we operated on 200 patients for abdominal aortic aneurysm over a 4-year period, and aortic dissection was the underlying pathology in eight of them. Diagnosis was based on history, imaging study findings and visualization at surgery. The mean size of the aorta at the time of diagnosis was 5.5 +/- 0.4 cm. Aortic dissection was complicated by acute ischemia of lower limb and paraplegia in 1 patient and four patients were admitted to hospital with severe abdominal and back pain. Two patients with contained rupture were admitted with hemodynamic collapse and shock. One of the patients who presented with abdominal pain experienced also sudden onset paraplegia. The diagnosis of dissecting abdominal aortic aneurysm was established incidentally in the remaining 2 patients. All patients were treated using open techniques...

Journal of Cardiothoracic Surgery, 2012

Background: The aim of the present study is to compare negative pressure wound therapy versus con... more Background: The aim of the present study is to compare negative pressure wound therapy versus conventional treatment outcomes at postoperative mediastinitis after cardiac surgery. Methods: Between January 2000 and December 2011, after 9972 sternotomies, postoperative mediastinitis was diagnosed in 90 patients. The treatment modalities divided the patients into two groups: group 1 patients (n = 47) were initially treated with the negative pressure wound therapy and group 2 patients (n = 43) were underwent conventional treatment protocols. The outcomes were investigated with Kaplan-Meier method, log-rank test, Student's test and Fisher's exact test. Results: The 90-days mortality was found significantly lower in the negative pressure wound group than in the conventionally treated group. Overall survival was significantly better in the negative pressure wound group than in the conventionally treated group. Conclusion: Negative pressure wound therapy is safe and reliable option in mediastinitis after cardiac surgery, with excellent survival and low failure rate when compared with conventional treatments.

Journal of Cardiothoracic Surgery, 2012

Background: In this study, we sought to analyze our experience in urgent surgical management for ... more Background: In this study, we sought to analyze our experience in urgent surgical management for embolized cardiac septal and ductal occluder devices resulting from trans-catheter closure of atrial septal defect, ventricular septal defect and patent ductus arteriosus in childhood patient group. Methods: We retrospectively reviewed 9 patients (aged 2-15 years) who underwent urgent surgery due to cardiac septal and ductal occluder embolization between January 2007 and December 2010. Congenital defects were atrial septal defect (n = 6), ventricular septal defect (n = 1), and patent ductus arteriosus (n = 2). Risk factors for device embolization and urgent surgical management techniques for embolized device removal were discussed. Results: Removal of embolized devices in all cases and repair of damaged tricuspid valve in 2 patients were performed. Inevitably, all congenital defects were closed or ligated up to the primary defect. Total circulator arrest necessitated in 1 patient with ascending aortic device embolization. All operations were completed successfully and no hospital mortality or morbidity was encountered. Conclusions: Although closure of left to right shunting defects by percutaneous occluder devices has a lot of advantages, device embolization is still a major complication. If embolized device retrieval fails with percutaneous intervention attempts, surgical management is the only method to remove embolized devices. In this circumstance, to provide an uneventful perioperative course, urgent management strategies should be well planned.

Journal of Cardiac Surgery, 2011

A case of pulmonary valve endocarditis in a patient with a ductus arteriosus (PDA) is reported. T... more A case of pulmonary valve endocarditis in a patient with a ductus arteriosus (PDA) is reported. The PDA was ligated, the septal leaflet of the pulmonary valve was excised, and a pericardial monocusp reconstruction was performed.

Journal of Cardiothoracic Surgery, 2013

Background: The goal of repair of right ventricular outflow tract obstruction with or without Tet... more Background: The goal of repair of right ventricular outflow tract obstruction with or without Tetralogy of Fallot (TOF) is to eliminate valvular and/or subvalvular obstruction. However, this operation has a high risk of late complication of pulmonary insufficiency. In this study, we aimed to present early period results of our new technique that we call "V-Plasty" developed to prevent pulmonary insufficiency after pulmonary valve reconstruction in selected patients. Methods: Between January 2006 and January 2010, we performed V-plasty for pulmonary valve reconstruction in 10 patients. Eight patients (5 males, 3 females) had TOF and 2 patients (1 male, 1 female) had atrial septal defect concomitant with pulmonary valve stenosis. Patient selection for V-plasty reconstruction was made due to the pulmonary valve anatomy and degree of stenosis. The mean follow-up time was 55.7 ± 16.2 months (ranging from 32 to 80 months). Results: Functional capacity of the patients improved immediately after the surgery. There were no mortality and re-operation in follow-up period. Patients were followed up with echocardiography one week after the operation, at 1st, 6th, 12th months and annually. There was no pulmonary insufficiency. Conclusions: Operative correction of the pulmonary outflow tract obstruction with or without TOF, frequently requires transannular enlargement because of the infundibular and/or annular-valvular obstruction. This conventional technique is usually a reason for late pulmonary insufficiency. In our study, we have not seen pulmonary insufficiency in early term follow-up period. Our early term results are encouraging, but long term follow-up results are needed with large case series.

Damar Cerrahi Dergisi, 2015

The Heart Surgery Forum, 2007

Visceral artery aneurysms are rare vascular malformations and the literature lacks satisfactory g... more Visceral artery aneurysms are rare vascular malformations and the literature lacks satisfactory general information about the pathology. The aim of this study was to review our experiences in the diagnosis and treatment of visceral artery aneurysms. We retrospectively reviewed data on 10 patients who were diagnosed with visceral artery aneurysms at our institution between June 2002 and September 2005. All available clinical, pathologic, and postoperative data were reviewed and analyzed for postoperative outcome. Four splenic artery aneurysms, 2 hepatic artery aneurysms, 5 renal artery aneurysms, 1 superior mesenteric artery aneurysm, and 1 inferior mesenteric artery aneurysm (13 total visceral artery aneurysms) were diagnosed in 10 patients. All the patients were treated except 1 patient with bilateral renal artery aneurysms. One patient required emergent surgical treatment due to splenic artery aneurysm rupture. Only 1 patient underwent endovascular treatment (ie, coil embolization for a superior mesenteric artery aneurysm); otherwise all the patients were treated surgically on an elective basis. Surgical treatment modalities included ligation with exclusion in 4 patients (2 splenic artery aneurysms, 1 renal artery aneurysm, 1 hepatic artery aneurysm) and resection with revascularization in 4 patients (1 splenic artery aneurysm, 2 renal artery aneurysms, 1 hepatic artery aneurysm, 1 inferior mesenteric artery aneurysm). Histopathologic examination of the vascular materials revealed major atherosclerotic changes except one that showed inflammatory vasculitic changes. One patient required bleeding revision, and mortality did not occur in any of the patients. Visceral artery aneurysms are rare and potentially life-threatening vascular disorders. The number of cases diagnosed every year increases because of advanced radiologic diagnostic methods and screening programs. Careful consideration and early management of these malformations can be life saving.

Annals of Thoracic and Cardiovascular Surgery, 2013

Purpose: Surgical correction of the partial anomalous pulmonary venous connection (PAPVC) drainin... more Purpose: Surgical correction of the partial anomalous pulmonary venous connection (PAPVC) draining into the superior vena cava (SVC) has been associated with sinus node dysfunction and venous return obstruction, postoperatively. We present the results of our lateral cavoatriotomy approach with little modifications to avoid injury to the sinus node and its artery. Methods: 32 patients who underwent surgical repair of PAPVC to SVC with modified lateral cavoatriotomy in our clinic between January 2003 and January 2009 were evaluated retrospectively. Results: Median age was 6 years (2-32 years). The mean follow-up time was 65.8 ± 23.7 months (36-111 months). There were no early or late deaths. No patients required reoperation. New onset of arrhythmia had developed in two patients and resolved before hospital discharge. Stenosis of the SVC in one patient had developed 11 months after the operation and was treated with balloon angioplasty, successfully. No sinus node dysfunction or venous return obstruction was detected in their last follow-up. Conclusion: Cavoatrial incision for repair of PAPVC to SVC may become a safer surgical technique with some modifications.

Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2012

Amaç: Çalışmamızda Fallot tetralojisi (TOF) olan hastalara uygulanan tam düzeltme ameliyatının or... more Amaç: Çalışmamızda Fallot tetralojisi (TOF) olan hastalara uygulanan tam düzeltme ameliyatının orta dönem sonuçları sunuldu. Ça lış ma pla nı: Ocak 2006-Ağustos 2011 tarihleri arasında toplam 104 TOF hastasına (60 erkek, 44 kadın; ort. yaş 4.1 yıl; dağıtım 1-24 yıl) tam düzeltme uygulandı. Sağ ventrikül çıkım yolu genişletilmesi 89 hastada transanüler yama ile (10 hastada V-Plasti tekniği ile), 12 hastada sadece sağ atriyotomiden kas rezeksiyonu ile üç hastada ise Contegra greft ile yapıldı. Hastalar pulmoner yetmezlik, transpulmoner gradyan, ventrikül fonksiyonları ve rezidüel ventriküler septal defekt (VSD) varlığını tespit etmek amacıyla ekokardiyografi ile takip edildi. Ortalama takip süresi 26.4 ay (dağılım, 6-62 ay) idi. Bul gu lar: Yedi hastada erken dönem mortalite izlenirken, geç dönem mortalite gözlenmedi. Olguların ikisine tam atriyoventriküler (AV) blok, birine Mobitz tip-2 AV blok nedeni ile kalıcı pacemaker implante edildi. Kontrol ekokardiyografilerde rezidüel VSD görülmedi. On üç hasta hafif pulmoner yetmezlik ile takip edilmekte iken, takip sırasında ileri pulmoner yetmezlik saptanan yedi olguya pompasız injektabl pulmoner kapak replasmanı uygulandı. So nuç: Ameliyat sonrası dönemde pulmoner yetmezliği gelişen hastalarda pompasız injektable pulmoner kapak replasmanı göz önünde bulundurulmalıdır. Anah tar söz cük ler: Pulmoner yetmezlik; Fallot tetralojisi; tam düzeltme. Background: We aimed to present midterm results of total correction surgery in patients with tetralogy of Fallot (TOF). Methods: A total of 104 patients with TOF (60 males, 44 females; mean age 4.1 years; range 1 to 24 years) underwent total correction between January 2006 and August 2011. Right ventricular outflow tract reconstruction was performed by transannular patching in 89 (V-Plasty technique in 10), by muscular resection from only right atriotomy in 12, and by Contegra graft in three patients. Patients were followedup by echocardiography to detect the presence of pulmonary insufficiency, transpulmonary gradient, ventricle functions, and residual ventricular septal defect (VSD). The mean follow-up was 26.4 months (range, 6-62). Results:Early-term mortality was seen in seven patients, while no late-term mortality was observed. A permanent pacemaker was implanted to two patients with complete atrioventricular (AV) block and one patient with Mobitz type-2 AV block. Repeated echocardiography showed no residual VSD. Of 13 patients with mild pulmonary insufficiency, seven with severe pulmonary insufficiency during the follow-up period underwent off-pump injectable pulmonary valve replacement. Conclusion: Off-pump injectable pulmonary valve replacement should be considered in patients with postoperative pulmonary insufficiency.

The Heart Surgery …, 2007

Visceral artery aneurysms are rare vascular pathologies with an incidence detected in autopsy ser... more Visceral artery aneurysms are rare vascular pathologies with an incidence detected in autopsy series ranging between 0.1% to 0.2% among all vascular aneurysms [Drescher 2006]. The natural history and clinical course of the pathology are uncer-tain, and the indications for surgical ...

Background: We investigated the efficacy, preoperative, postoperative and early stage outcomes of... more Background: We investigated the efficacy, preoperative, postoperative and early stage outcomes of Anaconda type endovascular stent-grafts in patients who had intervention in our clinic with the diagnosis of abdominal aortic aneurysm. Material – Methods: During the years of 2010 and 2013, 23 patients (19 male, 4 female) had endovascular stent-graft procedure with the diagnosis of infrarenal abdominal aortic aneurysm. The mean age was 76.1 (67-82). All patients had Anaconda endovascular stent graft procedure. Results: The intervention was performed to all patients in angiology laboratory under the sterilization and technical conditions of a surgery room. Aortoiliac stenting was done for all patients. The mean procedural time was 70.5 (55-97) minutes. No patient required open surgery. Graft placement was successful in all patients. None of the patients died during the procedure. One patient died in early stage due to congestive heart failure and pulmonary edema. None of the patients ha...

Turkish Journal of Vascular Surgery, 2014

Objective: Takayasu’s arteritis (TA) is first described by a Japanese ophthalmologist, Mikito Ta... more Objective: Takayasu’s arteritis (TA) is first described by a Japanese ophthalmologist,
Mikito Takayasu, in 1908. It is a disease of unknown etiology, primarily affecting aorta and its branches. We present mid-term results of 20 patients who underwent surgery or endovascular intervention due to TA.
Material and Methods: Between January 2003 and January 2013, 20 patients with TA underwent surgery or endovascular intervention in our clinic. Their symptoms and findings were upper extremity ischemia (n=10), upper extremity hypertension (n=7), lower extremity claudication (n=5), subclavian steal (n=5), syncope (n=2), vertebro-basillary insufficiency (n=2), and visual disturbances (n=1). Of 20 patients, 13 underwent surgery, 6 underwent endovascular intervention, and 1 underwent a hybrid approach.
Results: Restenosis was observed in 6 patients. Aneurysm occurred at right distal anastomotic site of the aorto-bifemoral graft in 1 patient who underwent surgery due to atypical coarctation of the aorta. Transient ischemic attack occurred in 1 patient on 48th day after endovascular intervention to the left carotid artery. There was no mortality in our series.
Conclusion: Both surgical and endovascular approaches are commonly used techniques in TA. Restenosis rates of these interventions are similar. Treatment depends on the on the characteristics of the lesion, and the experience of the surgeon.

Journal of Cardiothoracic Surgery, Jul 11, 2012

Background: The aim of the present study is to compare negative pressure wound therapy versus con... more Background: The aim of the present study is to compare negative pressure wound therapy versus conventional treatment outcomes at postoperative mediastinitis after cardiac surgery. Methods: Between January 2000 and December 2011, after 9972 sternotomies, postoperative mediastinitis was diagnosed in 90 patients. The treatment modalities divided the patients into two groups: group 1 patients (n = 47) were initially treated with the negative pressure wound therapy and group 2 patients (n = 43) were underwent conventional treatment protocols. The outcomes were investigated with Kaplan-Meier method, log-rank test, Student's test and Fisher's exact test. Results: The 90-days mortality was found significantly lower in the negative pressure wound group than in the conventionally treated group. Overall survival was significantly better in the negative pressure wound group than in the conventionally treated group. Conclusion: Negative pressure wound therapy is safe and reliable option in mediastinitis after cardiac surgery, with excellent survival and low failure rate when compared with conventional treatments.

Background: In this study, we sought to analyze our experience in urgent surgical management for ... more Background: In this study, we sought to analyze our experience in urgent surgical management for embolized cardiac septal and ductal occluder devices resulting from trans-catheter closure of atrial septal defect, ventricular septal defect and patent ductus arteriosus in childhood patient group. Methods: We retrospectively reviewed 9 patients (aged 2-15 years) who underwent urgent surgery due to cardiac septal and ductal occluder embolization between January 2007 and December 2010. Congenital defects were atrial septal defect (n = 6), ventricular septal defect (n = 1), and patent ductus arteriosus (n = 2). Risk factors for device embolization and urgent surgical management techniques for embolized device removal were discussed. Results: Removal of embolized devices in all cases and repair of damaged tricuspid valve in 2 patients were performed. Inevitably, all congenital defects were closed or ligated up to the primary defect. Total circulator arrest necessitated in 1 patient with ascending aortic device embolization. All operations were completed successfully and no hospital mortality or morbidity was encountered. Conclusions: Although closure of left to right shunting defects by percutaneous occluder devices has a lot of advantages, device embolization is still a major complication. If embolized device retrieval fails with percutaneous intervention attempts, surgical management is the only method to remove embolized devices. In this circumstance, to provide an uneventful perioperative course, urgent management strategies should be well planned.

The Journal of Heart Valve Disease, Mar 1, 2013

The study aim was to present the short- and mid-term results for patients who underwent aortic va... more The study aim was to present the short- and mid-term results for patients who underwent aortic valve replacement (AVR) with the Sorin Freedom Solo third-generation stentless prosthetic valve. AVR with a Sorin Freedom Solo valve was performed in 14 patients between March 2006 and March 2011. Patients aged 60 years (male:female ratio 6:8; mean age 73.28 +/- 5.42 years) who required AVR with the Sorin Freedom Solo valve according to the surgeon's choice were included in the study. The valvular prosthesis was implanted in the supra-annular position, using a single suture line. Eight patients underwent an isolated AVR; combined interventions were carried out in the other patients due to concomitant cardiac disease. One patient died during the immediate perioperative period, and two more during the follow up, from non-cardiac causes. The mean maximum transvalvular gradient of patients with aortic stenosis was 88.1 +/- 20.2 mmHg, and this fell to 26.4 +/- 7.6 mmHg during the early postoperative period. The mean gradient at one year of follow up was further decreased to 19.4 +/- 5.3 mmHg. The left ventricular end-diastolic and end-systolic diameters were also significantly reduced, from 4.8 +/- 0.9 to 4.3 +/- 0.6 cm and from 3.2 +/- 0.6 to 2.8 +/- 5.3 cm, respectively. The average left ventricular ejection fraction was 60.2 +/- 4.9% preoperatively, and 63.2 +/- 2.1% at one year after surgery (p = NS). No paravalvular leakage, endocarditis, prosthesis failure or neurologic events were reported among patients. The Sorin Freedom Solo stentless valve has provided good early and intermediate-term results. Implantation of the prosthesis is straightforward, with low rates of morbidity and mortality. However, these data require further support from larger patient series and long-term follow up.

Journal of Cardiac Surgery, 2011

A case of pulmonary valve endocarditis in a patient with a ductus arteriosus (PDA) is reported. T... more A case of pulmonary valve endocarditis in a patient with a ductus arteriosus (PDA) is reported. The PDA was ligated, the septal leaflet of the pulmonary valve was excised, and a pericardial monocusp reconstruction was performed.

The heart surgery forum, 2011

Cardiac leiomyosarcoma is a rare tumor with poor survival prospects. Surgery prolongs survival, b... more Cardiac leiomyosarcoma is a rare tumor with poor survival prospects. Surgery prolongs survival, but the tumor often recurs early after surgery. The diagnosis is often made by transthoracic echocardiography. Magnetic resonance imaging and computed tomography are required to characterize the location and extent of cardiac masses. In this report, we present a patient with a leiomyosarcoma that was resected completely. The tumor was located in the left atrium, mimicked a myxoma, and protruded into the left ventricle during diastole.

Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2008

Spontaneous dissection of the abdominal aorta should be considered as a vascular surgical emergen... more Spontaneous dissection of the abdominal aorta should be considered as a vascular surgical emergency. We report here our experience with this rare pathology. At our hospital, we operated on 200 patients for abdominal aortic aneurysm over a 4-year period, and aortic dissection was the underlying pathology in eight of them. Diagnosis was based on history, imaging study findings and visualization at surgery. The mean size of the aorta at the time of diagnosis was 5.5 +/- 0.4 cm. Aortic dissection was complicated by acute ischemia of lower limb and paraplegia in 1 patient and four patients were admitted to hospital with severe abdominal and back pain. Two patients with contained rupture were admitted with hemodynamic collapse and shock. One of the patients who presented with abdominal pain experienced also sudden onset paraplegia. The diagnosis of dissecting abdominal aortic aneurysm was established incidentally in the remaining 2 patients. All patients were treated using open techniques...

Journal of Cardiothoracic Surgery, 2012

Background: The aim of the present study is to compare negative pressure wound therapy versus con... more Background: The aim of the present study is to compare negative pressure wound therapy versus conventional treatment outcomes at postoperative mediastinitis after cardiac surgery. Methods: Between January 2000 and December 2011, after 9972 sternotomies, postoperative mediastinitis was diagnosed in 90 patients. The treatment modalities divided the patients into two groups: group 1 patients (n = 47) were initially treated with the negative pressure wound therapy and group 2 patients (n = 43) were underwent conventional treatment protocols. The outcomes were investigated with Kaplan-Meier method, log-rank test, Student's test and Fisher's exact test. Results: The 90-days mortality was found significantly lower in the negative pressure wound group than in the conventionally treated group. Overall survival was significantly better in the negative pressure wound group than in the conventionally treated group. Conclusion: Negative pressure wound therapy is safe and reliable option in mediastinitis after cardiac surgery, with excellent survival and low failure rate when compared with conventional treatments.

Journal of Cardiothoracic Surgery, 2012

Background: In this study, we sought to analyze our experience in urgent surgical management for ... more Background: In this study, we sought to analyze our experience in urgent surgical management for embolized cardiac septal and ductal occluder devices resulting from trans-catheter closure of atrial septal defect, ventricular septal defect and patent ductus arteriosus in childhood patient group. Methods: We retrospectively reviewed 9 patients (aged 2-15 years) who underwent urgent surgery due to cardiac septal and ductal occluder embolization between January 2007 and December 2010. Congenital defects were atrial septal defect (n = 6), ventricular septal defect (n = 1), and patent ductus arteriosus (n = 2). Risk factors for device embolization and urgent surgical management techniques for embolized device removal were discussed. Results: Removal of embolized devices in all cases and repair of damaged tricuspid valve in 2 patients were performed. Inevitably, all congenital defects were closed or ligated up to the primary defect. Total circulator arrest necessitated in 1 patient with ascending aortic device embolization. All operations were completed successfully and no hospital mortality or morbidity was encountered. Conclusions: Although closure of left to right shunting defects by percutaneous occluder devices has a lot of advantages, device embolization is still a major complication. If embolized device retrieval fails with percutaneous intervention attempts, surgical management is the only method to remove embolized devices. In this circumstance, to provide an uneventful perioperative course, urgent management strategies should be well planned.

Journal of Cardiac Surgery, 2011

A case of pulmonary valve endocarditis in a patient with a ductus arteriosus (PDA) is reported. T... more A case of pulmonary valve endocarditis in a patient with a ductus arteriosus (PDA) is reported. The PDA was ligated, the septal leaflet of the pulmonary valve was excised, and a pericardial monocusp reconstruction was performed.

Journal of Cardiothoracic Surgery, 2013

Background: The goal of repair of right ventricular outflow tract obstruction with or without Tet... more Background: The goal of repair of right ventricular outflow tract obstruction with or without Tetralogy of Fallot (TOF) is to eliminate valvular and/or subvalvular obstruction. However, this operation has a high risk of late complication of pulmonary insufficiency. In this study, we aimed to present early period results of our new technique that we call "V-Plasty" developed to prevent pulmonary insufficiency after pulmonary valve reconstruction in selected patients. Methods: Between January 2006 and January 2010, we performed V-plasty for pulmonary valve reconstruction in 10 patients. Eight patients (5 males, 3 females) had TOF and 2 patients (1 male, 1 female) had atrial septal defect concomitant with pulmonary valve stenosis. Patient selection for V-plasty reconstruction was made due to the pulmonary valve anatomy and degree of stenosis. The mean follow-up time was 55.7 ± 16.2 months (ranging from 32 to 80 months). Results: Functional capacity of the patients improved immediately after the surgery. There were no mortality and re-operation in follow-up period. Patients were followed up with echocardiography one week after the operation, at 1st, 6th, 12th months and annually. There was no pulmonary insufficiency. Conclusions: Operative correction of the pulmonary outflow tract obstruction with or without TOF, frequently requires transannular enlargement because of the infundibular and/or annular-valvular obstruction. This conventional technique is usually a reason for late pulmonary insufficiency. In our study, we have not seen pulmonary insufficiency in early term follow-up period. Our early term results are encouraging, but long term follow-up results are needed with large case series.