Unal Aydin - Academia.edu (original) (raw)

Papers by Unal Aydin

The anatolian journal of cardiology, 2023

To the Editor, The first question was, why we didn't mention the histological changes in the aort... more To the Editor, The first question was, why we didn't mention the histological changes in the aorta while we emphasized in the method's section that we aimed to examine the histological changes in the aorta, myocardium, and striated muscles. Actually, you are right about this. When we were conducting the study, we aimed to investigate the side effects of energy drinks (EDs) and alcohol on the aorta, but during the pathological examination, we abandoned the aortic examination. Because we observed abnormal morphology in the vascular endothelium in the heart, and we wrote this finding in the results section. Another pathological examination of the aorta would require extra effort and probably give similar results. Because we observed abnormal morphology in the vascular endothelium in the heart walls, and we wrote this finding in the results section. Another pathological examination of the abdominal aorta would require extra effort and probably give similar results. However, we should have removed it from the Methods section or expressed it in the article.

The Heart Surgery Forum

Background: Improving health related quality of life is an important goal of aortic valve replace... more Background: Improving health related quality of life is an important goal of aortic valve replacement. Inadequate effective orifice area of prosthesis according to the patient's body surface area may be associated with poor outcomes. In this study, we aimed to analyze impact of indexed effective orifice area (iEOA) on patients' quality of life after aortic valve replacement. Methods: A total of 138 patients who underwent isolated aortic valve replacement were included to the study. Quality of life assessment was performed with EuroQol Group EQ-5D-5L questionnaire. Patients were divided into three groups based on iEOA (Group 1 had an iEOA of <0.65 cm2/m2 (19 patients), Group 2 had an iEOA between 0.65–0.85 cm2/m2 (71 patients), and Group 3 had an iEOA of >0.85 cm2/m2). Mean EQ-5D-5L scores were compared among the groups statistically. Results: Mean EQ-5D-5L scores were lower in Group 1 than in Groups 2 and 3 (Group 1: 0.72 ± 0.18, Group 2: 0.83 ± 0.20, and Group 3: 0.86...

Turkish Journal of Vascular Surgery

Aim: Technological developments on endovascular stents have increased the percutaneous repair of ... more Aim: Technological developments on endovascular stents have increased the percutaneous repair of abdominal aortic aneurysm(AAAs). Open repair of abdominal aneurysm remains as the first option for treatment of aneurysm with compromising necks that need suprarenal aortic clamping(SAC). Open surgical repair with suprarenal aortic clamping may be associated with renal ischemia that may lead into renal injury. Our study focused on our clinical experience on the use of custodiol solution for renal protection during open repair of abdominal aortic aneurysm with suprarenal aortic clamping. Material and Methods: Our study consisted of 25 patients who underwent open repair for abdominal aortic aneurysm with suprarenal aortic clamping. During the repair, cold custodiol solution was used for renal protection in all patients. Outcomes included postoperative renal functions, mortality, hospital stay, need of postoperative dialysis and readmission due to renal injury. Results: 2 (8%) of our patien...

Turkish Journal of Vascular Surgery

Aim: The gold standard repair of thoracoabdominal aortic aneurysm (TAAA) is still open surgery. H... more Aim: The gold standard repair of thoracoabdominal aortic aneurysm (TAAA) is still open surgery. However, few cardiovascular centers are experienced in TAAA repair. The aim of this study was to examine the methods and four-year outcomes of the open TAAA repair program initiated by a single surgical team. Material and Methods: In this retrospective cohort, patients who were operated for TAAA between August 2018 and March 2022 were collected. Patients treated with the endovascular approach were excluded. After exclusion, 19 patients were included in our analysis. As postoperative outcomes, in-hospital mortality, spinal cord deficit, major neurologic complications, need for dialysis, and visceral ischemia were collected. Results: Crawford extent II TAAA repair was performed in 10 (52.6%) patients, Crawford extent III in 5 (26.3%) patients, and Crawford extent IV in 4 (21.1%) patients. In hospital mortality occurred in 6 (31.6%) patients. The causes of mortality were perioperative myocar...

Brazilian Journal of Cardiovascular Surgery

Introduction: Custodiol (histidine-tryptophan-ketoglutarate) and repetitive blood cardioplegia ar... more Introduction: Custodiol (histidine-tryptophan-ketoglutarate) and repetitive blood cardioplegia are the solutions for myocardial protection and cardiac arrest. In this study, we aimed to compare immunohistochemical analysis, clinical outcomes, and cardiac enzyme values of Custodiol and blood cardioplegia groups. Methods: This was a randomized prospective study consisting of 2 groups and 20 patients, 10 patients for each group, who underwent mitral and mitral/tricuspid valve surgery. Group 1 was formed for Custodiol cardioplegia and group 2 for blood cardioplegia. Perioperative and postoperative cardiac events were recorded, cardiac enzymes were analyzed with intervals, and myocardial samples were taken for immunohistochemical analysis. Recorded data were statistically evaluated. Results: There was no significant difference for the Custodiol and blood cardioplegia groups in perioperative and postoperative cardiac performance and adverse events. Cardiac enzyme analysis showed no significant difference between groups. However, two parameters (eNOS, Bcl-2) were in favor of the Custodiol group in immunohistochemical studies. Custodiol performed better in cellular oxidative stress resistance and cellular viability. Conclusion: Clinical outcomes and cardiac enzyme analysis results were similar regarding myocardial protection. However, Custodiol performed better in the immunohistochemical analysis.

Cureus, 2021

Background It is well known that approximately 20% of patients who undergo cardiac surgery experi... more Background It is well known that approximately 20% of patients who undergo cardiac surgery experience weight loss in postoperative period. However, there is a lack of data on postoperative consequences of malnutrition. This study aimed to investigate the relationship between nutritional status and long-term outcomes in patients undergoing isolated coronary artery bypass grafting (CABG). Material and methods A total of 586 patients who underwent isolated CABG in our center between January 2015 and March 2016 were included in this study. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of all-cause death, non-fatal myocardial infarction (MI), and stroke. Patients were divided into two groups based on their MACCE outcomes. Prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), and controlling nutritional status (CONUT) scores were used to show the nutritional status. Results The mean follow-up time of the whole study group was 38.08 ± 13.4 months. The follow-up time was 39 ± 13 months in patients with mortality, while it was 20 ± 15 months in those without mortality. The PNI and GNRI values were lower in patients with major adverse cardiac and cerebrovascular events (MACCE) compared to patients without MACCE. The median CONUT score was higher in patients with MACCE. Conclusion Our study showed that nutritional indices including PNI, CONUT, and GNRI were associated with long-term MACCE and mortality in patients who underwent isolated CABG. The use of these scores in order to predict prognosis in patients treated with CABG seems to be an applicable method in clinical practice.

Turkish Journal of Vascular Surgery, 2021

The COVID-19 pandemic has presented a great challenge for the healthcare systems and healthcare w... more The COVID-19 pandemic has presented a great challenge for the healthcare systems and healthcare workers worldwide. The resources and the infrastructure of the healthcare systems are reorganized to provide care for abundant number of pandemic patients. All elective procedures and treatments have either cancelled or postponed. Treatment of lower extremity ulcers may be misclassified as non-essential during this pandemic; however, without regular best wound care, these ulcers are at a great risk of becoming quickly infected, which may lead to an increased rate of septicemia, amputations, and even deaths in this fragile patient population. In this review, we discuss the treatment strategies for lower leg ulcers and vascular pathologies during pandemic and provide an algorithm for triage which may be a useful guide for vascular surgeons.

Kosuyolu Heart Journal, 2020

Introduction: The mean platelet volume (MPV) is one of several indicators of platelet activity. R... more Introduction: The mean platelet volume (MPV) is one of several indicators of platelet activity. Recent studies have shown that MPV is increased in myocardial infarction, unstable angina, and stroke. Peripheral artery disease (PAD) manifests with the narrowing or obstruction of the abdominal aorta and arteries distal to the aortic bifurcation due to progressive atherosclerosis. The objective of this study is to investigate the MPV and platelet count in patients with PAD. Patients and Methods: This study included 67 patients aged 40-80 years who underwent elective surgery for PAD in our hospital between January 2018 and June 2019, along with a control group comprising 67 patients without PAD. The MPV and platelet count values were obtained from a preoperatively performed hemogram analysis. Importantly, the groups were statistically compared in our study. Results: As compared to the control group, the patients with PAD had a significantly higher mean age (p= 0.02), prevalence of diabetes mellitus (p< 0.01), as well as frequency of antiaggregant use (p< 0.01) and smoking (p< 0.01). There were no statistically significant differences in the other clinical features between the groups (p> 0.05). The mean platelet count and MPV were also significantly higher in patients with PAD as compared to patients without PAD (p< 0.01). Conclusion: The use of inexpensive and widely used tests such as platelet count and MPV can facilitate an early diagnosis of the diseases with high morbidity and mortality, such as PAD.

Journal of Cardiac Surgery, 2020

This study assessed the feasibility and outcomes of performing robotic cardiac surgery without lu... more This study assessed the feasibility and outcomes of performing robotic cardiac surgery without lung isolation using single‐lumen (SL) endotracheal tube intubation.

The Heart Surgery Forum, 2010

The aim of this study was to compare De Vega semicircular annuloplasty and a new biodegradable ri... more The aim of this study was to compare De Vega semicircular annuloplasty and a new biodegradable ring annuloplasty technique in patients requiring surgical intervention for tricuspid valve disease with concomitant disease of the mitral valve. Methods: Between January 2004 and May 2008, 129 consecutive patients underwent annuloplasty procedures to correct tricuspid valve regurgitation during a concomitant mitral valve operation requiring replacement. Additionally, 24 patients underwent aortic valve replacement (AVR), 11 underwent coronary artery bypass grafting (CABG), 5 underwent AVR plus CABG, 3 underwent mitral valve replacement plus atrial septal defect (ASD) closure, and 2 underwent ASD closure. The patients in this study were assigned to 2 groups: Kalangos ring annuloplasty was performed in 67 patients (group 1), and De Vega semicircular annuloplasty was performed in the remaining 62 patients (group 2). Results: Both tricuspid valve repair techniques produced a low rate of complications; however, the number of patients who developed residual tricuspid regurgitation was significantly lower in group 1. Conclusion: The biodegradable ring annuloplasty technique may be used easily and safely in moderate and severe cases of tricuspid regurgitation; however, larger clinical series are necessary to confi rm our promising results.

pjms.com.pk

Objective: Atrial fibrillation (AF) is the most common arhythmia type among other arythmias. In t... more Objective: Atrial fibrillation (AF) is the most common arhythmia type among other arythmias. In this study, we aimed to search the effect of left atrium diameter in AF treatment with radiofrequency ablation procedure. Methodology: Preoperative left atrium diameter and postoperative sinus rhythm restoration was prospectively studied in 84 patients who had undergone valve surgery and radiofrequency (RF) ablation procedure in Department of Cardiovascular Surgery from January 2004 to March 2009. The patients were classified in two groups. Group-I consisted of the patients with left atrial diameter less than 5 cm, and Group II consisted of the ones whose left atrial size was more than 5cm. Normal sinus rhytm restoration was followed by electrocardiography (ECG). ECG monitoring was done in early postoperative period, 12 th , 24 th and 36 th monthes following the operation. Results: In early post-operative period normal sinus rhythm (NSR) was recorded in 34 patients (Group I: 20, Group II: 14) in which unipolar RFA was performed. Supraventricular tachycardia (SVT) was observed in 20 patients (Group I: 10, Group II: 10) and NSR was restored with medical treatment in these patients. AF was permanent in 26 patients (Group I: 8, Group II: 18) and nodal rhythm was observed in 4 patients (Group I: 2, Group II: 2). The ECG monitoring was done in the patients in early postoperative period at 12 th , 24 th and 36 th monthes. Datas were evaluated with statistical studies, too. Conclusion: Radiofrequency (RF) ablation is a feasible, efficient and safe method for the treatment for Atrial fibrillation (AF). In our study we found that left atrial diameter is an important factor in restoring sinus rhythm. However, AF treatment with extended left atrium is more difficult.

Türk göğüs kalp damar cerrahisi dergisi :/Türk göğüs kalp damar cerrahisi dergisi, 2024

Acute kidney injury after surgical treatment of failed endovascular aneurysm repair Başarısız end... more Acute kidney injury after surgical treatment of failed endovascular aneurysm repair Başarısız endovasküler anevrizma onarımının cerrahi tedavisi sonrası akut böbrek hasarı Institution where the research was done:

Journal of Vascular Surgery, 2008

The issues surrounding the role of endovascular aneurysm repair (EVAR) in the management of ruptu... more The issues surrounding the role of endovascular aneurysm repair (EVAR) in the management of ruptured abdominal aortic aneurysms (AAAs) are complex. This meta-analysis set out to examine the current published data. Statistical analysis of the overall hospital length of stay was not affected by heterogeneity or bias and showed an 8.6-day reduction in those patients treated with EVAR relative to open surgery. We suspect that most surgeons, patients, and hospital managers would be very pleased with this outcome. Although we accept that there may be some potential publication bias that resulted in us finding a 37.6% reduction in mortality and a 4-day reduction in the intensive treatment unit with EVAR, these findings would be supported by the overall improvement in length of stay. It is very difficult to see how these data could be interpreted in such a negative way for the authors of the letter to state "EVAR may be an option for symptomatic intact, but not for ruptured AAAs." Many people have called for more randomized controlled trials in this area, and some have even tried to run them. We believe that trying to find out whether open repair or EVAR is better for ruptured AAAs is asking the wrong question. A trial such as this would exclude two important groups-those not stable enough for EVAR and those who are not potentially fit enough to survive an open repair. Those in the latter group are not EVAR II type patients because they have ruptured AAAs and their immediate life expectancy is very different. The question that should be asked about EVAR is "What happens to the overall mortality of all patients admitted to our institution with ruptured AAAs if we include EVAR in our armamentarium?" Centers committed to offering the best treatment for patients with ruptured AAAs should provide a service that can offer EVAR on a 24-hour basis.

Acta Chirurgica Belgica, 2007

The purpose of this study is to compare the use of epidural and general anaesthesia techniques in... more The purpose of this study is to compare the use of epidural and general anaesthesia techniques in the treatment of abdominal aortic aneurysms (AAA) through mini-laparotomy in patients with severe chronic obstructive pulmonary disease (COPD). Between March 2002 and October 2005, 23 patients with severe COPD underwent elective infrarenal abdominal aortic aneurysm repair. Endovascular therapy could not be established due to financial reasons and health insurance policies. All the operations were performed through mini-laparotomy, using epidural anaesthesia on 10 patients (Group I) and general anaesthesia on the remaining patients (Group II). Pulmonary disease was diagnosed by clinical history and pulmonary function tests. The diagnosis of severe COPD was made with the presence of one or more of the following criteria : Room air PaO2 < or = 60 mmHg, PaCO2 > or = mmHg in arterial blood gas samples, FEV1 < or = 50% of predicted value and FVC < or = 75% of predicted value in respiratory function tests. There was no significant difference between the ages, sex, pre-operative morbidity status, operation time and total blood loss of the patients in the two groups. Postoperative intensive care unit requirement, postoperative pulmonary complications and hospital stay were significantly higher in group II. All patients tolerated surgery safely. There was one in-hospital mortality from group II on the 35th postoperative day due to prolonged entubation and sepsis related to pulmonary infections. There was no late morbidity or mortality related to the technique in the postoperative follow-up period of the discharged patients. Epidural anaesthesia for abdominal aortic aneurysm repair through mini-laparotomy is feasible and should be especially considered in patients with severe COPD where endovascular treatment could not be performed.

Journal of robotic surgery, Jan 23, 2018

Left-sided partial anomalous pulmonary venous connection to the coronary sinus is a rare congenit... more Left-sided partial anomalous pulmonary venous connection to the coronary sinus is a rare congenital cardiac defect. Surgical repair is indicated to prevent cardiopulmonary morbidities that may occur in later age. Although the conventional median sternotomy or thoracotomy incisions are used during surgical repair, robotic surgery can be a feasible alternative approach to this pathology. In this case, we report a 14-year-old child, who was diagnosed with left partial anomalous pulmonary venous connection to the coronary sinus. A total endoscopic robotic repair was successfully done via right atriotomy approach. After routing of the pulmonary venous return from the left lung to the left atrium, the interatrial septum was reconstructed with a pericardial patch. We report a successful use of totally endoscopic robotic approach in a patient diagnosed with left-sided partial anomalous pulmonary venous connection.

Artificial organs, Jan 12, 2018

Robotic surgery for intracardiac pathologies in children is relatively uncommon. This study prese... more Robotic surgery for intracardiac pathologies in children is relatively uncommon. This study presents our initial experience with robotic-assisted cardiac surgery in children. We also present the feasibility and safety of robotic surgery in children. From May 2013 to June 2018, 30 children underwent totally endoscopic robotic atrial septal defect closure (n = 22), right-sided (n = 5) or left-sided (n = 1) partial anomalous pulmonary venous connection repair, tricuspid valve annuloplasty (n = 4), and mitral valve replacement (n = 2, due to Barlow and rheumatic diseases). The mean age of the patients was 16.1 ± 1.1 years (range, 13-17) and the mean weight was 56.7 ± 0.1 kg (range, 42-77). Associated anomalies included left persistent superior vena cava (n = 2) and the absence of innominate vein (n = 1). All procedures were completed uneventfully. Operation time was 4.1 ± 0.6 h. No patient was converted to thoracotomy or sternotomy. Cardiopulmonary bypass and aortic clamping times were ...

Brazilian Journal of Cardiovascular Surgery

The heart surgery forum, Dec 7, 2016

Optimal surgical approach for patients with hemodynamically significant carotid and coronary dise... more Optimal surgical approach for patients with hemodynamically significant carotid and coronary disease remains controversial. We analyzed our 5-year experience and compared early and long-term outcome following staged and combined carotid and coronary artery bypass. 312 consecutive patients undergoing carotid endarterectomy and coronary artery bypass between 2008 and 2013 were prospectively enrolled in the study. Patients were scheduled for a staged (carotid endarterectomy followed by coronary artery bypass within 1 week) procedure (Group S) unless they were unstable in terms of cardiac status (were deemed to a combined procedure; Group C). All patient data including demographics, risk factors, immediate perioperative events, 30-day, and long-term outcome were prospectively recorded and then analyzed. Groups S and C were compared for pre- and perioperative data as well as immediate, 30-day, and long-term survival. A P value less than .05 was considered significant. Survival analysis w...

Artificial Organs, 2016

The objective is to demonstrate safety and early clinical results of surgical transapical closure... more The objective is to demonstrate safety and early clinical results of surgical transapical closure of paravalvular leaks (PVLs) following mitral valve replacement in significant regurgitation. Between March 2014 and February 2015, 12 patients (mean age 52.1 ± 6.0 years, 66.6% male) with severe symptomatic mitral PVLs (n = 13) underwent surgical transapical closure procedure through left mini-thoracotomy. All patients were in NYHA functional class III-IV and median logistic EuroSCORE was 24.2 ± 6.4% (range, 13.5-34.6%). Indications were heart failure (n = 10) and symptomatic hemolysis (n = 2) due to severe mitral regurgitation (MR). Amplatzer Vascular Plug-III devices (n = 9) were used for smaller and regular defects; whereas Atrial Septal Defect closure devices (n = 4) were used for larger defects. Technical success was achieved in 10 (83.3%) patients. One (8.5%) patient with 2 + MR was treated medically. A patient with residual 4 + MR underwent re-operation. There was no procedure-related complication including mortality, device migration, embolization, or cardiac laceration. Mean procedure and fluoroscopy times were 166.4 ± 39.5 (range, 90-210) and 25.7 ± 17.3 (range, 16-64) minutes, respectively. The mean intensive care and hospital stays were 2.1 ± 1.3 and 10.3 ± 6.5 days, respectively. Clinical efficacy was achieved in 9 (75%) of 12 patients at early follow-up of 8.5 ± 2.1 months. NYHA status was class II in two patients, and no hemolytic anemia was diagnosed. Echocardiographic studies revealed a significant reduction of preoperative MR (3-4+) to less than 1+ MR after operations (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Surgical transapical approach to PVL closure is a safe and effective procedure following mitral valve replacement. Early results show that this procedure can be an alternative to re-operation for high-risk patients. Further studies are needed to prove its effectiveness in the long term.

Journal of Cardiac Surgery, 2016

Partial anomalous venous return from the right lung to the right atrium is a rare congenital hear... more Partial anomalous venous return from the right lung to the right atrium is a rare congenital heart anomaly in adults. We report a 20-year-old female, who presented with right partial anomalous pulmonary venous return and an associated inferior atrial septal defect. A complex repair was successfully done through a right atriotomy approach using a robotic surgical system. doi: 10.1111/jocs.12753 (J Card Surg 2016;31:394-397).

The anatolian journal of cardiology, 2023

The Heart Surgery Forum

Turkish Journal of Vascular Surgery

Brazilian Journal of Cardiovascular Surgery

Cureus, 2021

Turkish Journal of Vascular Surgery, 2021

Kosuyolu Heart Journal, 2020

Journal of Cardiac Surgery, 2020

The Heart Surgery Forum, 2010

pjms.com.pk

Türk göğüs kalp damar cerrahisi dergisi :/Türk göğüs kalp damar cerrahisi dergisi, 2024

Journal of Vascular Surgery, 2008

Acta Chirurgica Belgica, 2007

Journal of robotic surgery, Jan 23, 2018

Artificial organs, Jan 12, 2018

Brazilian Journal of Cardiovascular Surgery

The heart surgery forum, Dec 7, 2016

Artificial Organs, 2016

Journal of Cardiac Surgery, 2016