Murat Yanar - Academia.edu (original) (raw)
Papers by Murat Yanar
Kardiyopulmoner bypass sistemik inflamatuar cevabı indüklemektedir. Bypass sonrası görülen inflam... more Kardiyopulmoner bypass sistemik inflamatuar cevabı indüklemektedir. Bypass sonrası görülen inflamatuar yanıt, içinde interlökin-6'nında bulunduğu proinflamatuar sitokinlerin salınımı ile karakterizedir. Kardiyopulmoner bypass öncesi steroid kullanımı inflamatuar cevabı baskılayabilir ve postoperatif toparlanmayı iyileştirebilir. Bu prospektif ardışık randomize yapılan çalışmada amaç konjenital kalp cerrahisinde deksametazon kullanımının kardiyopulmoner bypass sonrası görülen sistemik inflamatuar yanıta etkisini göstermektir.Normotermik kardiopulmoner bypass altında elektif konjenital kalp cerrahisi yapılacak 30 hasta ardışık randomize olarak çalışmaya alındı. Steroid alan grupta (grup 2) kardiyopulmoner bypass devresinin başlangıç solüsyonuna deksametazone (1 mg/kg) eklendi. Diğer grupta steroid kullanılmadı (grup 1). Kan örnekleri anestezi indüksiyonundan önce, postoperatif 1. saat ve 24. saat arteryel yoldan alındı. Laboratuvar parametreleri tam kan sayımı, üre, kreatinin, int...
Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2011
Uludağ Üniversitesi, 2010
The Effect of Steroid Use to Systemic Inflammatory Response Seen After Cardiopulmonary Bypass in ... more The Effect of Steroid Use to Systemic Inflammatory Response Seen After Cardiopulmonary Bypass in Pediatric Cardiac Surgery Cardiopulmonary bypass induces a systemic inflammatory response. Postbypass inflammatory responce characterized by release of proimflammatory cytokines, including interleukin-6. Pre-bypass steroid administration may modulate the inflammatory responce, resulting in improved postoperatif recovery. The purpose of this prospective consucutive randomized study is to demonstrate the effect of dexamethazone on congenital cardiac surgery postcardiopulmonary bypass systemic inflammatory responce. Routinely operated 30 patients will be selected consucutive randomly for congenital cardiac surgery under normothermic cardiopulmonary bypass. Group 1 which received steroid, dexamethasone (1 mg/kg) added to prime solution of the cardiopulmonary circuit. The other group (group 1) steroid not used. Blood samples taken before anesthesia induction, postoperative first hour and 24 hours later from arterial line. Laboratory parameters includes whole blood account, blood urine nitrogene, creatinin, interleukin-6, Creactive protein, serum amiloid A, procalcitonin. Clinical outcome parameters includes cardiopulmonary bypass and cross clamp time, inotrop therapy, respiratory stay time, intensive care and hospital stay time. Between groups preoperatif clinical parameters, cardiopulmonary bypass and cross clamp time was smiliar. Either in group 1 postoperative first and 24 th hour interleukin-6 plazma level and inotrop use significantly higher than group 2 or acute phase reactants was higher in nonsteroid group than steroid group. However there is no statistical differences between two groups due to small number of population. Although postoperative clinical outcomes was smiliar in patients treated with or without steroids. v This study shows that administration dexamethasone into the priming solution of the cardiopulmonary bypass circuit in children leads to a reduction in the postbypass inflammatory responce.
In patients with concomitant carotid and coronary artery disease, no consensus has been establish... more In patients with concomitant carotid and coronary artery disease, no consensus has been established in terms of the surgical approach. Though succesful results have been reported for combined surgery, studies that showed an increase in mortality and morbidity have also been reported. In this study, we aimed to compare the results of cases with concomitant carotis endarterectomy and coronary artery bypass with cases who had staged carotis endarterectomy with coronary bypass surgery in beating heart. In our clinic, a total of 45 cases (15 woman, 30 male) that had combined carotis endarterectomy with coronary artery bypass and staged carotis endarterectomy with coronary bypass surgery in beating heart between 2000-2006 were retrospectively evaluated. The cases were examined in two groups: group 1 had combined carotis endarderectomy and coronary artery bypass and group 2 had staged carotid endarderectomy and coronary bypass surgery in beating heart. There were no significant differences...
arastirmax.com
... Murat BİÇER, Davit SABA, Murat YANAR, Işık ŞENKAYA SIĞNAK, Mustafa TOK, Tolunay SEVİNGİL, Atı... more ... Murat BİÇER, Davit SABA, Murat YANAR, Işık ŞENKAYA SIĞNAK, Mustafa TOK, Tolunay SEVİNGİL, Atıf YOLGÖSTEREN, Tolga ÖNDER, Mete ... KEA için endikasyonlar; 14 hastada asemptomatik ipsilateral stenoz, 51 hastada geçici iskemik atak, 33 hastada oküler bulgular ( ...
The Journal of Thoracic and Cardiovascular Surgery, Sep 1, 2005
Objective: Off-pump coronary artery bypass grafting may result in fewer myocardial and vascular c... more Objective: Off-pump coronary artery bypass grafting may result in fewer myocardial and vascular complications than on-pump. Although differences in aortic manipulations likely play a role, the systemic responses of endothelial progenitor cells to both types of operations have not been examined. We sought to examine endothelial progenitor cell characteristics after off-pump versus on-pump coronary artery bypass grafting. Methods: Twenty patients undergoing off-pump or on-pump coronary artery bypass grafting were prospectively enrolled and had endothelial progenitor cells isolated and cultured from their peripheral blood before and 24 hours after surgery. Endothelial progenitor cells were identified by fluorescent dual lectin/low-density lipoprotein binding. Their number, phenotype characteristics, proliferation, migratory function, and viability were determined in a blinded fashion. Results: Patient characteristics and numbers of grafts were equivalent. Endothelial progenitor cells had similar phenotypes between groups before and after surgery. Off-pump and on-pump coronary artery bypass grafting resulted in similar increases in endothelial progenitor cell numbers and showed equivalent proliferation activity. However, endothelial progenitor cell migratory function was higher in off-pump patients (25.3 +/- 5.0 vs 5.0 +/- 1.0 cells per high-powered field for off-pump vs on-pump coronary artery bypass grafting, respectively; P = .04). Postoperative endothelial progenitor cell viability adjusted for preoperative baseline was also higher after off-pump than on-pump coronary artery bypass grafting by 72.4% +/- 14.6% (P = .01). Endothelial progenitor cells of on-pump patients were less viable after surgery than before surgery, whereas the reverse was observed in off-pump patients. Conclusions: Both on-pump and off-pump coronary artery bypass grafting elicit mobilization of endothelial progenitor cells into the peripheral blood. On-pump coronary artery bypass grafting, however, impairs the migratory function and viability of these vascular repair cells, which are conversely preserved after off-pump surgery. Further work is necessary to determine whether the function and viability of endothelial progenitor cells correlate with vascular outcomes and whether their therapeutic modulation may one day benefit coronary artery bypass grafting patients.
Cases journal, 2009
Venous thromboembolus is an important cause of hospital acquired morbidity and mortality. Venous ... more Venous thromboembolus is an important cause of hospital acquired morbidity and mortality. Venous thrombosis is a very rare occurrence in patients with haemophilia A. The thrombosis originated from the right main and external iliac veins, and effects the cranial segments of the main, deep and superficial femoral veins as an acute phase thrombus. Neither any local anatomic compression nor any predisposing thrombophilic risk factors were identified. We treated the patient with enoxaparine 1 mg/kg twice a day subcutaneously and then started oral anticoagulation with warfarin.
Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2008
Congenital coronary-to-pulmonary artery fistulas are rare anomalies and they generally have an as... more Congenital coronary-to-pulmonary artery fistulas are rare anomalies and they generally have an asymptomatic course. We presented three symptomatic patients (2 men, 1 woman; age range 46 to 53 years) who underwent surgical repair via the epicardial approach for coronary-to-pulmonary artery fistulas. Treatment was successful in two patients. Reoperation in extracorporeal circulation was required in one patient having a plexus-like fistula. The distal orifice of the fistula was closed under direct vision from within the pulmonary artery. No complications or symptoms were seen during the follow-up of patients ranging from six months to four years. During repair of coronary-to-pulmonary artery fistulas, the presence of a plexus-like variant must be kept in mind and the treatment should be planned accordingly.
Kardiyopulmoner bypass sistemik inflamatuar cevabı indüklemektedir. Bypass sonrası görülen inflam... more Kardiyopulmoner bypass sistemik inflamatuar cevabı indüklemektedir. Bypass sonrası görülen inflamatuar yanıt, içinde interlökin-6'nında bulunduğu proinflamatuar sitokinlerin salınımı ile karakterizedir. Kardiyopulmoner bypass öncesi steroid kullanımı inflamatuar cevabı baskılayabilir ve postoperatif toparlanmayı iyileştirebilir. Bu prospektif ardışık randomize yapılan çalışmada amaç konjenital kalp cerrahisinde deksametazon kullanımının kardiyopulmoner bypass sonrası görülen sistemik inflamatuar yanıta etkisini göstermektir.Normotermik kardiopulmoner bypass altında elektif konjenital kalp cerrahisi yapılacak 30 hasta ardışık randomize olarak çalışmaya alındı. Steroid alan grupta (grup 2) kardiyopulmoner bypass devresinin başlangıç solüsyonuna deksametazone (1 mg/kg) eklendi. Diğer grupta steroid kullanılmadı (grup 1). Kan örnekleri anestezi indüksiyonundan önce, postoperatif 1. saat ve 24. saat arteryel yoldan alındı. Laboratuvar parametreleri tam kan sayımı, üre, kreatinin, int...
Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2011
Uludağ Üniversitesi, 2010
The Effect of Steroid Use to Systemic Inflammatory Response Seen After Cardiopulmonary Bypass in ... more The Effect of Steroid Use to Systemic Inflammatory Response Seen After Cardiopulmonary Bypass in Pediatric Cardiac Surgery Cardiopulmonary bypass induces a systemic inflammatory response. Postbypass inflammatory responce characterized by release of proimflammatory cytokines, including interleukin-6. Pre-bypass steroid administration may modulate the inflammatory responce, resulting in improved postoperatif recovery. The purpose of this prospective consucutive randomized study is to demonstrate the effect of dexamethazone on congenital cardiac surgery postcardiopulmonary bypass systemic inflammatory responce. Routinely operated 30 patients will be selected consucutive randomly for congenital cardiac surgery under normothermic cardiopulmonary bypass. Group 1 which received steroid, dexamethasone (1 mg/kg) added to prime solution of the cardiopulmonary circuit. The other group (group 1) steroid not used. Blood samples taken before anesthesia induction, postoperative first hour and 24 hours later from arterial line. Laboratory parameters includes whole blood account, blood urine nitrogene, creatinin, interleukin-6, Creactive protein, serum amiloid A, procalcitonin. Clinical outcome parameters includes cardiopulmonary bypass and cross clamp time, inotrop therapy, respiratory stay time, intensive care and hospital stay time. Between groups preoperatif clinical parameters, cardiopulmonary bypass and cross clamp time was smiliar. Either in group 1 postoperative first and 24 th hour interleukin-6 plazma level and inotrop use significantly higher than group 2 or acute phase reactants was higher in nonsteroid group than steroid group. However there is no statistical differences between two groups due to small number of population. Although postoperative clinical outcomes was smiliar in patients treated with or without steroids. v This study shows that administration dexamethasone into the priming solution of the cardiopulmonary bypass circuit in children leads to a reduction in the postbypass inflammatory responce.
In patients with concomitant carotid and coronary artery disease, no consensus has been establish... more In patients with concomitant carotid and coronary artery disease, no consensus has been established in terms of the surgical approach. Though succesful results have been reported for combined surgery, studies that showed an increase in mortality and morbidity have also been reported. In this study, we aimed to compare the results of cases with concomitant carotis endarterectomy and coronary artery bypass with cases who had staged carotis endarterectomy with coronary bypass surgery in beating heart. In our clinic, a total of 45 cases (15 woman, 30 male) that had combined carotis endarterectomy with coronary artery bypass and staged carotis endarterectomy with coronary bypass surgery in beating heart between 2000-2006 were retrospectively evaluated. The cases were examined in two groups: group 1 had combined carotis endarderectomy and coronary artery bypass and group 2 had staged carotid endarderectomy and coronary bypass surgery in beating heart. There were no significant differences...
arastirmax.com
... Murat BİÇER, Davit SABA, Murat YANAR, Işık ŞENKAYA SIĞNAK, Mustafa TOK, Tolunay SEVİNGİL, Atı... more ... Murat BİÇER, Davit SABA, Murat YANAR, Işık ŞENKAYA SIĞNAK, Mustafa TOK, Tolunay SEVİNGİL, Atıf YOLGÖSTEREN, Tolga ÖNDER, Mete ... KEA için endikasyonlar; 14 hastada asemptomatik ipsilateral stenoz, 51 hastada geçici iskemik atak, 33 hastada oküler bulgular ( ...
The Journal of Thoracic and Cardiovascular Surgery, Sep 1, 2005
Objective: Off-pump coronary artery bypass grafting may result in fewer myocardial and vascular c... more Objective: Off-pump coronary artery bypass grafting may result in fewer myocardial and vascular complications than on-pump. Although differences in aortic manipulations likely play a role, the systemic responses of endothelial progenitor cells to both types of operations have not been examined. We sought to examine endothelial progenitor cell characteristics after off-pump versus on-pump coronary artery bypass grafting. Methods: Twenty patients undergoing off-pump or on-pump coronary artery bypass grafting were prospectively enrolled and had endothelial progenitor cells isolated and cultured from their peripheral blood before and 24 hours after surgery. Endothelial progenitor cells were identified by fluorescent dual lectin/low-density lipoprotein binding. Their number, phenotype characteristics, proliferation, migratory function, and viability were determined in a blinded fashion. Results: Patient characteristics and numbers of grafts were equivalent. Endothelial progenitor cells had similar phenotypes between groups before and after surgery. Off-pump and on-pump coronary artery bypass grafting resulted in similar increases in endothelial progenitor cell numbers and showed equivalent proliferation activity. However, endothelial progenitor cell migratory function was higher in off-pump patients (25.3 +/- 5.0 vs 5.0 +/- 1.0 cells per high-powered field for off-pump vs on-pump coronary artery bypass grafting, respectively; P = .04). Postoperative endothelial progenitor cell viability adjusted for preoperative baseline was also higher after off-pump than on-pump coronary artery bypass grafting by 72.4% +/- 14.6% (P = .01). Endothelial progenitor cells of on-pump patients were less viable after surgery than before surgery, whereas the reverse was observed in off-pump patients. Conclusions: Both on-pump and off-pump coronary artery bypass grafting elicit mobilization of endothelial progenitor cells into the peripheral blood. On-pump coronary artery bypass grafting, however, impairs the migratory function and viability of these vascular repair cells, which are conversely preserved after off-pump surgery. Further work is necessary to determine whether the function and viability of endothelial progenitor cells correlate with vascular outcomes and whether their therapeutic modulation may one day benefit coronary artery bypass grafting patients.
Cases journal, 2009
Venous thromboembolus is an important cause of hospital acquired morbidity and mortality. Venous ... more Venous thromboembolus is an important cause of hospital acquired morbidity and mortality. Venous thrombosis is a very rare occurrence in patients with haemophilia A. The thrombosis originated from the right main and external iliac veins, and effects the cranial segments of the main, deep and superficial femoral veins as an acute phase thrombus. Neither any local anatomic compression nor any predisposing thrombophilic risk factors were identified. We treated the patient with enoxaparine 1 mg/kg twice a day subcutaneously and then started oral anticoagulation with warfarin.
Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2008
Congenital coronary-to-pulmonary artery fistulas are rare anomalies and they generally have an as... more Congenital coronary-to-pulmonary artery fistulas are rare anomalies and they generally have an asymptomatic course. We presented three symptomatic patients (2 men, 1 woman; age range 46 to 53 years) who underwent surgical repair via the epicardial approach for coronary-to-pulmonary artery fistulas. Treatment was successful in two patients. Reoperation in extracorporeal circulation was required in one patient having a plexus-like fistula. The distal orifice of the fistula was closed under direct vision from within the pulmonary artery. No complications or symptoms were seen during the follow-up of patients ranging from six months to four years. During repair of coronary-to-pulmonary artery fistulas, the presence of a plexus-like variant must be kept in mind and the treatment should be planned accordingly.