erdem cetin - Academia.edu (original) (raw)
Papers by erdem cetin
Kosuyolu Kalp Dergisi, 2014
Bu çalışmanın amacı, yeni faaliyete geçen Diyarbakır Eğitim ve Araştırma Hastanesi Kalp ve Damar ... more Bu çalışmanın amacı, yeni faaliyete geçen Diyarbakır Eğitim ve Araştırma Hastanesi Kalp ve Damar Cerrahisi Kliniği'nde yapılan ilk 195 kalp ameliyatının sonuçlarını değerlendirmektir. Hastalar ve Yöntem: Haziran 2009-Haziran 2011 tarihleri arasında 195 ardışık olgu retrospektif olarak değerlendirildi. Toplam 144 vakada koroner arter bypass cerrahisi uygulanmış olup bunlardan 43 tanesi atan kalpte gerçekleştirilmiş, dört hastada eş zamanlı karotid endarterektomi yapılmıştır. Otuz yedi hastada kapak replasmanı, sekiz hastada kapak replasmanı ve eş zamanlı koroner arter baypass greftleme, dört hastada kardiyak yaralanmaya müdahale, bir hastada koroner arter baypass greftleme ve sol ventrikül anevrizma onarımı, bir hastada da sol ventrikül duvarından kist hidatik rezeksiyonu uygulanmıştır. Bulgular: Hastaların yaş ortalaması 59,3±14,1 (20-84 y) idi. Hastaların 128 tanesi erkek, 67 tanesi ise kadın idi. Hipertansiyon (%59) en sık eşlik eden hastalık olup bunu sigara (%55,4), hiperlipidemi (%54,4), kronik obstrüktif akciğer hastalığı (%33,8) ve diabetes mellitus (%30,8) takip ediyordu. Yoğun bakım ünitesinde kalma süresi ortalama 20,7±15,0 saat, ortalama hastanede kalma süresi ise 6,3±4,1 gün olarak saptandı. Hastane mortalitesi toplam 12 hastada görülmüştür (%6,15). Erken dönemde (ilk 30 gün içinde) postoperatif kanama nedeniyle beş hastada revizyon gerçekleştirilmiş olup revizyon oranı %2,56'dır. Sonuç: Kliniğimiz, Güneydoğu Anadolu Bölgesi'nin hasta yoğunluğunun en çok olduğu Diyarbakır ilinde, T.C. Sağlık Bakanlığı ve koordinatör hastanemiz olan Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi'nin katkıları ile açık kalp cerrahisi uygulamalarına başlamış olup başarı ile devam etmektedir. Anahtar Kelimeler: Yeni merkez; açık kalp cerrahisi; koroner arter bypass greftleme; kapak replasman Introduction: The aim of this article is to present the early results of 195 heart surgery procedures performed in a newly established cardiovascular clinic at Diyarbakır Training and Research Hospital. Patients and Methods: Between June 2009-June 2011, 195 consecutive patients were evaluated retrospectively. A total of 144 cases of coronary artery bypass surgery has been applied; in 43 of them beating heart was performed, in four patients simultaneous carotid endarterectomy was performed. Valve replacement was performed in 37 cases, valve replacement and concomitant coronary artery bypass surgery was performed in eight cases. Repair of cardiac injury was performed in four cases. Coronary bypass surgery and left ventricle aneurysm repair was performed in one case. One patient underwent resection of hydatid cyst of in the left ventricular wall. Results: The mean age of the patients was 59.31±14:17 (20-84 years). One hundred and twenty-eight of the patients were men, while 67 of them were women. The most common comorbidity was hypertension (59%), following smoking (55.4%), hyperlipidemia (54.4%), chronic obstructive pulmonary disease (33.8%) and diabetes mellitus (30.8). Mean duration of stay in the intensive care unit was 20.76±7.15 hours, the mean length of hospital stay was 6.38±4.19 days, respectively. Hospital mortality was observed in 12 patients (6.15%). Revision has been carried out in five patients due to postoperative bleeding, revision rate was 2.56%. Conclusion: Our clinic has started to perform and continue cardiac operations in Diyarbakır, with the leadership
Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2005
Amac: Obstruktif uyku apnesi (OSA), ateroskleroz ve metabolik sendrom (MetS) gelisimi icin onemli... more Amac: Obstruktif uyku apnesi (OSA), ateroskleroz ve metabolik sendrom (MetS) gelisimi icin onemli bir risk faktorudur. Vaskuler kalsifikasyon ateroskleroz gelisiminde onemli bir rol oynamaktadir. Buna ragmen, literaturde MetS ile vaskuler kalsifikasyon arasindaki iliskiyi gosteren veriler yetersizdir. Bu calismanin amaci, OSA'li hastalarda MetS ile aortik ark kalsifikasyonu arasindaki iliskiyi arastirmaktir. Gerec ve Yontemler: Bir gece polisomnografi laboratuvarinda yatan ve OSA tanisi koyulan hastalar calismaya dahil edildi. Hastalar MetS varligina gore iki gruba ayrildi. Polisomnografik degerlendirme sonuclarindan habersiz olan iki arastirmaci akciger grafilerini inceledi. Bulgular: Calismaya OSA tanisi alan toplam 314 hasta dahil edildi. Hastalarin %33,1 kadin ve ortalama yas 51,2±10,9 idi. Calismaya alinan hastalarin %43,6'sinda hafif OSA, %30,9'unda orta derecede OSA ve %25,5'inde agir OSA varligi saptandi. Hastalarin %56,4'unde (n=177) aortik ark kalsifika...
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2005
Cardiology Research and Practice, 2020
N-acetylcysteine (NAC) is an antioxidant which works as a free radical scavenger and antiapoptoti... more N-acetylcysteine (NAC) is an antioxidant which works as a free radical scavenger and antiapoptotic agent. N-acetylcysteine-amide (NACA) is a modified form of NAC containing an amide group instead of a carboxyl group of NAC. Our study aims to investigate the effectiveness of these two substances on erythrocyte deformability and oxidative stress in muscle tissue. Materials and Methods. A total of 24 Wistar albino rats were used in our study. The animals were randomly divided into five groups as control (n: 6), ischemia (n: 6), NAC (n: 6), and NACA (n: 6). In the ischemia, NAC, and NACA groups, 120 min of ischemia and 120 min of reperfusion were achieved by placing nontraumatic vascular clamps across the abdominal aorta. The NAC and NACA groups were administered an injection 30 min before ischemia (100 mg/kg NAC; 100 mg/kg NACA; intravenous). Blood samples were taken from the animals at the end of the ischemic period. The lower extremity gastrocnemius muscle was isolated and stored at ...
Cardiovascular Journal of Africa
The Open Anesthesia Journal
Aim: To investigate the effect of high thoracic epidural analgesia combined with general anesthes... more Aim: To investigate the effect of high thoracic epidural analgesia combined with general anesthesia on pain management and postoperative outcomes in patients undergoing off-pump Coronary Artery Bypass Grafting (CABG). Materials and Methods: Patients were divided into two groups; Group 1 received general anesthesia and high thoracic epidural anesthesia whereas Group 2 received general anesthesia alone during off-pump coronary artery bypass grafting. Epidural catheters were placed at least 6 hours before transfer to the operating room. An epidural analgesic solution of 0.25% bupivacaine and 10 µg/ml fentanyl was started as continuous infusion at 5 ml/hour and maintained for at least 12 hours after completion of surgery. A 10-cm visual analog scale was used to measure pain at 4th, 6th, 9th and 12th postoperative hours. Results: Mean time to extubation was similar between two groups (2.45±0.88 vs. 2.59±1.31 for Groups 1 and 2, respectively, p=0.90). In all measurements, mean Visual Anal...
The Clinical Respiratory Journal
SANAMED
Aim: The aim of this study was to determine the effect of beating heart technique on mortality an... more Aim: The aim of this study was to determine the effect of beating heart technique on mortality and morbidity after redo valve operations. Material and Method: Fifty-two patients who had redo open-heart surgery between May 2005 and November 2006 in a Hospital included in this prospective study. All patients had a history of open-heart surgery with median sternotomy. Thirty-two patients who had redo open-heart surgery with beating heart technique were included in Group 1 and 20 patients who had redo open-heart surgery with conventional cardioplegic myocardial arrest technique were included in Group 2. Patients who had any cardiac surgery without median sternotomy were excluded. Results: Functional capacity according to New York Heart Association classification was significantly lower and number of patients with chronic obstructive lung disease was significantly higher in Group 1 (p = 0.011 and p = 0.003 respectively). There was no significant difference in other preoperative variables. Operation, cardiopulmonary bypass and aortic cross-clamping times were significantly higher in Group 2 (p = 0.001, p = 0.003, p = 0.04 respectively). Mechanical ventilation, inotropic agent support and hospitalization times were significantly higher in Group 2 (p < 0.05). Intensive care unit time was significantly longer in Group 1 (p < 0.05). Drainage volumes, blood product transfusion volumes, intra-aortic balloon pump support times were not significantly different between the groups. Conclusion: Beating heart technique in redo heart valve operations has better outcomes than the conventional technique.
Journal Cardiovascular Surgery, 2014
Turkiye Klinikleri Journal of Case Reports, 2014
Innovations (Philadelphia, Pa.), 2010
Thrombosis of mechanical heart valve prosthesis is a rare fatal complication after heart valve re... more Thrombosis of mechanical heart valve prosthesis is a rare fatal complication after heart valve replacement. Although surgical intervention is the suggested treatment in many series, fibrinolytic treatment offers a good alternative. We describe eight cases with mechanical aortic valve thrombosis and compare their results after fibrinolytic treatment or redo aortic valve replacement. Methods: Between February 2008 and March 2009, eight patients with previous mechanical prosthetic aortic valve replacement history were admitted to our center with mechanical aortic valve thrombosis. Four patients were operated, and the remaining four patients received low-dose fibrinolytic treatment. All patients' data were collected prospectively. Results: Two of the four operated patients died. In the fibrinolytic group, all patients totally recovered, and there was no mortality or morbidity during the follow-up period. Conclusions: We thought that fibrinolytic treatment is a feasible and effective method for thrombosed mechanical aortic valve. However, much more populated patient groups are needed for the vigorous inference.
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2005
Case Reports, 2014
Coronary artery diseases and neoplastic disorders are the leading causes of morbidity and mortali... more Coronary artery diseases and neoplastic disorders are the leading causes of morbidity and mortality in the elderly. Recently, controversial approaches have been raised about the treatment of cases with concomitant occurrence of coronary artery diseases and malignancies. The detrimental effects of cardiopulmonary bypass on neoplastic cells are always a challenge for such cases. We present a case of a large renal tumour associated with a recently symptomatic coronary artery disease which was successfully treated with staged off-pump coronary artery bypass grafting followed by radical nephrectomy. In such patients, off-pump revascularisation is favourable in order to decrease the risk of cancer spreading when compared to traditional on-pump cases. In our opinion, staged off-pump coronary arterial revascularisation followed by definitive surgical treatment for the malignancy is a safe and effective treatment modality in patients with coronary artery disease and oncological diseases.
Case Reports, 2014
Spontaneous coronary artery dissection is a rare clinical condition with a wide range of clinical... more Spontaneous coronary artery dissection is a rare clinical condition with a wide range of clinical presentations ranging from asymptomatic cases to life-threatening ventricular arrhythmias and sudden cardiac death. The exact pathophysiological mechanism has not been fully established yet. We would like to present a survivor of sudden cardiac death presenting with ventricular fibrillation due to spontaneous coronary artery dissection. The prompt evaluation, medical management, surgical myocardial revascularisation and value of off-pump coronary artery bypass surgery are discussed.
Case Reports, 2014
It is a rare entity to observe the coexistence of thyroid gland pathologies and coronary artery d... more It is a rare entity to observe the coexistence of thyroid gland pathologies and coronary artery disease, whose surgical treatment may be performed simultaneously. In this case, we present a case of a patient with substernal thyroidectomy concurrent with off-pump coronary artery bypass grafting. A 57-year-old female patient was admitted to the hospital with exertional dyspnoea, intermittent coughing and stable angina pectoris. The substernal goitre measuring 5×5×4 cm was accompanied by a 95% in-stent restenosis at the left anterior descending artery. Thyroidectomy and off-pump coronary artery bypass grafting procedures were performed simultaneously. The postoperative period was uneventful and the patient was discharged 5 days after the operation. This case indicates that off-pump revascularisation seems to be a better option in cases where surgical interventions for thyroid and coronary artery diseases are necessary instead of on-pump revascularisation where the adverse effects of the cardiopulmonary bypass are considered.
Journal-Cardiovascular Surgery, 2014
Journal-Cardiovascular Surgery, 2014
Journal of Cardiac Surgery, 2009
Background: The aim of this study was to assess the effect of timing and techniques of tracheosto... more Background: The aim of this study was to assess the effect of timing and techniques of tracheostomy on mortality and morbidity in cardiovascular surgery patients. Methods: Between January 2000 and October 2007, a total of 19,559 cardiac and vascular operations were performed in our hospital, and 205 of these patients (1.04%) who underwent a tracheostomy procedure were included in this retrospective study. Results: Surgical tracheostomy (ST) was employed in 134 (65.4%) and percutaneous tracheostomy (PT) in 71 (34.6%) of the cases. There were 17 complications related to all tracheostomy procedures in 15 (7.3%) patients. Bleeding, requiring surgical intervention, occurred in five (3.7%) ST patients and in one (1.4%) PT patient. Cardiac arrest related to the procedure occurred in two (1.5%) ST patients. Pneumothorax occurred in three (2.2%) ST patients and in one (1.4%) PT patient, subcutaneous emphysema in three (2.2%) ST patients and in one (1.4%) PT patient, and tracheoesophageal fistula in one (0.7%) ST patient (p > 0.05). The postoperative infection rate was significantly lower, and cooperation of the patients, postoperative patient mobilization, and oral feeding rates were higher in the early tracheostomy group. The multifactorial mortality rates of early (<seven days) and late tracheostomies were 71.4% and 88.1%, respectively (p = 0.037). Conclusions: We believe that both techniques can be performed safely in the ICUs. Although the need of tracheostomy is one of the foremost causes of mortality and morbidity in cardiovascular surgery patients, an early application of the procedure may have favorable effects on the expected mortality and overall infection rates of the critically ill patients.
Kosuyolu Kalp Dergisi, 2014
Bu çalışmanın amacı, yeni faaliyete geçen Diyarbakır Eğitim ve Araştırma Hastanesi Kalp ve Damar ... more Bu çalışmanın amacı, yeni faaliyete geçen Diyarbakır Eğitim ve Araştırma Hastanesi Kalp ve Damar Cerrahisi Kliniği'nde yapılan ilk 195 kalp ameliyatının sonuçlarını değerlendirmektir. Hastalar ve Yöntem: Haziran 2009-Haziran 2011 tarihleri arasında 195 ardışık olgu retrospektif olarak değerlendirildi. Toplam 144 vakada koroner arter bypass cerrahisi uygulanmış olup bunlardan 43 tanesi atan kalpte gerçekleştirilmiş, dört hastada eş zamanlı karotid endarterektomi yapılmıştır. Otuz yedi hastada kapak replasmanı, sekiz hastada kapak replasmanı ve eş zamanlı koroner arter baypass greftleme, dört hastada kardiyak yaralanmaya müdahale, bir hastada koroner arter baypass greftleme ve sol ventrikül anevrizma onarımı, bir hastada da sol ventrikül duvarından kist hidatik rezeksiyonu uygulanmıştır. Bulgular: Hastaların yaş ortalaması 59,3±14,1 (20-84 y) idi. Hastaların 128 tanesi erkek, 67 tanesi ise kadın idi. Hipertansiyon (%59) en sık eşlik eden hastalık olup bunu sigara (%55,4), hiperlipidemi (%54,4), kronik obstrüktif akciğer hastalığı (%33,8) ve diabetes mellitus (%30,8) takip ediyordu. Yoğun bakım ünitesinde kalma süresi ortalama 20,7±15,0 saat, ortalama hastanede kalma süresi ise 6,3±4,1 gün olarak saptandı. Hastane mortalitesi toplam 12 hastada görülmüştür (%6,15). Erken dönemde (ilk 30 gün içinde) postoperatif kanama nedeniyle beş hastada revizyon gerçekleştirilmiş olup revizyon oranı %2,56'dır. Sonuç: Kliniğimiz, Güneydoğu Anadolu Bölgesi'nin hasta yoğunluğunun en çok olduğu Diyarbakır ilinde, T.C. Sağlık Bakanlığı ve koordinatör hastanemiz olan Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi'nin katkıları ile açık kalp cerrahisi uygulamalarına başlamış olup başarı ile devam etmektedir. Anahtar Kelimeler: Yeni merkez; açık kalp cerrahisi; koroner arter bypass greftleme; kapak replasman Introduction: The aim of this article is to present the early results of 195 heart surgery procedures performed in a newly established cardiovascular clinic at Diyarbakır Training and Research Hospital. Patients and Methods: Between June 2009-June 2011, 195 consecutive patients were evaluated retrospectively. A total of 144 cases of coronary artery bypass surgery has been applied; in 43 of them beating heart was performed, in four patients simultaneous carotid endarterectomy was performed. Valve replacement was performed in 37 cases, valve replacement and concomitant coronary artery bypass surgery was performed in eight cases. Repair of cardiac injury was performed in four cases. Coronary bypass surgery and left ventricle aneurysm repair was performed in one case. One patient underwent resection of hydatid cyst of in the left ventricular wall. Results: The mean age of the patients was 59.31±14:17 (20-84 years). One hundred and twenty-eight of the patients were men, while 67 of them were women. The most common comorbidity was hypertension (59%), following smoking (55.4%), hyperlipidemia (54.4%), chronic obstructive pulmonary disease (33.8%) and diabetes mellitus (30.8). Mean duration of stay in the intensive care unit was 20.76±7.15 hours, the mean length of hospital stay was 6.38±4.19 days, respectively. Hospital mortality was observed in 12 patients (6.15%). Revision has been carried out in five patients due to postoperative bleeding, revision rate was 2.56%. Conclusion: Our clinic has started to perform and continue cardiac operations in Diyarbakır, with the leadership
Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2005
Amac: Obstruktif uyku apnesi (OSA), ateroskleroz ve metabolik sendrom (MetS) gelisimi icin onemli... more Amac: Obstruktif uyku apnesi (OSA), ateroskleroz ve metabolik sendrom (MetS) gelisimi icin onemli bir risk faktorudur. Vaskuler kalsifikasyon ateroskleroz gelisiminde onemli bir rol oynamaktadir. Buna ragmen, literaturde MetS ile vaskuler kalsifikasyon arasindaki iliskiyi gosteren veriler yetersizdir. Bu calismanin amaci, OSA'li hastalarda MetS ile aortik ark kalsifikasyonu arasindaki iliskiyi arastirmaktir. Gerec ve Yontemler: Bir gece polisomnografi laboratuvarinda yatan ve OSA tanisi koyulan hastalar calismaya dahil edildi. Hastalar MetS varligina gore iki gruba ayrildi. Polisomnografik degerlendirme sonuclarindan habersiz olan iki arastirmaci akciger grafilerini inceledi. Bulgular: Calismaya OSA tanisi alan toplam 314 hasta dahil edildi. Hastalarin %33,1 kadin ve ortalama yas 51,2±10,9 idi. Calismaya alinan hastalarin %43,6'sinda hafif OSA, %30,9'unda orta derecede OSA ve %25,5'inde agir OSA varligi saptandi. Hastalarin %56,4'unde (n=177) aortik ark kalsifika...
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2005
Cardiology Research and Practice, 2020
N-acetylcysteine (NAC) is an antioxidant which works as a free radical scavenger and antiapoptoti... more N-acetylcysteine (NAC) is an antioxidant which works as a free radical scavenger and antiapoptotic agent. N-acetylcysteine-amide (NACA) is a modified form of NAC containing an amide group instead of a carboxyl group of NAC. Our study aims to investigate the effectiveness of these two substances on erythrocyte deformability and oxidative stress in muscle tissue. Materials and Methods. A total of 24 Wistar albino rats were used in our study. The animals were randomly divided into five groups as control (n: 6), ischemia (n: 6), NAC (n: 6), and NACA (n: 6). In the ischemia, NAC, and NACA groups, 120 min of ischemia and 120 min of reperfusion were achieved by placing nontraumatic vascular clamps across the abdominal aorta. The NAC and NACA groups were administered an injection 30 min before ischemia (100 mg/kg NAC; 100 mg/kg NACA; intravenous). Blood samples were taken from the animals at the end of the ischemic period. The lower extremity gastrocnemius muscle was isolated and stored at ...
Cardiovascular Journal of Africa
The Open Anesthesia Journal
Aim: To investigate the effect of high thoracic epidural analgesia combined with general anesthes... more Aim: To investigate the effect of high thoracic epidural analgesia combined with general anesthesia on pain management and postoperative outcomes in patients undergoing off-pump Coronary Artery Bypass Grafting (CABG). Materials and Methods: Patients were divided into two groups; Group 1 received general anesthesia and high thoracic epidural anesthesia whereas Group 2 received general anesthesia alone during off-pump coronary artery bypass grafting. Epidural catheters were placed at least 6 hours before transfer to the operating room. An epidural analgesic solution of 0.25% bupivacaine and 10 µg/ml fentanyl was started as continuous infusion at 5 ml/hour and maintained for at least 12 hours after completion of surgery. A 10-cm visual analog scale was used to measure pain at 4th, 6th, 9th and 12th postoperative hours. Results: Mean time to extubation was similar between two groups (2.45±0.88 vs. 2.59±1.31 for Groups 1 and 2, respectively, p=0.90). In all measurements, mean Visual Anal...
The Clinical Respiratory Journal
SANAMED
Aim: The aim of this study was to determine the effect of beating heart technique on mortality an... more Aim: The aim of this study was to determine the effect of beating heart technique on mortality and morbidity after redo valve operations. Material and Method: Fifty-two patients who had redo open-heart surgery between May 2005 and November 2006 in a Hospital included in this prospective study. All patients had a history of open-heart surgery with median sternotomy. Thirty-two patients who had redo open-heart surgery with beating heart technique were included in Group 1 and 20 patients who had redo open-heart surgery with conventional cardioplegic myocardial arrest technique were included in Group 2. Patients who had any cardiac surgery without median sternotomy were excluded. Results: Functional capacity according to New York Heart Association classification was significantly lower and number of patients with chronic obstructive lung disease was significantly higher in Group 1 (p = 0.011 and p = 0.003 respectively). There was no significant difference in other preoperative variables. Operation, cardiopulmonary bypass and aortic cross-clamping times were significantly higher in Group 2 (p = 0.001, p = 0.003, p = 0.04 respectively). Mechanical ventilation, inotropic agent support and hospitalization times were significantly higher in Group 2 (p < 0.05). Intensive care unit time was significantly longer in Group 1 (p < 0.05). Drainage volumes, blood product transfusion volumes, intra-aortic balloon pump support times were not significantly different between the groups. Conclusion: Beating heart technique in redo heart valve operations has better outcomes than the conventional technique.
Journal Cardiovascular Surgery, 2014
Turkiye Klinikleri Journal of Case Reports, 2014
Innovations (Philadelphia, Pa.), 2010
Thrombosis of mechanical heart valve prosthesis is a rare fatal complication after heart valve re... more Thrombosis of mechanical heart valve prosthesis is a rare fatal complication after heart valve replacement. Although surgical intervention is the suggested treatment in many series, fibrinolytic treatment offers a good alternative. We describe eight cases with mechanical aortic valve thrombosis and compare their results after fibrinolytic treatment or redo aortic valve replacement. Methods: Between February 2008 and March 2009, eight patients with previous mechanical prosthetic aortic valve replacement history were admitted to our center with mechanical aortic valve thrombosis. Four patients were operated, and the remaining four patients received low-dose fibrinolytic treatment. All patients' data were collected prospectively. Results: Two of the four operated patients died. In the fibrinolytic group, all patients totally recovered, and there was no mortality or morbidity during the follow-up period. Conclusions: We thought that fibrinolytic treatment is a feasible and effective method for thrombosed mechanical aortic valve. However, much more populated patient groups are needed for the vigorous inference.
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2005
Case Reports, 2014
Coronary artery diseases and neoplastic disorders are the leading causes of morbidity and mortali... more Coronary artery diseases and neoplastic disorders are the leading causes of morbidity and mortality in the elderly. Recently, controversial approaches have been raised about the treatment of cases with concomitant occurrence of coronary artery diseases and malignancies. The detrimental effects of cardiopulmonary bypass on neoplastic cells are always a challenge for such cases. We present a case of a large renal tumour associated with a recently symptomatic coronary artery disease which was successfully treated with staged off-pump coronary artery bypass grafting followed by radical nephrectomy. In such patients, off-pump revascularisation is favourable in order to decrease the risk of cancer spreading when compared to traditional on-pump cases. In our opinion, staged off-pump coronary arterial revascularisation followed by definitive surgical treatment for the malignancy is a safe and effective treatment modality in patients with coronary artery disease and oncological diseases.
Case Reports, 2014
Spontaneous coronary artery dissection is a rare clinical condition with a wide range of clinical... more Spontaneous coronary artery dissection is a rare clinical condition with a wide range of clinical presentations ranging from asymptomatic cases to life-threatening ventricular arrhythmias and sudden cardiac death. The exact pathophysiological mechanism has not been fully established yet. We would like to present a survivor of sudden cardiac death presenting with ventricular fibrillation due to spontaneous coronary artery dissection. The prompt evaluation, medical management, surgical myocardial revascularisation and value of off-pump coronary artery bypass surgery are discussed.
Case Reports, 2014
It is a rare entity to observe the coexistence of thyroid gland pathologies and coronary artery d... more It is a rare entity to observe the coexistence of thyroid gland pathologies and coronary artery disease, whose surgical treatment may be performed simultaneously. In this case, we present a case of a patient with substernal thyroidectomy concurrent with off-pump coronary artery bypass grafting. A 57-year-old female patient was admitted to the hospital with exertional dyspnoea, intermittent coughing and stable angina pectoris. The substernal goitre measuring 5×5×4 cm was accompanied by a 95% in-stent restenosis at the left anterior descending artery. Thyroidectomy and off-pump coronary artery bypass grafting procedures were performed simultaneously. The postoperative period was uneventful and the patient was discharged 5 days after the operation. This case indicates that off-pump revascularisation seems to be a better option in cases where surgical interventions for thyroid and coronary artery diseases are necessary instead of on-pump revascularisation where the adverse effects of the cardiopulmonary bypass are considered.
Journal-Cardiovascular Surgery, 2014
Journal-Cardiovascular Surgery, 2014
Journal of Cardiac Surgery, 2009
Background: The aim of this study was to assess the effect of timing and techniques of tracheosto... more Background: The aim of this study was to assess the effect of timing and techniques of tracheostomy on mortality and morbidity in cardiovascular surgery patients. Methods: Between January 2000 and October 2007, a total of 19,559 cardiac and vascular operations were performed in our hospital, and 205 of these patients (1.04%) who underwent a tracheostomy procedure were included in this retrospective study. Results: Surgical tracheostomy (ST) was employed in 134 (65.4%) and percutaneous tracheostomy (PT) in 71 (34.6%) of the cases. There were 17 complications related to all tracheostomy procedures in 15 (7.3%) patients. Bleeding, requiring surgical intervention, occurred in five (3.7%) ST patients and in one (1.4%) PT patient. Cardiac arrest related to the procedure occurred in two (1.5%) ST patients. Pneumothorax occurred in three (2.2%) ST patients and in one (1.4%) PT patient, subcutaneous emphysema in three (2.2%) ST patients and in one (1.4%) PT patient, and tracheoesophageal fistula in one (0.7%) ST patient (p > 0.05). The postoperative infection rate was significantly lower, and cooperation of the patients, postoperative patient mobilization, and oral feeding rates were higher in the early tracheostomy group. The multifactorial mortality rates of early (<seven days) and late tracheostomies were 71.4% and 88.1%, respectively (p = 0.037). Conclusions: We believe that both techniques can be performed safely in the ICUs. Although the need of tracheostomy is one of the foremost causes of mortality and morbidity in cardiovascular surgery patients, an early application of the procedure may have favorable effects on the expected mortality and overall infection rates of the critically ill patients.