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Öğe A case with double-chambered right ventricle and left ventricular-right atrial communication (Gerbode defect): potential pitfall for Eisenmenger syndrome(Springer Japan Kk, 2012) Özkaramanlı Gür, Demet; Gür, Özcan; Göksülük, Hüseyin; Oral, DervişThe ventricular septal defect (VSD) can rarely be associated with other malformations such as double-chambered right ventricle (DCRV) in which hypertrophied muscle bundles divide the right ventricle into two chambers causing progressive obstruction (Mao et al., Asia Pac J Thorac Cardiovasc Surg 5: 14-17, 1996). Most VSDs close spontaneously by apposition of the tricuspid leaflets, but the process is rarely disrupted, resulting in communication between left ventricle and right atrium called Gerbode defect [Cho et al., J Cardiovasc Ultrasound 19(3): 148-151, 2011]. Hence, the Gerbode defect involves potential misinterpretation of its high-velocity shunt as pulmonary hypertension. Here we present a case with DCRV and Gerbode defect initially misdiagnosed to have Eisenmenger syndrome.Öğe A comparison of the intensive care experiences of emergency and elective cardiac surgery patients(Wolters Kluwer Medknow Publications, 2016) Göktaş, Sonay Baltacı; Yıldız, T.; Nargiz, Sibel Kosucu; Gür, ÖzcanPurpose: The study was planned to review the experiences of patients in the intensive care units (ICUs) and determine their states of awareness following an emergency or elective cardiac surgery. Materials and Methods: This was a multicenter and descriptive study. Approval was granted by the Institutional Ethics Committee and informed consent for participation in the study was obtained from all the patients. The study included a total of 300 patients who underwent emergency or elective cardiovascular surgery and were then transferred to the ICU. Data were gathered from the demographic data form and the intensive care experience scale, which was developed by the researchers and applied through face-to-face interviews with the patients. The independent-samples t-test, MannuWhitney U (Exact) test, one-way ANOVA (Robust Test: BrownuForsythe), and multivariate analysis of variance were used in the analysis of the data. Results: The study included 300 patients, comprising 108 (36%) females and 192 (64%) males. No difference was found between the groups in respect of total intensive care points of emergency (57.9 4.92) and elective (56.6 4.58) operations (P = 0.32). The environmental awareness level and patient satisfaction of the elective group were seen to be higher, and the emergency group reported more bad experiences. Patients who had undergone emergency cardiac valve surgery were more satisfied (P 0.001) and remembered more (P = 0.001). Conclusion: Patients who had undergone urgent and elective cardiac surgery were seen to have had a relatively negative intensive care experience. When there was more environment awareness in patients with ICU experience, it was determined that as the duration of stay in the ICU lengthens out, the pessimistic experiences increased and ICU satisfaction decreases.Öğe A comparison of the vasodilatory effects of verapamil, papaverine and nitroglycerin on isolated rat aorta(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Ege, Turan; Halıcı, Umit; Gür, Özcan; Gürkan, Selami; Özkaramanlı Gür, Demet; Duran, EnverBackground: This study aims to compare the vasodilatory effects of verapamil, papaverine and nitroglycerin on rat aortic preparations in in vitro isolated tissue bath system and to evaluate the role of vascular endothelium on vasodilatory responses of the isolated rat aorta samples. Methods: The thoracic aorta segments collected from 30 male Wistar rats (20 endothelialized and 20 de-endothelialized vascular rings for each drug in 2 mm wide strips, total number of 120 vascular rings) were suspended into the Krebs solution of the isolated tissue bath system. Phenylephrine was used to induce isometric contraction and tissue samples were treated with verapamil, papaverine and nitroglycerin separately to draw concentration-response curves of isometric vasodilatory responses. This procedure was repeated for de-endothelialized aorta samples. Results: Papaverine and verapamil induced vasodilatatory responses starting from the concentration of 10(-8) M and reached its maximum at concentration of 10(-3) M, while nitroglycerin induced vasodilation at lower concentrations starting from a concentration of 10(-12) M, reaching its maximum at 10(-6) M. Nitroglycerin was the most potent agent, followed by verapamil and papaverine. Efficacy analysis revealed that the most efficient agents were papaverine (140 +/- 6.7%), nitroglycerin (110.8 +/- 1.35%) and verapamil (99 +/- 4.14%), respectively. The results were similar in aorta samples without endothelium (p >= 0.05, F test). Conclusion: In this study examining isolated rat aorta, nitroglycerin was the most potent agent, while papaverine was the most efficient agent. Our study results showed that endothelium played no role in vasodilatation responses of these drugs.Öğe A new center: First six months analysis of adult cardiac surgery(2012) Gürkan, Selami; Gür, Özcan; Arar, Makbule Cavidan; Ege, TuranObjective: Cardiac surgery centers are developing and growing in recent years. We aimed to evaluate the first six months results of cardiac surgery operations that performed in our clinic which built new. Material and Methods: One hundred seven (73 men, 34 women; mean age 58.35±11.15 years) consecutive patient operated between October 2011 and March 2012 were analyzed retrospectively. While hypertension (43.9%) was the most common disease followed by diyabetes (39.2%), hyperlipidemia (35.5%) and chronic obstructive pulmonary disease (21.4%). Coronary artrey bypass graft operation was applied to 86 (80.3%) patients. The other procedures were; valve operation, atrial septal defect repair and Benthall. Results: Hospital mortality was 2.8% with 3 cases. Two of the patients were acute myocardial infarction, the other one was with left ventricular aneurysm. One of these patients diagnosed with acute myocardial infarction was taken to operation accompanied by cardiopulmonary resuscitation because of cardiopulmonary arrest. Postoperative wound infection was seen in 5 patiens. Saphenous vein wound infection in 3 and sternal wound infection in 2 patients was seen. Postoperative atrial fibrillation was seen in 28% of patients. Sinusal rhythm restored in all postoperative atrial fibrillations by medikal treatment. Revision operation for bleeding in 3 and for resistant ventricular fibrillation in 1 patient were performed. Conclusion: We thought that cardiac surgery operations that started at October 2011 in our clinic could be performed with acceptable mortality and morbidity rates. Copyright © 2012 by Türkiye Klinikleri.Öğe Açık kalp cerrahisi uygulanan olgularda negatif basınç altında dren çekme yöntemi(2012) Gür, Özcan; Çakır, Habib; Demiray, Erdoğan; Sarı, Bekir; Özkaramanlı Gür, Demet; Özsöyler, İbrahimAmaç: Postoperatif dönemde gözlenebilen komplikasyonlar hasta mortalitesini olumsuz yönde etkilemektedir. Bu komplikasyonlardan biri de solunum sistemi ile ilgili komplikasyonlardır. Çalışmamızda toraks dreninin çekilmesi sırasında negatif basınç uygulanması ile ilgili klinik deneyimlerimizi sunmayı amaçladık. Yöntem: Aralık 2007- Kasım 2008 tarihleri arasında açık kalp cerrahisi uygulanan 337 erkek ve 111 kadın toplam 448 hasta çalışmaya alındı. Hastaların yaş ortalaması 57,33±3,6 yaş idi. Olgulara postoperatif drenaj takibi amacıyla dren takıldı. Drenler drenajın fazla olması ya da pnömotoraks olması durumları dışında postoperatif birinci günde çekildi. Drenler 70-100 mmHg aralığında negatif basınç ile aspire edilerek çekildi. Bulgular: Hastalara toplam 1008 adet dren takıldı. 3 hastaya sol toraksta sıvı birikmesi nedeniyle torosentez işlemi uygulandı. 1 hasta da pnömotoraks gelişti. Sonuç: Kardiyak cerrahi sonrası dren çekilmesi sırasında yapılacak küçük bir modifikasyon ile postoperatif dönemde pnömotoraks ve sıvı birikmesine bağlı oluşabilecek pulmoner enfeksiyon oranlarının azaltılabileceği kanaatindeyiz.Öğe Amiodarone versus esmolol in the perioperative period: an in vitro study of coronary artery bypass grafts(Oxford Univ Press, 2016) Özkaramanlı Gür, Demet; Gür, Özcan; Gürkan, Selami[No Abstract Available]Öğe Association of vaspin rs2236242 gene variants and circulating serum vaspin concentrations with coronary artery disease in a Turkish population(Wiley, 2021) Akçılar, Raziye; Yümün, Gündüz; Bayat, Zeynep; Donbaloğlu, Mehmet Okan; Gür, Özcan; Gürkan, Selami; Arık, ÖzlemCoronary artery disease (CAD) is the primary cause of death worldwide. Vaspin was a recently described adipokine, playing a protective role in many metabolic and cardiovascular diseases. This study aimed to assess the relation of serum vaspin levels and vaspin rs2236242 polymorphisms with CAD. The study included 105 healthy subjects and 105 CAD patients. Serum vaspin concentrations and vaspin rs2236242 polymorphisms were determined by enzyme-linked immunosorbent assay and polymerase chain reaction, respectively. There was a statistically significant difference between the genotypes of CAD patients (TT 26.7%, TA 71.4%, and AA 1.9%) and controls (TT 70.5%, TA 28.6%, and AA 1%;chi(2) = 40.3;df = 2;p = .000). The TA genotype increased the risk of CAD (odds ratio [OR] = 6.60; 95% confidence interval [CI] = 3.60-12.1;p = .000) as compared to the TT genotype. There was a statistically significant difference between the allelic distribution of CAD patients (T 62.4% and A 37.6%) and controls (T 84.8% and A 15.2%;chi(2) = 27.0;df = 1;p = .000). Those carrying the A allele had a higher risk of CAD compared to those with the T allele (OR = 3.35; 95% CI = 2.10-5.36;p = .000). The serum vaspin concentrations of the patients with TT, TA, and AA genotypes were 30.4 +/- 1.72, 28.4 +/- 2.89, and 36.4 +/- 6.38 pg/ml, respectively, and there was no significant difference between the serum vaspin levels and vaspin genotypes (p = .696). All of the above suggested that the vaspin rs2236242 polymorphism was associated with CAD in the Turkish population.Öğe Author's reply: the impact of body mass index on mortality and morbidity in patients undergoing isolated valve surgery(Baycinar Medical Publishing, 2015) Gür, Özcan[No abstract available]Öğe Body mass index as a determinant of postoperative morbidity(Cardiology Academic Press, 2013) Gürkan, Selami; Gür, Özcan; Özkaramanlı Gür, Demet; Ege, Turan; Canbaz, Suat; İşcan, ŞahinBACKGROUND: The impact of obesity on postoperative mortality and morbidity in coronary artery bypass grafting (CABG) operations is a widely studied but poorly defined topic. OBJECTIVE: To investigate the effect of body mass index (BMI) on in-hospital mortality and morbidity after isolated CABG surgery. METHODS: Prospectively collected data of a series of 1057 consecutive patients who underwent on-pump isolated CABG surgery were retrospectively analyzed. Patients were divided into five groups according to WHO BMI categorization (defined as underweight [BMI <20 kg/m(2)]; normal weight [BMI >= 20 kg/m(2) to <25 kg/m(2)]; overweight [BMI >= 25 kg/m(2) to <30 kg/m(2)]; obese, [BMI >= 30 kg/m(2) to <35 kg/m(2)]; and morbidly obese, [BMI >= 35 kg/m(2)]). RESULTS: Of 1057 patients, 13 patients (1.2%) were underweight, 298 (28.2%) were normal weight, 462 (43.7%) were overweight, 218 (20.6%) were obese and 66 (6.2%) were morbidly obese. The mean age was significantly lower in underweight patients, who were also more likely to be male. In contrast, obese and morbidly obese patients were older, and more likely to have comorbidities such as diabetes and hypertension. The incidence of postoperative bronchodilator use (P<0.001), leg wound infection (P=0.038), sternal dehiscence (P=0.039) and development of new-onset atrial fibrillation (P<0.001) was significantly higher in obese and morbidly obese groups. In contrast, postoperative prolonged ventilation (P<0.001), need for blood transfusions (P<0.001) and revision for bleeding (P=0.041), as well as gastrointestinal complications (P<0.001), were significantly higher in underweight patients. Multivariate logistic regression analysis showed that not BMI but female sex, older age and diabetes mellitis were independent risk factors for early mortality after CABG surgery. CONCLUSION: No effect of BMI on early postoperative mortality after CABG surgery could be demonstrated. However, in terms of morbidity, postoperative bleeding and revision for bleeding were increased in underweight patients while sternal dehiscence, wound infections and occurrence of atrial fibrillation were increased in obese and morbidly obese patients.Öğe Büyük safen ven yetmezliğinde manuel 980 nm lazer çıplak-uçlu fiber ile otomatik geri çekme sistemli 1470 nm radial fiber lazerin karşılaştırılması: Erken dönem etkinlik ve komplikasyonlarin analizi(2013) Gürkan, Selami; Gür, Özcan; Arar, Makbule Cavidan; Donbaloğlu, Mehmet Okan; Ege, TuranAmaç: Endovenöz lazer ablasyon, variköz ven tedavisinde en çok kabul gören tedavi seçeneklerinden biridir. Bu retrospektif çalışmanın amacı manuel 980 nm çıplak fiber lazer ile otomatik geri çekme sistemli 1470 nm radial fiber lazerin erken dönem etkinliklerinin karşılaştırılması. Gereç ve Yöntemler: Ekim 2011 ile Ocak 2013 arasında büyük safen ven yetmezliği sebebiyle endovenöz lazer ablasyon ile tedavi edilen 78 hasta ve 89 ekstremite incelendi. 980 nm lazer ve çıplak fiber ile tedavi edilen 40 hasta ve 45 ekstremite Grup 1 olarak tanımlandı. 1470 nm lazer radial fiber ve otomatik geri çekme sistemi ile tedavi edilen 38 hasta ve 44 ekstremite Grup 2 olarak tanımlandı. Ağrı, ekimoz, endurasyon, parestezi gibi lokal komplikasyonlar postoperatif 3, 7 ve 30. günlerde klinik olarak ve Doppler ultrasonografi ile değerlendirildi. Bulgular: Grup 1 ve grup 2de erken kapanma oranları sırasıyla %91 (n=41) ve %93 (n=41) idi. Bir aylık takipler sonunda her iki grupta da venöz klinik şiddet skorlarında belirgin derecede azalma oldu. Postoperatif ekimoz, endurasyon parestezi ve analjezik ihtiyacı grup 1de anlamlı derecede yüksek olmasına rağmen, major komplikasyonlar her iki grupta da görülmedi. Sonuç: Her iki tip lazer ile yapılan endovenöz lazer ablasyon işleminin erken dönem sonuçları tatmin ediciydi. Otomatik geri çekme sistemli 1470 nm dalga boyunda radial fiber kullanılarak yapılan büyük safen venin endovenöz lazer ablasyonunun etkili ve güvenli bir tedavi seçeneği olduğu söylenebilir.Öğe Cerebral emboli as the predictor of mortality in patients with ‘definite’ infective endocarditis(2021) Gür, Demet Özkaramanlı; Uslu, Nurullah; Akyüz, Aydın; Alpsoy, Seref; Gür, Özcan; Doğan, Mustafa; Dınckal, Mustafa HakanInfective endocarditis (IE) is among the most fatal infectious diseases. Since the introduction of various intracardiac devices and interventions, the clinical aspects of IE have rapidly evolved. In this paper, we aim to define the contemporary characteristics of patients diagnosed with definite IE and to identify the predictors associated with mortality. Through retrospective analysis of patients with TEE proven vegetation, those fulfilling the modified Duke criteria for definite IE were identified. Patient characteristics in relation to clinical outcomes and mortality were analyzed. Out of 50 patients (mean age 57±15.9 years, 34% female), 72% was native-valve endocarditis of which only 32% had a predisposing valve disease such as rheumatic valve. The rate of prosthetic-valve IE was 10% and that of device-related IE was 18%. The most common causative organisms were S. aureus (16%), Coagulase-negative Staphylococci (16%), Enterococci (14%) and Viridans streptococci (12%). In-hospital mortality was 24% and was associated with concomitant diabetes, coronary artery disease, higher baseline creatinine, anemia, occurrence of cranial complications and absence of surgery during the index hospitalization. Regression analyses revealed that cerebral emboli were the only predictor of early mortality, possibly through delayed surgical treatment. In conclusion, our small cohort of definite IE patients showed that contemporary characteristics of IE has evolved with higher rates of device-related IE. Within established prognostic factors, cerebral emboli and timing of surgery are intervening factors, which suggests that the timing of surgical treatment, particularly in patients with neurologic complications, needs to be evaluated when shaping future perspectives on IE.Öğe Combined treatment of both arterial and deep venous thrombosis in a young adult with antiphospholipid syndrome: case report(2014) Gürkan, Selami; Gür, Özcan; Chousein-Hüseyin, Serchat-Serhat; Yüksel, Volkan; Canbaz, SuatAntifosfolipid sendromu değişik tromboembolik olaylara sebep olabilen, otoimmün hiperkoagülabilite sendromudur. Olguların %35inde pulmoner emboli ve infarktla komplike olabilen derin ven trombozu görülebilir. Hastalığın klinik görünümleri arasında; venöz ve arteriyel trombozlarla birlikte emboliler, multiorgan iskemisi ve infarktına neden olabilen küçük ve yaygın büyük damar trombozları, prematür koroner arter hastalığı, strok ve düşükler sayılabilir. Bu yazıda 25 yaşındaki genç erkek hastada görülen arteriyel ve venöz trombozu ile cerrahi ve medikal tedavi birlikteliğini sundukÖğe Comparison of Clinical Follow-up and Complications according to Cancer Types in Patients with Permanent Port Catheter Insertion due to Malignancy(2018) Gür, Özcan; Donbaloğlu, Mehmet Okan; Gürkan, SelamiAim: In patients diagnosed with cancer, port catheter insertion is of critical importance for the appropriate delivery of the treatmentand patient comfort. Aim of this study is to compare the patients placed subcutaneous port catheter in terms of the complications andthe port remaining open based on cancer types.Material and Methods: A total of 530 patients who had port catheter insertion in our clinic for chemotherapy between January 2011and December 2017 were included into the study. Of the cases, 234 (44.1%) were female and 296 (55.9%) were male; and the meanage was 57.90±10.18 years. The port catheters were placed subcutaneously under vascular ultrasonography and the position of thecatheter was checked using fluoroscopy. Patients underwent physical examination to check for hemorrhage or hematoma, andunderwent chest x-ray to check for pneumothorax or hemothorax. Patients were called in for checkup for wound-site infection and portthrombosis on the postoperative 10th and 30th days.Results: The majority of the patients who had port insertion were being followed up for gastrointestinal malignancies. Of the patients,224 (42.2%) had port catheter insertion due to colon cancer, 68 (12.8%) due to breast cancer, and 111 (20.9%) due to gastric cancer.Frequency of catheter thrombosis was statistically higher in cases with colon and breast cancer. Wound site infection was observedmore frequently in hematological malignancies.Conclusion: We suggest that, after port insertion, these complications can be reduced by using prophylactic anticoagulants for longterm port use in cases with breast and colon cancer, and by continuing empirical antibiotic treatment against endemic pathogens incases with hematological cancers.Öğe Comparison of drug eluting balloon versus standard balloon results in patients with below knee peripheral artery disease(Duzce University Medical School, 2018) Gür, Özcan; Donbaloğlu, Mehmet Okan; Gürkan, SelamiAim: Atherosclerotic peripheral arterial disease is frequently seen with critical leg ischemia. Despite the benefits of pharmacological agents in the lesions, the most effective treatment method is revascularization. In this study, we aimed to compare the results of drug-eluting balloon and standard balloon endovascular treatment methods. Material and Methods: One hundred and ninety-six patients who underwent infrapopliteal revascularization in Cardiovascular Surgery clinic in Namık Kemal University Hospital between January 2015 and June 2017 were included in the study. During the study, 100 patients were treated with drug-eluting balloon (DEB) (Lutonix, Bard, USA), while 96 patients were treated with standard balloon (PTA) (Nanocross, Medtronic, USA). The one-year patency rates were compared between the two groups. The patients were followed up at 1st, 3rd, 6th and 12th months after the procedure and followed by Ankle-Brachial Index (ABI) measurements and Rutherford classification. Results: Eighty three female and 113 male patients were included in the study. The mean age of the patients was 63.56±11.21. The median Rutherford classification was 4 (3-5) in the drug-eluting group according to the Rutherford classification and 4 (3-5) in the naked balloon group. During the 12-month follow-up period, limb salvage rate was 82.0% (n=82) in drug-eluting balloons and this rate was found to be 65.6% (n=63) in naked balloon group. In terms of amputation rates, the drug-eluting balloon group was found to be statistically superior (p=0.009). Conclusion: In this study, 12-month patency rates were found to be superior to naked balloons at 12-month patency rates and clinical follow-up. © 2018, Duzce University Medical School. All rights reserved.Öğe Comparison of endothelial function of coronary artery bypass grafts in diabetic and nondiabetic patients: Which graft offers the best?(Turkish Soc Cardiology, 2015) Özkaramanlı Gür, Demet; Gür, Özcan; Gürkan, Selami; Çömez, Selcem; Gonultas, Aylin; Yılmaz, MuratObjective: Diabetes associated endothelial dysfunction, which determines both long and short term graft patency, is not uniform in all coronary artery bypass surgery (CABG) grafts. Herein this study, we aimed to investigate the degree of endothelial dysfunction in diabetic radial artery (RA), internal mammarian artery (IMA) and saphenous vein (SV) grafts in vitro tissue bath system. Methods: This is a prospective experimental study. Fifteen diabetic and 15 non-diabetic patients were included to the study. A total number of 96 graft samples were collected; 16 graft samples for each graft type from both diabetic and non-diabetic patients. Arterial grafts were harvested with pedicles and SV grafts were harvested by 'no touch' technique. Vasodilatation response of vascular rings to carbachol, which induces nitric oxide (NO) mediated vasodilatation, was designated as the measure of endothelial function. Results: The IMA grafts had the most prominent NO mediated vasodilatation in both diabetic and non-diabetic patients, concluding a better preserved endothelial function than SV and RA. The 'no-touch' SV and RA grafts had similar vasodilatation responses in non-diabetic patients. In diabetic patients, on the other hand, RA grafts exhibited the least vasodilatation response (ie. worst endothelial function), even less vasodilatation than 'no touch' SV grafts (p<0.0001). Conclusion: Deteriorated function of RA grafts in diabetic patients, even worse than SV grafts made evident by this study, encourages the use of 'no touch' technique as the method of SV harvesting and more meticulous imaging of RA before its use as a graft in diabetic patients.Öğe Comparison of Paclitaxel Eluting Balloon Angioplasty Combined with Directional Atherectomy and Self Expandable Nitinol Stent Implantation in Treatment of Calcified Stenotic Superficial Femoral Artery Lesions(Duzce University Medical School, 2019) Gürkan, Selami; Gür, Özcan; Yüksel, V.Aim: The frequency and variety of endovascular interventions have increased with the rise in peripheral arterial occlusive disease incidence and to lessen undesirable outcomes after peripheral vascular surgery. Extensive calcific stenotic lesions affect patency rates of endovascular interventions and enhance complication rates. In this study we aimed to compare paclitaxel eluting balloon angioplasty (PEBA) combined with directional atherectomy (DA) with self expandable nitinol stent (SENS) implantation in terms of patency rates. Material and Methods: Fifty-six patients (28 patients in each group) underwent endovascular interventions for calcific stenotic superficial femoral artery lesions between March 2013 and May 2014 at Cardiovascular Surgery clinic in Namik Kemal University Hospital were included in the study. Mean age was 65.4±7.6 and male to female ratio was 46/10. Patients were followed up with ankle brachial index (ABI), Rutherford score (RS) and Doppler ultrasonography (DUSG) from the pre-intervention period to sixth month after intervention. Results: Mean lesion length in DA and PEBA group was 66.4±24.8 mm and 65.0±20.6 mm in SENS group. Primary and secondary patency rates were 85.7% and 92.9% in DA and PEBA group, and 57.1% and 71.4% in SENS group in six months follow up. There was a statistically significant difference between groups. Significant improvement was detected in terms of ABI and RS in both groups. Conclusion: We conclude from this study results that PEBA combined with DA is better than SENS implantation, because of its successful early-term results, no intravascular foreign bodies, and continues the chance of surgery without affecting the anastomosis field. © 2019, Duzce University Medical School. All rights reserved.Öğe Comparison of the efficacy of the cardiac hypothermia and normothermia to myocardial damage in coronary artery bypass graft surgery with systemic normothermic cardiopulmonary bypass(Edizioni Minerva Medica, 2013) Çakır, Habib; Gür, Özcan; Ege, Turan; Kunduracilar, H.; Ketenciler, S.; Duran, E.Aim. The aim of our research is to investigate the cardiac damage formed by either local cardiac hypothermia or cardiac normothermia technique in patients who undergone isolated coronary artery bypass graft (CABG) surgery. Methods. The total of 40 patients who underwent isolated CABG operation under normothermic cardiopulmonary bypass (CPB) were studied. Patients were randomly divided into two groups as cardiac hypothermia and cardiac normothermia. Myocardial temperature was measured from the interventricular septum before aortic cross-clamp (ACC) (baseline), the ACC 20th minutes (ischemia) and after 20 minutes removal of the ACC (reperfusion). The coronary sinus blood samples were simultaneously obtained from the retrograde cardioplegia cannula while myocardial temperature was being measured. Complement component 3 (C3), complement component 4 (C4), troponin I and tumor necrosis factor-alpha (TNF-alpha) was measured from the coronary sinus blood samples. Results. Myocardial temperature was between 18-28 degrees C (deep hypothermia) during ACC in group 1. Myocardial temperature was over 34 degrees C (normothermia) during ACC in group 2. TNF-alpha values of group 1 for ischemia and reperfusion were higher than group 2, and it was found statistically significant (P<0.05). Conclusion. Myocardial damage was less than in normothermia group according to hypothermia group. The results show that ice-cold blood cardioplegia and local ice treatment of the heart during CPB seems to harm the heart more than warm blood cardioplegia.Öğe Comparison of vasodilatation responses of arterial grafts harvested with and without electrocautery: in vitro study results(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2015) Gürkan, Selami; Gür, Özcan; Yüksel, Volkan; Güçlü, OrkutBackground: In this study, we aimed to compare vasodilatation responses of arterial grafts harvested by electrocautery and without electrocautery by using the tissue bath system. Methods: Between May 2013 and June 2014, 30 patients (19 males, 11 females, mean age 60.0 +/- 8.2 years; range 47 to 77 years) who underwent elective coronary artery bypass grafting (CABG) surgery were enrolled in the study. Sixteen samples from internal thoracic artery and radial artery grafts in each group were collected. The grafts were divided into two groups: grafts harvested by electrocautery (group 1) and grafts harvested without electrocautery (group 2). Results: The vasodilatation responses of internal thoracic artery grafts were significantly reduced in group 1, compared to group 2. Although the vasodilatation responses of radial artery grafts in group 1 were lesser than in group 2, the difference was not statistically significant. Conclusion: Vessel harvesting by electrocautery may cause serious endothelial injury particularly in internal thoracic artery grafts, rather than radial artery grafts. The procedure without electrocautery may be more advantageous during the harvesting of arterial grafts in terms of preventing early graft failure.Öğe Comparison of vasospasm and vasodilatation response of saphenous vein grafts harvested by conventional and no-touch techniques(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2012) Gür, Özcan; Gürkan, Selami; Özkaramanlı Gür, Demet; Karadağ, Hakan; Ege, TuranBackground: In this study, we aimed to compare vasoconstriction and vasodilatation responses of saphenous vein grafts (SVG) harvested by conventional and no touch techniques in tissue bath system. Methods: Between February 2007 and September 2007, 12 patients (10 males, 2 females; mean age 55.6 +/- 5.8 years; range 38 to 75 years) who underwent coronary artery bypass graft (CABG) surgery in our clinic with signed informed consents were included. Based on the techniques used during harvesting, the grafts were divided into two groups, including group 1 (n=16) with SVGs harvested by conventional technique and group 2 by no-touch technique. In group 1, SVG was removed completely from adjacent adipose tissues. In group 2, SVG was removed with adjacent adipose tissues, preserving saphenous nerves. Results: The vasodilatation response of SVGs was significantly higher with the no touch technique, while the vasoconstriction response of SVGs was significantly higher with the conventional technique at lower doses. Conclusion: We belive that no-touch harvesting technique of SVGs may decrease early graft failure and reduce also postoperative morbidity and mortality rate, contributing to improve graft patency rate in the long-term.Öğe Concomitant Coronary Artery Bypass and Plunging Goiter Surgery(2016) Yümün Alparslan, Havva Nur; Gür, Özcan; Gürkan, Selami; Yümün, Gündüz[No Abstract Available]
