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Öğe Assessing volumetric changes in abdominal aortic aneurysms following endovascular repair(Clinics Cardive Publ Pty Ltd, 2021) Gunerhan, Yalcin; Isik, Mehmet; Dereli, Yuksel; Tanyeli, Omer; Kadiyoran, Cengiz; Iyisoy, Mehmet Sinan; Gormus, NiyaziObjective: Volumetric changes in the aneurysm sac were evaluated following endovascular aortic repair (EVAR) in intact abdominal aortic aneurysm (AAA) patients who underwent EVAR. Methods: Fifty-two patients, who underwent EVAR from 2015 to 2019, were analysed retrospectively. A total of 158 computed tomography angiography scans was examined by performing reconsctructive volumetric calculations. Total aneurysm volume (TAV), patent lumen volume (PLV) and thrombus-coated aneurysm wall volume (TCAWV) were calculated. The results obtained at six, 12 and 24 months postoperatively were compared with those of the pre-operative period. Results: Mean TAV had regressed 7% by the sixth month (p = 0.1), 27% by the 12th month (p = 0.0003) and 19% by the 24th month (p = 0.0008). Mean TCAWV had increased 2% by the sixth month (p = 0.3), and regressed 26% by the 12th month (p = 0.3) and 14% by the 24th month (p = 0.8). Mean PLV had regressed by 20% by the sixth month (p = 0.008), 29% by the 12th month (p = 0.0002) and 26% by the 24th month (p = 0.0006). For each individual proximal, middle and distal measurement, regression was observed at six and 12 months; however, an increase was observed at 24 months compared to the previous follow ups. Conclusion: The expansion measurements of TAV in the 24th month support the doubts on the medium- to long-term results of EVAR. The largest regression in the aneurysm sac was observed in the distal portion, then in the proximal portion, and the least regression was observed in the middle section.Öğe Clinical experience of repair of pectus excavatum and carinatum deformities(Clinics Cardive Publ Pty Ltd, 2013) Oncel, Murat; Tezcan, Bekir; Akyol, Kazim Gurol; Dereli, Yuksel; Sunam, Guven SadiBackground: We present the results of surgical correction of pectus excavatum (PE) and pectus carinatum (PC) deformities in adults, and also report a new method of sternal support used in surgery for PE deformities. Methods: We present the results of 77 patients between the ages of 10 and 29 years (mean 17) with PE (n = 46) or PC (n = 31) deformities undergoing corrective surgery from 2004 to 2011, using the Ravitch repair method. Symptoms of the patients included chest pain (15%) and tachycardia (8%). Three patients underwent repair of recurrent surgical conditions. Results: All of the patients with dyspnoea with exercise experienced marked improvement at five months post operation. Complications included pneumothorax in 5.1% (n = 4), haemothorax in 2.6% (n = 2), chest discomfort in 57% (n = 44), pleural effusion in 2.6% (n = 2), and sternal hypertrophic scar in 27% (n = 21) of patients. Mean hospitalisation was eight days. Pain was mild and intravenous analgesics were used for a mean of four days. There were no deaths. Results after surgical correction were very good or excellent in 62 patients (80%) at a mean follow up of three years. Three patients had recurrent PE and were repaired with the Nuss procedure. In three patients who underwent the Ravitch procedure, a stainless steel bar was used for sternal support instead of Kirschner wire. Conclusions: Pectus deformities may be repaired with no mortality, low morbidity, very good cosmetic results and improvement in cardiological and respiratory symptoms.Öğe The effects of botulinum toxin A and papaverine on human saphenous vein and internal mammary artery grafts: an in vitro study(Termedia Publishing House Ltd, 2022) Duman, Ipek; Tanyeli, Omer; Dereli, Yuksel; Oltulu, Pembe; Toy, Hatice; Sahin, Ayse SaideIntroduction: Autologous saphenous vein (SV) and internal mammary ar-tery (IMA) are used as bypass conduits during coronary artery bypass graft surgery. Vasospasm of the arterial and venous grafts may constitute a sig-nificant clinical problem. Pretreatment with a vasodilator drug of the graft ex vivo or intraluminal injection before implantation may be used for spasm prophylaxis. This in vitro study was designed to assess the vasoactive ef-fects and time-dependent changes of botulinum toxin A (BTX-A) and pa-paverine pretreatment on vasospasm of human SV and IMA grafts. Also, histomorphology of the vessels was assessed.Material and methods: SV and IMA segments were suspended in organ baths, and isometric contraction responses to 2 different concentrations of 5-hydroxytryptamine (5-HT) and endothelin-1 (ET-1) were recorded after in-cubation with 2 different concentrations of BTX-A and papaverine at 2 time points (0 h and 2 h).Results: The results revealed the following: 1) incubation with BTX-A and papaverine relaxes both SV and IMA rings contracted with 5-HT and ET-1; 2) the duration of the relaxant effect of BTX-A lasts longer than papaverine; and 3) no apparent histomorphological changes were observed in the grafts under light microscopy.Conclusions: This study demonstrates that in human SV and IMA grafts, pretreatment with both BTX-A and papaverine are safe and have a potent inhibitory effect depending on the vessel and vasoconstrictor agent. The long-lasting vasodilatory effect of BTX-A on vascular smooth muscle may provide promising results in the prevention of venous and arterial graft spasm.Öğe Evaluation of post-operative flow and diameter changes in brachial and ulnar arteries in coronary artery bypass surgery patients in which the radial artery is used as graft(Turkish Soc Cardiology, 2015) Isik, Mehmet; Yuksek, Tahir; Dereli, Yuksel; Gormus, Niyazi; Durgut, Kadir; Koc, OsmanObjective: The radial artery is widely used in coronary bypass surgery. In these patients, forearm and hand circulation is provided by the ulnar artery. This study aimed to investigate post-operative changes in flow and diameter in brachial and ulnar arteries in patients undergoing coronary bypass surgery in which the radial artery is used as graft. Methods: Between September 2007 and September 2008, 20 patients (16 men, 4 women; mean age 57.8 years; range 44 to 70 years) underwent elective coronary bypass surgery at our clinic. The radial artery was used as graft in all cases. Pre-operatively, adequacy of the ulnar artery for forearm circulation was investigated by Allen test and duplex ultrasonography. Basal flow and diameter values of the brachial and ulnar arteries were measured. Control duplex ultrasound measurements were performed at three months post-operatively. Flow and diameter changes in the brachial and ulnar arteries were recorded. Results: Significant increase was shown in ulnar artery flow and diameter values in post-operative measurements. A significant increase was observed in brachial artery diameter, accompanied by a relative decrease in flow value. There were no mortality or ischemic complications in our study. Transient paresthesia as a neurological complication was observed in 4 patients. Conclusion: Radial artery use for coronary bypass surgery leads to significant changes in ulnar and brachial arteries. All flow and diameter changes can be detected by color Doppler ultrasonography in the early stages. These adaptation mechanisms show that the radial artery can be safely harvested as graft material.Öğe Full metal jacket: transfemoral aortic valve implantation for regurgitant valve after endovascular aortic repair(Oxford Univ Press, 2017) Tanyeli, Omer; Dereli, Yuksel; Gormus, Niyazi; Duzenli, Mehmet AkifTransfemoral aortic valve implantation has become an almost routine interventional procedure for severe aortic stenosis in high-risk patients. Over time an increased number of experiences has led to unusual procedures. In this report, we present a successful valve-in-valve transfemoral aortic valve implantation in a patient with aortic regurgitation, who previously had debranching and thoracic endovascular aortic repair operations.Öğe Inappropriate sensing events revealing electrocautery-induced implantable cardioverter-defibrillator lead failure(Turkish Soc Cardiology, 2015) Can, Ilknur; Aribas, Alpay; Dereli, Yuksel; Tholakanalli, Venkatakrishna[Abstract Not Availabe]Öğe Management of Cardiac Surgery in a Pandemic Region Hospital: Precautions, Results and Experiences During COVID-19(Aves, 2021) Isik, Mehmet; Yildirim, Serkan; Dereli, Yuksel; Tanyeli, Omer; Gormus, NiyaziObjective: The aim of the present study was to share the experiences gained from emergency and semi-emergency cases of open heart surgery performed during the COVID-19 outbreak in Necmettin. Erbakan University Meram Medical Faculty Hospital, which was defined as a pandemic hospital by Turkish Ministry of Health and provided third degree health services. Materials and Methods: A total of 54 patients were retrospectively analyzed between 23 March and 22 May 2020, who were diagnosed to have aortic dissection, coronary artery disease, and heart valve diseases. Results: Thirty-two CABG, 12 valve surgery, 6 aortic surgery, 4 CABG + valve surgeries were performed. During the postoperative follow-up of I I patients, who were suspicious of COVID-19, 8 of them displayed respiratory problems and partial oxygen depletion and required continuous positive airway pressure. The hospitalization duration of COVID-19-suspicious patients were approximately 5 days longer than that of normal patients. In one of the patient, who was treated positive for COVID-19, acute coronary syndrome developed and CABG was performed following the treatment. Conclusion: During the pandemic period, acute cardiac diseases needing urgent surgery could be misdiagnosed because of similar symptoms with COVID-19 and the health care practitioners concentrated with the COVID-19 primarily. On the other hand, pandemic fear could cause delayed admission to the hospital and increased postoperative mortality and morbidity. When a COVID-19 positive or -suspicious patient undergo open-heart surgery, problems resulting from both COVID-19 infection and cardiopulmonary bypass-associated systemic effects could arise. The combination of these two cases could worsen the complications.Öğe New World's old disease: cardiac hydatid disease and surgical principles(Clinics Cardive Publ Pty Ltd, 2017) Tanyeli, Omer; Dereli, Yuksel; Mercan, Ilker; Gormus, Niyazi; Yuksek, TahirBackground: Hydatid cyst is a parasitic disease caused by infection with the Echinococcus granulosus tapeworm larva. It is a major public health problem in endemic regions. Cardiac involvement of the disease is rare. Methods: Between 1985 and 2015, 12 patients were admitted to our clinic with a possible diagnosis of cardiac hydatid disease. Of these patients, six (50%) were male and six (50%) were female. Mean age of the patients was 42.6 years. Results: The most common location of cardiac hydatid disease was left sided (six patients, 50%). Five (41.7%) patients had cysts located in the right heart, whereas one (8.3%) had a cyst in the interventricular septum. Eleven (91.7%) of the patients were operated on via median sternotomy and the remaining one was operated on via a left anterolateral thoracotomy. Ten (83.3%) of the patients were operated on using cardiopulmonary bypass under moderate hypothermia, whereas the remaining two (16.7%) had off-pump surgery. There was no surgical mortality in our series. All patients were discharged with medical therapy (mebendazole or albendazole) for the duration of six months. No recurrences were observed in their follow ups. Conclusion: Although cardiac hydatid disease is rare, its prevalence seems to have increased in the last decade. Any patient with suspected cardiac symptoms suggesting mass lesions should be considered for a differential diagnosis of cardiac hydatid disease, especially in developing countries. Definitive treatment is removal of the cyst, combined with medical therapy.Öğe Penetrating cardiac injury in blunt trauma: a case report(Turkish Assoc Trauma Emergency Surgery, 2015) Dereli, Yuksel; Oncel, MuratCardiac injuries may rarely be observed due to blunt thoracic traumas. Cardiac injury often creates a life-threatening condition requiring urgent surgical intervention, and follow-up of these patients should be carefully carried out in the perioperative period. These injuries depend on various factors including clinical presentation, type of injury, the time that passes until the patient reaches the hospital, bleeding, cardiac tamponade, or additional injuries. This article aimed to report a case who suffered penetrating cardiac injury in blunt thoracic trauma. Evaluated in the emergency department due to a motor vehicle accident, the 61-year-old male patient's chest x-ray revealed pulmonary contusion, rib fractures and cardiac tamponade. The patient was operated emergently. Right atrial injury was observed in the operation. The cardiac injury was repaired with primary suture technique. Cardiac injury in patients with blunt thoracic trauma is likely to be observed. In these patients, careful physical examination, early diagnosis, and treatment are very important.Öğe Predictive Value of Neutrophil-to-Lymphocyte, Aspartate-to-Alanine Aminotransferase, Lymphocyte-to-Monocyte and Platelet-to-Lymphocyte Ratios in Severity and Side of Carotid Artery Stenosis: Are Those Significant?(Forum Multimedia Publishing, Llc, 2021) Altinbas, Ozgur; Demiryurek, Seniz; Isik, Mehmet; Tanyeli, Omer; Dereli, Yuksel; Gormus, NiyaziBackground: Atherosclerosis is a chronic disease that leads to mortality and morbidity by affecting arterial vascular structures. Carotid artery is one of these arterial structures and occlusive disease of carotid artery may cause stroke or cranial ischemic infarction. Inflammation plays a role in the atherosclerotic process. In this study, we aimed to discuss the relationship between the severity and side of carotid artery occlusion and novel inflammatory parameters include platelet-to-lymphocyte, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios. Methods: One-hundred-fifteen patients who had carotid artery stenosis between 50%-99% and 115 healthy subjects with no carotid artery stenosis or additional disease were included in the study. The relationship between the side and degree of the lesion and platelet-to-lymphocyte, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios were studied in the patient group. The patients with carotid artery stenosis and the healthy subjects were compared, in the terms of same parameters. Data were evaluated statistically. Results: There were no statistically significant differences between the groups, in the terms of platelet-to-lymphocyte, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios and the degree of stenosis. There was no statistically significant difference between the sides of the lesions and the parameters above except lymphocyte-to-monocyte ratio. It was statistically significantly higher in left-sided lesions. Aspartate-to-alanine aminotransferase and neutrophil-to-lymphocyte ratios were markedly higher in the patient group, when compared to controls. Conclusion: Platelet-to-lymphocyte, neutrophil-tolymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios are inexpensive, easy, fast, and reproducible parameters that can be used in determining the prediction of carotid artery stenosis.Öğe Predictive Value of Neutrophil-to-Lymphocyte, Aspartate-to-Alanine Aminotransferase, Lymphocyte-to-Monocyte and Platelet-to-Lymphocyte Ratios in Severity and Side of Carotid Artery Stenosis: Are Those Significant?(Forum Multimedia Publishing, Llc, 2021) Altinbas, Ozgur; Demiryurek, Seniz; Isik, Mehmet; Tanyeli, Omer; Dereli, Yuksel; Gormus, NiyaziBackground: Atherosclerosis is a chronic disease that leads to mortality and morbidity by affecting arterial vascular structures. Carotid artery is one of these arterial structures and occlusive disease of carotid artery may cause stroke or cranial ischemic infarction. Inflammation plays a role in the atherosclerotic process. In this study, we aimed to discuss the relationship between the severity and side of carotid artery occlusion and novel inflammatory parameters include platelet-to-lymphocyte, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios. Methods: One-hundred-fifteen patients who had carotid artery stenosis between 50%-99% and 115 healthy subjects with no carotid artery stenosis or additional disease were included in the study. The relationship between the side and degree of the lesion and platelet-to-lymphocyte, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios were studied in the patient group. The patients with carotid artery stenosis and the healthy subjects were compared, in the terms of same parameters. Data were evaluated statistically. Results: There were no statistically significant differences between the groups, in the terms of platelet-to-lymphocyte, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios and the degree of stenosis. There was no statistically significant difference between the sides of the lesions and the parameters above except lymphocyte-to-monocyte ratio. It was statistically significantly higher in left-sided lesions. Aspartate-to-alanine aminotransferase and neutrophil-to-lymphocyte ratios were markedly higher in the patient group, when compared to controls. Conclusion: Platelet-to-lymphocyte, neutrophil-tolymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios are inexpensive, easy, fast, and reproducible parameters that can be used in determining the prediction of carotid artery stenosis.Öğe Primary Intravascular Lipoma of the Superior Vena Cava(Galenos Publ House, 2015) Tanyeli, Omer; Dereli, Yuksel; Gormus, Niyazi; Odev, Kemal[Abstract Not Availabe]Öğe Rare images of tuberculous pericarditis causing constrictive pericarditis(Oxford Univ Press Inc, 2014) Tanyeli, Omer; Dereli, Yuksel; Gormus, Niyazi[Abstract Not Availabe]Öğe Relaxation matters: comparison of in-vitro vasodilatory role of botulinum toxin-A and papaverine in human radial artery grafts(Bmc, 2019) Tanyeli, Omer; Duman, Ipek; Dereli, Yuksel; Gormus, Niyazi; Toy, Hatice; Sahin, Ayse SaideBackground: Radial artery (RA) is widely used in coronary artery bypass (CABG) surgery and the prevention of spasm is crucial for graft patency. Botulinum toxin A (BTX-A) and B are commonly used for aesthetic reasons and neuromuscular disorders. They are proven to raise blood flow and increase survival of ischemic skin flaps. In this study we evaluated and compared the vasodilator effects of BTX-A and papaverine on human RA grafts. Methods: After resting 60 min in isolated organ baths, human RA grafts were examined. Contraction responses for different doses of serotonin (5-HT) and endothelin-1 (ET-1) were evaluated as a percent of maximum contraction response elicited by 80 mM potassium chloride (KCl). The inhibitory effects of BTX-A and papaverine on contraction responses taken at the 0th hour were compared with the 1st and 2nd hour responses. Inhibitory effects of BTX-A and papaverine against the contractile agent were evaluated by comparing the results of the first and last (0th and 2nd hour) application. Results: In low concentrations, when we compared the effects of BTX-A (10(-8) M) and papaverine (10(-6) M) on 5-HT, papaverine was found to be more effective at both the 0th and 2nd hour (p < 0.05). Both BTX-A and papaverine inhibited the maximum contractile effect of ET-1 to the same extent at the 0th hour; but, the inhibitory effect of BTX-A was significantly stronger at the 2nd hour (p < 0.05). In high concentrations, when we compared the effects of BTX-A (10(-6) M) and papaverine (10(-4) M) on 5-HT, papaverine showed stronger inhibition (p < 0.05), whereas both agents had similar action of inhibition on ET-1 mediated maximum contraction responses. Conclusion: BTX-A inhibits both ET-1 and 5-HT induced contractions and its effectiveness does not decrease over time as observed with papaverine. This study is the first in the literature using human RA for prevention of vasospasm by BTX-A.Öğe Relaxation matters: comparison of in-vitro vasodilatory role of botulinum toxin-A and papaverine in human radial artery grafts(Bmc, 2019) Tanyeli, Omer; Duman, Ipek; Dereli, Yuksel; Gormus, Niyazi; Toy, Hatice; Sahin, Ayse SaideBackground: Radial artery (RA) is widely used in coronary artery bypass (CABG) surgery and the prevention of spasm is crucial for graft patency. Botulinum toxin A (BTX-A) and B are commonly used for aesthetic reasons and neuromuscular disorders. They are proven to raise blood flow and increase survival of ischemic skin flaps. In this study we evaluated and compared the vasodilator effects of BTX-A and papaverine on human RA grafts. Methods: After resting 60 min in isolated organ baths, human RA grafts were examined. Contraction responses for different doses of serotonin (5-HT) and endothelin-1 (ET-1) were evaluated as a percent of maximum contraction response elicited by 80 mM potassium chloride (KCl). The inhibitory effects of BTX-A and papaverine on contraction responses taken at the 0th hour were compared with the 1st and 2nd hour responses. Inhibitory effects of BTX-A and papaverine against the contractile agent were evaluated by comparing the results of the first and last (0th and 2nd hour) application. Results: In low concentrations, when we compared the effects of BTX-A (10(-8) M) and papaverine (10(-6) M) on 5-HT, papaverine was found to be more effective at both the 0th and 2nd hour (p < 0.05). Both BTX-A and papaverine inhibited the maximum contractile effect of ET-1 to the same extent at the 0th hour; but, the inhibitory effect of BTX-A was significantly stronger at the 2nd hour (p < 0.05). In high concentrations, when we compared the effects of BTX-A (10(-6) M) and papaverine (10(-4) M) on 5-HT, papaverine showed stronger inhibition (p < 0.05), whereas both agents had similar action of inhibition on ET-1 mediated maximum contraction responses. Conclusion: BTX-A inhibits both ET-1 and 5-HT induced contractions and its effectiveness does not decrease over time as observed with papaverine. This study is the first in the literature using human RA for prevention of vasospasm by BTX-A.Öğe Treatment Approaches to Combined Orthopedic and Vascular Traumas: A Single-Center Experience(Zamensalamati Publ Co, 2021) Dereli, Yuksel; Isik, Mehmet; Tanyeli, Omer; Yildirim, Serkan; Altinbas, Ozgur; Korucu, Ismail Hakki; Taban, Volkan BurakBackground: Orthopedic and vascular trauma can be clinically observed and have negative consequences if not treated appropriately. Objectives: This study aimed to present the clinical experiences of the authors regarding vascular traumas in combination with extremity fractures or dislocations. Methods: In total, 95 patients (78 males, 17 females, with the mean age of 34.7 +/- 5.6 years old) who underwent surgical treatment for combined orthopedic and vascular trauma between November 2012 and February 2020 were included in the study. Patients were retrospectively evaluated according to their clinical properties, treatment strategies, and results. Results: Traffic accidents were the most common reason for trauma with a rate of 36.8% (n=35). The most common orthopedic injury was seen in the femur, whereas the most common vascular injury was on the superficial femoral artery. The most commonly performed treatment methods for vascular and orthopedic trauma were primary repair and external fixation, respectively. Based on findings, the mortality and amputation rates were 2.1% (n=2) and 15.7% (n=15), respectively. Conclusion: Combined orthopedic vascular traumas are less frequent than isolated vascular traumas, but they have higher mortality and amputation rates. In order to decrease mortality and amputation rates, communication should be perfectly coordinated between the emergency department and orthopedic and cardiovascular surgery clinics; moreover, urgent intervention is crucial.Öğe Ultrasound guided fascia lata plane block: A novel anesthetic technique for percutaneous endovascular procedures(Elsevier Science Inc, 2020) Kilicaslan, Alper; Ince, Ilker; Sarkilar, Gamze; Dereli, Yuksel[Abstract Not Availabe]
