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Öğe Early Surgical Results of Patent Ductus Arteriosus in Premature Infants(Gazi Univ, Fac Med, 2018) Altinbas, Ozgur; Ozer, Abdullah; Isik, Mehmet; Sarigul, Ali; Ege, ErdalObjective:Our aim is to evaluate the closure of patent ductus arteriosus through surgery at an early stage, commonly seen in premature infants and a leading cause of left-to-right shunt and mortality/morbidity, as a safe modality to prevent complications that may develop in postnatal preiod in patients with bronchopulmonary displasia or respiratory distress syndrome followed up in mechanical ventilation, and whose ductus arteriosus can not be closed despite medical treatment. Material and Methods:Thirty two cases of patent ductus arteriosus with premature birth history and no additional cardiac pathology, performed in the Department of Cardiovascular Medical School, Necmettin Erbakan University between 2006-2015 were included into the study. Results:Of the 32 patients, 14 (43,7%) were females and 18 (56,3%) were males. The most frequently seen preoperative disorder was respiratory distress syndrome(n=20). Twenty-two (68%) of the patients were following as intubated in newborn intensive care unit. Surgical procedure was performed in patients whose ductus were not closed via medical treatmentorin whom medical treatment was contraindicated for problems such as intracranial hemorrhage, renal failure or thrombocytopenia. Excitus rate was 15,6% (n=5) in our series. Removal time of mechanical ventilation was average 6,2 days. Postoperative echocardiography showed no recurrence of patent ductus arteriosus. Conclusion:Prevention of postnatal mortality and morbidity due to patent ductus arteriosus in premature infants can be achieved by early surgical closure during postnatal early period before secondary organ failure due to shunting develops and infants with critical general status-dependent on mechanical vantilation-,and for whom medical treatment is unsuccessful.Öğe Early Surgical Results of Patent Ductus Arteriosus in Premature Infants(Gazi Univ, Fac Med, 2018) Altinbas, Ozgur; Ozer, Abdullah; Isik, Mehmet; Sarigul, Ali; Ege, ErdalObjective:Our aim is to evaluate the closure of patent ductus arteriosus through surgery at an early stage, commonly seen in premature infants and a leading cause of left-to-right shunt and mortality/morbidity, as a safe modality to prevent complications that may develop in postnatal preiod in patients with bronchopulmonary displasia or respiratory distress syndrome followed up in mechanical ventilation, and whose ductus arteriosus can not be closed despite medical treatment. Material and Methods:Thirty two cases of patent ductus arteriosus with premature birth history and no additional cardiac pathology, performed in the Department of Cardiovascular Medical School, Necmettin Erbakan University between 2006-2015 were included into the study. Results:Of the 32 patients, 14 (43,7%) were females and 18 (56,3%) were males. The most frequently seen preoperative disorder was respiratory distress syndrome(n=20). Twenty-two (68%) of the patients were following as intubated in newborn intensive care unit. Surgical procedure was performed in patients whose ductus were not closed via medical treatmentorin whom medical treatment was contraindicated for problems such as intracranial hemorrhage, renal failure or thrombocytopenia. Excitus rate was 15,6% (n=5) in our series. Removal time of mechanical ventilation was average 6,2 days. Postoperative echocardiography showed no recurrence of patent ductus arteriosus. Conclusion:Prevention of postnatal mortality and morbidity due to patent ductus arteriosus in premature infants can be achieved by early surgical closure during postnatal early period before secondary organ failure due to shunting develops and infants with critical general status-dependent on mechanical vantilation-,and for whom medical treatment is unsuccessful.Öğe The effect of renal dose dopamine use on renal tubular function in diabetic patients undergoing coronary artery bypass graft surgery(2014) Tanyeli, Ömer; Sarkılar, Gamze; Ege, Erdal; Sarıgül, Ali; Narin, Cüneyt; Özkara, Ahmet; Yeniterzi, MehmetBackground: This study aims to evaluate clinical results of the prophylactic use of renal dose dopamine infusion in diabetic patients undergoing coronary artery bypass grafting (CABG). Methods: In this prospective randomized study, 40 consecutive diabetic patients who were scheduled for elective CABG were randomized into two equal groups: group 1 received dopamine infusion at renal dose (2.5-4.0 mg/kg/min) starting from induction of anesthesia for 48 hours; group 2 consisted of untreated controls. Standard sternotomy technique using aortic and right atrial cannulation was performed for cardiopulmonary bypass. Results: Daily urine output, fluid balance, serum creatinine, blood urea levels and creatinine clearance were measured at three and five days. In the control group, third and fifth postoperative day, creatinine clearance levels decreased about 24.8±12.3 mL/min and 18.1±10.1 mL/min, respectively. In the dopamine group, creatinine clearance levels in the third and fifth postoperative days increased by 7.7±10.8 mL/min (p0.005) and 10.7±11.7 mL/min (p0.001), respectively. Group 1 patients demonstrated less increase in serum creatinine level at three and five days than the controls (p>0.001). Conclusion: Creatinine and creatinine clearance levels, suggestive of renal tubular function, were positively affected by renal dose dopamine infusion started at time of anesthesia induction. Our data may help us to re-normalize the renal functions in the postoperative period in diabetic patients, particularly.Öğe Investigation of left ventricular changes according to valve type in patients with surgical replacement due to isolated aortic stenosis(Clinics Cardive Publ Pty Ltd, 2023) Guener, Abdullah; Isik, Mehmet; Tanyeli, Oemer; Yildirim, Serkan; Ege, Erdal; Taban, Volkan BurakObjective: The aim of this study was to investigate postoperative left ventricular changes [left ventricular mass (LVM), left ventricular mass index (LVMI), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), patient-prosthesis mismatch (PPM), pulmonary artery pressure (PAP), gradients, and ejection fraction (EF)] according to the valve type used in patients undergoing aortic valve replacement (AVR) due to isolated aortic stenosis. Methods: A total of 199 patients with isolated AVR due to aortic stenosis between 2010 and 2020 was retrospectively investigated. Four groups were identified according to the valve type used (mechanical, bovine pericardium, porcine and sutureless). Pre-operative and first year postoperative transthoracic echocardiography findings for the patients were compared. Results: Mean age was 64.4 +/- 13.0 years, while the gender distribution was 41.7% women and 58.3% men. Of the valves used in patients, 39.2% were mechanical, 18.1% were porcine, 8.5% were bovine pericardial and 34.2% were sutureless valves. Analysis independent of the valve groups observed LVEDD, LVESD, maximum gradient, mean gradient, PAP, LVM and LVMI values reduced significantly postoperatively (p < 0.001). EF was observed to increase by 2.1% (p = 0.008). Comparisons of the four valve groups revealed that LVEDD, LVESD, maximum gradient, mean gradient, LVM and LVMI significantly decreased in all groups. EF significantly increased only in the sutureless valve group (p = 0.006). Analysis of PPM groups showed that LVESD, maximum gradient, mean gradient, PAP, LVM and LVMI were significantly reduced in all groups. In the normal PPM group, there was an improvement in EF, which was significantly different to the other groups (p = 0.001), while in the severe PPM group, EF appeared to be reduced (p = 0.19).Öğe Minimal İnvaziv Yöntemle Dikişsiz Aort Kapak Replasmanı: Olgu Sunumu(2016) Özer, Abdullah; Uğurlu, Okan; Sarkılar, Gamze; Ege, Erdal; Sarıgül, AliKliniğimize Aort Darlığı (AD) tanısıyla kabul edilen iki hastamıza, ileri yaş ve klasik cerrahi riskinin yüksek olması nedeniyle anterior torakotomi ile minimal invaziv girişim yapılarak dikişsiz aort kapağı implantasyonu yapılmıştır. Minimal invaziv girişimin ileri yaş ve yüksek riskli ciddi aort darlığı olan hastalarda, klasik cerrahiye oranla çok daha uygun bir cerrahi tedavi seçeneği olduğu kanısındayız.Öğe Predictive value of platelet to lymphocyte ratio and mean platelet volume in atrial fibrillation after isolated coronary artery bypass graft operation(2019) Tanyeli, Ömer; Dereli, Yüksel; Ege, Erdal; Altınbaş, ÖzgürAim: The relationship between inflammation and the development of atrial fibrillation and the relationship between platelet tolymphocyte ratio and mean platelet volume in relation to inflammation were investigated in patients with atrial fibrillation after isolated coronary artery bypass graft operation. Material And Methods: Clinical and laboratory data of 132 patients, who did not have preoperative atrial fibrillation and underwent isolated coronary artery bypass graft operation using cardiopulmonary pump, were analyzed retrospectively. Patients were divided into two groups as patients with developed atrial fibrillation and those without atrial fibrillation. Concomitant diseases, preoperative drug use, echocardiographic and angiographic findings, preoperative, intraoperative and postoperative laboratory parameters were obtained from medical records and compared statistically. Results: Of the 132 patients, 68 with atrial fibrillation (mean age: 68.3+/-10.7 years, 50 males and 18 females) and 64 patients without atrial fibrillation (mean age: 64.5+/-9.8 years, 55 males and 9 females) were identified, and difference in the mean age was statistically significant (p=0.016). Postoperative platelet to lymphocyte ratio and mean platelet volume values (280.3+/-112.3;9.9+/-1.7) were also significantly higher in those with atrial fibrillation group than preoperative values (129.2+/-49.3; 9.6+/-1.6,p<0.0001, p<0.0009). Conclusıon: According to our study higher values of postoperative platelet to lymphocyte ratio and mean platelet volume are correlated with development of atrial fibrillation after coronary artery bypass graft operation.Öğe Prematür İnfantlarda Patent Duktus Arteriozusun Erken Cerrahi Sonuçları(2018) Altınbaş, Özgür; Özer, Abdullah; Işık, Mehmet; Sarıgül, Ali; Ege, ErdalAmaç: Prematür bebeklerde sık görülen, soldan sağa şant ve mortalite ilemorbiditenin önemli bir nedeni olan patent duktus arteriozusun, mekanikventilatörde uzun süre takipli, bronkopulmoner displazi veya respiratuardistres sendromu gibi respiratuar problemleri olan veya medikal tedaviyerağmen patent duktus arteriozusları kapanmayan hastalarda cerrahi ile erkendönemde kapatılmasının, doğum sonrası dönemde gelişebilecekkomplikasyonların önlenmesi açısından güvenilir bir yöntem olduğunuliteratür destekli sunmaktır.Gereçve Yöntem: Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi KalpDamar Cerrahisi bölümünde 2006-2015 yılları arasında yapılan, prematürdoğum öyküsü olan ve ek kardiyak patolojisi olmayan 32 patent duktusarteriozus vakası çalışmaya dahil edildi.Bulgular: Çalışmaya dahil edilen 32 hastanın 14’ü (%43,7) kız, 18 ‘i (%56,3)erkekti. Operasyon öncesi en sık görülen rahatsızlık respiratuar distressendromu idi (n20). Hastaların 22 tanesi(%68,7) pediatrik yoğun bakımdaentübe takip edilmekteydi. Cerrahi prosedür; medikal tedavi ile duktuslarıkapanmayan veya intrakranial kanama, böbrek yetmezliği veyatrombositopeni gibi medikal tedavinin kontrendike olduğu vakalarauygulandı.Serimizde eksitus oranı %15,6 idi (n5). Mekanik ventilatördenayrılma süreleri ortalama 6,2 gündü. Postoperatif ekokardiyografikontrollerinde erken dönemde yineleyen patent duktus arteriozus görülmedi.Sonuç:Prematür bebeklerde patent duktus arteriozusa bağlı doğum sonrasıgelişebilecek mortal ve morbid tabloları engellemek için patent duktusarteriozus, medikal tedavinin başarısız olduğu veya genel durumu kritikmekanik ventilatör bağımlı infantlardaşanta bağlı ikincil organ yetmezliğigelişmeden önce postnatal erken dönemde güvenli bir şekilde kapatılabilir.Öğe Sutureless Aortic Valve Replacement with Minimally Invasive Method: Case Report(Gazi Univ, Fac Med, 2016) Ozer, Abdullah; Ugurlu, Okan; Sarkilar, Gamze; Ege, Erdal; Sarigul, AliTwo patients accepted to our clinic with the diagnosis of aortic stenosis were considered to have high risk for classic surgery and were planned to undergo aortic valve replacement by a minimally invasive procedure with anterior thoracotomy. We believe that, the minimally invasive procedure is much more convenient than classical surgical techniques in patients having high risk for severe aortic stenosis.Öğe Sutureless Aortic Valve Replacement with Minimally Invasive Method: Case Report(Gazi Univ, Fac Med, 2016) Ozer, Abdullah; Ugurlu, Okan; Sarkilar, Gamze; Ege, Erdal; Sarigul, AliTwo patients accepted to our clinic with the diagnosis of aortic stenosis were considered to have high risk for classic surgery and were planned to undergo aortic valve replacement by a minimally invasive procedure with anterior thoracotomy. We believe that, the minimally invasive procedure is much more convenient than classical surgical techniques in patients having high risk for severe aortic stenosis.Öğe Transapical Aortic Valve Implantation in High-Risk Aortic Stenosis: A Case Report(2016) Özer, Abdullah; Dal, İlker; Okan, Uğurlu; Sarkılar, Gamze; Kayrak, Mehmet; Ege, Erdal; Özdemir, Kurtuluş; Sarıgül, AliYetmiş iki yaşında bayan hasta göğüs ağrısı ve solunum sıkıntısı şikayetiyle ekokardiyografiye yönlendirildi, sonrasında ciddi aort darlığı tanısı konuldu. Klinik bakış açısıyla AVR bu vakada çok riskliydi, bu yüzden tedavi seçeneği sol ön torakotomiyle transapikal yaklaşımla TAVI'ydi. Bu olgu sunumunda ülkemizde bu yeni prosedürle olan deneyimimizi paylaşıyoruz.
