Browsing by Author "Onalan, Mehmet A."

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Evaluation of chronic inflammation in the aetiology of venous insufficiency by investigating cytomegalovirus DNA
(TERMEDIA PUBLISHING HOUSE LTD, 2022-01-01) Beyaz, Metin O.; Bozkurt, Emre; Onalan, Mehmet A.; Oztas, Didem M.; Meric, Mert; Ulukan, Mustafa Ozer; Coskun, Ugur; Ugurlucan, Murat
Introduction: Lower extremity venous insufficiency is a significant health problem with economic and sociological consequences, lowering the quality of life, and sometimes leading to serious complications. The aim of this study is to evaluate the cytomegalovirus (CMV) effect on chronic inflammation in the aetiology of chronic venous insufficiency. Material and methods: Between November 2017 and August 2018, 468 patients who underwent radio-frequency ablation therapy and phlebectomy were included in the study. PCR analyses for CMV DNA were performed on the venous tissue samples. Patients with post-thrombotic syndrome were excluded from the study. After ethical approval, the relationship between the presence of CMV DNA, gender, body mass index, and bilaterality of chronic venous insufficiency were investigated. Results: When the relationship between CMV DNA and gender or body mass index was examined, a significant relationship was not detected. But when the patients with bilateral chronic venous insufficiency and patients with unilateral chronic venous insufficiency were compared regarding CMV DNA positivity, the patients with bilateral chronic venous insufficiency had significantly higher CMV DNA positivity (p = 0.002). Also, the incidence of venous ulcers in the CMV DNA exposed group was significantly higher. Conclusions: In the literature there are many studies showing that CMV triggers atherosclerosis, but there is no study in which CMV directly produces chronic venous insufficiency. The high rates of positivity suggest that CMV, which is the basis of chronic inflammation, may be a significant factor in the aetiology of chronic venous insufficiency.
Management of aortic arch hypoplasia in neonates and infants
(WILEY, 2021-01-01) Onalan, Mehmet A.; Temur, Bahar; Aydin, Selim; Basgoze, Serdar; Guzelmeric, Fusun; Odemis, Ender; Erek, Ersin
Objectives Surgical management of aortic arch hypoplasia (AAH) with associated intracardiac anomalies is a challenge in newborns. We reviewed the characteristics and outcomes of neonates and infants who underwent pulmonary artery banding concomitant to arch repair and single-stage total repair at our institution. Methods Medical records of 60 patients undergoing aortic arch reconstruction for AAH from 2014 to 2019 were retrospectively reviewed. Twenty-five patients were female (41.6\%), and the age of the patients ranged from 4 to 120 days (median, 19.5 days). The patients were divided into two groups: Group 1 (23 patients) underwent pulmonary artery banding concomitant to arch repair, and Group 2 (37 patients) underwent single-stage total repair in addition to arch repair. All arch repair procedures consisted of an extended (to the midportion of the ascending aorta) patch aortoplasty. Results Postoperative early mortality occurred in 12 patients, eight in Group 1 (34.8\%) and four in Group 2 (10.8\%). There was an early survival advantage in Group 2 (p = .019). Recoarctation occurred in 13 cases (21.6\%), and 11 (18.3\%) of them required reintervention (balloon angioplasty: 7, reoperation: 4). On univariate analysis, risk factors associated with death were pulmonary artery banding (hazard ratio {[}HR], 0.44
Outcomes of home mechanical ventilation with tracheostomy after congenital heart surgery
(CAMBRIDGE UNIV PRESS, 2021-01-01) Temur, Bahar; Emre, Ismet E.; Aydin, Selim; Onalan, Mehmet A.; Basgoze, Serdar; Ozcan, Esra; Dogruoz, Alper; Erek, Ersin
Objective: After congenital heart surgery, some patients may need long-term mechanical ventilation because of chronic respiratory failure. In this study, we analysed outcomes of the patients who need tracheostomy and home mechanical ventilation. Methods: Amongst 1343 patients who underwent congenital heart surgery between January, 2014 and June, 2018, 45 needed tracheostomy and HMV. The median age of these patients was 6.4 months (12 days-6.5 years). Nineteen patients underwent palliation while 26 patients underwent total repair. Post-operative diaphragm plication was performed in five patients (11\%). Median duration of mechanical ventilation before tracheostomy was 32 days (8-154 days). The patients were followed up with their home ventilators in ward and at home. Mean follow-up time was 36.24 +/- 11.61 months. Results: The median duration of ICU stay after tracheostomy was 27 days (range 2-93 days). Follow-up time in ward was median 30 days (2-156 days). A total of 12 patients (26.6\%) were separated from the ventilator and underwent decannulation during hospital stay. Thirty-two patients (71.1\%) were discharged home with home ventilator support. Of them, 15 patients (46.9\%) were separated from the respiratory support in median of 6 weeks (1 week-11 months) and decannulations were performed. Total mortality was 31.1\%. in which four patients are still HMV dependent. There was no significant difference for decannulation between total repair and palliation patients. Conclusion: HMV via tracheostomy is a useful option for the treatment of children who are dependent on long-term ventilation after congenital heart surgery although there are potential risks.