Browsing by Author "Zencirci, Ertugrul"

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    An analysis of the learning curve for robotic-assisted mitral valve repair
    (WILEY, 2021-01-01) Gullu, Ahmet U.; Senay, Sahin; Kocyigit, Muharrem; Zencirci, Ertugrul; Akyol, Ahmet; Degirmencioglu, Aleks; Karakus, Gultekin; Ersin, Egemen; Karabiber, Alara; Alhan, Cem
    Background Many cardiac surgeons receive training for sternotomy-based cardiac surgical operations in residency programs and only a few education programs offer training specifically in minimally invasive cardiac surgery. In this report, we aimed to search and analyze the learning curve for robotic-assisted mitral valve (MV) repair in cardiac surgeons. Method Between January 2010 and July 2019, 60 robotic-assisted isolated MV repair surgeries were performed with DaVinci Robotic Systems in our center. Different kinds of surgical techniques were used. The assessment of the learning curve was based on cardiopulmonary bypass (CPB) and transthoracic aortic clamp (CC) times. Result There were 23 (38.3\%) men and 37 (61.7\%) women with a mean age of 48.3 years. The lesions of the MV were posterior leaflet prolapsus (n = 42, 70.0\%), anterior leaflet prolapsus (n = 8, 13.3\%), Barlow disease (n = 3, 5\%), and annular dilatation (n = 7, 11.6\%). The patients underwent notochordal implantation (n = 27, 45\%), quadrangular or triangular resection (n = 23, 38.3\%), isolated ring annuloplasty (n = 7, 11.7\%), resection, and leaflet reduction (n = 2, 3.3\%) or edge to edge repair (n = 1, 1.7\%). The maturation of the learning curve appeared to be about 30 cases. The statistical analysis showed that the mean CPB and CC times for the first 30 cases were greater compared with the 30 after learning curve (155.3 vs. 118.9 min {[}p = .00], 102.3 vs. 80 min {[}p = .00], respectively). There was no case of conversion to open surgery. No perioperative mortality was observed. Conclusion The maturation of the learning curve for robotic-assisted MV repair appeared to be about 30 cases in our group of patients. This study had encouraging results for surgeons who desire to start a robotic mitral surgery program.
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    Application of cryoablation for the treatment of atrial fibrillation in patients undergoing cardiac surgery: Our mid-term results
    (BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2018-01-01) Arnaz, Ahmet; Gullu, A. Umit; Akyol, Ahmet; Zencirci, Ertugrul; Senay, Sahin; Degirmencioglu, Aleks; Kocyigit, Muharrem; Alhan, Cem
    Background: In this study, we aimed to present mid-term results of concomitant argon-based cryoablation in patients undergoing cardiac surgery. Methods: Between August 2014 and May 2016, 33 patients (17 males, 16 females
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    Catheter entrapment due to severe radial artery spasm during transradial approach
    (VIA MEDICA, 2016-01-01) Zencirci, Ertugrul; Degirmencioglu, Aleks
    Background: Catheter entrapment due to severe radial artery spasm (RAS) during transradial coronary catheterization has been rarely reported and its management is not precisely defined. The aim of this study was to determine the incidence, predictors and management of catheter entrapment due to severe RAS. Methods: A total of 723 patients undergoing transradial coronary catheterization at a single center were retrospectively enrolled in the present study. Patients were divided into two groups: those with catheter entrapment due to severe RAS and those without. Results: The incidence of catheter entrapment was 0.8\%. Height (161.2 +/- 9.1 cm vs. 169.6 +/- +/- 10 cm, p = 0.047) and body surface area (1.86 +/- 0.04 vs. 1.95 +/- 0.18, p = 0.002) were found to be lower, and total procedure time 33.2 +/- 13.4 min vs. 15.2 +/- 12.3 min, p < 0.001) was longer in the entrapment group. Multivariate logistic regression analysis demonstrated that total procedure time independently predicted catheter entrapment (odds ratio: 1.057, 95\% confidence interval {[}CI] 1.004-1.114, p = 0.035). Receiver-operating characteristic curve demonstrated good diagnostic accuracy for prolonged total procedure time in predicting catheter entrapment (area under curve = 0.8, 95\% CI 0.63-0.97, p = 0.01). Patients were effectively treated with stepwise administration of systemic vasodilators, forearm heating, sedation and as a last resort general anesthesia with no significant complication. Conclusions: Catheter entrapment due to severe RAS during transradial approach was rare and prolonged total procedure time is an independent predictor of catheter entrapment. Treatment with stepwise administration of different treatment modalities is possible with no significant complication.
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    Comparison of Pericardiocentesis in Post-Cardiac Surgery and Nonsurgical Patients with Pericardial Tamponade
    (SOC BRASIL CIRURGIA CARDIOVASC, 2022-01-01) Degirmencioglu, Aleks; Karakus, Gultekin; Zencirci, Ertugrul; Gullu, Ahmet Umit; Senay, Sahin
    Introduction:There are several approaches for pericardiocentesis. However, there is no definite suggestion about puncture location after cardiac surgery. The purpose of this study is to examine whether there is any difference regarding puncture location during pericardiocentesis in postoperative cardiac tamponade comparing to nonsurgical cardiac tamponade. Methods: We retrospectively analyzed patients who had undergone pericardiocentesis from August 2011 to December 2019. Patients were examined in two groups, nonsurgical and postsurgical, based on the etiology of pericardial tamponade. Clinical profiles, echocardiographic findings, and procedural outcomes were identified and compared. Results: Sixty-eight pericardiocenteses were performed in this period. The etiology of pericardial effusion was cardiac surgery in 27 cases and nonsurgical medical conditions in 41 cases. Baseline demographic variables were similar between the surgical and nonsurgical groups. Loculated effusion was more common in the postsurgical group (48.1\% vs. 4.9\%, P<0.001). Maximal fluid locations were different between the groups
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    The Association between Subclinical Hypothyroidism and Epicardial Adipose Tissue Thickness
    (KOREAN SOC CARDIOLOGY, 2015-01-01) Belen, Erdal; Degirmencioglu, Aleks; Zencirci, Ertugrul; Tipi, Fatih Fahri; Altun, Ozgur; Karakus, Gultekin; Helvaci, Aysen; Zencirci, Aycan Esen; Kalaycioglu, Ezgi
    Background and Objectives: Subclinical hypothyroidism (SH) is considered to be a potential risk factor for cardiovascular disease. Epicardial adipose tissue (EAT) thickness is also closely related to cardiovascular disorders. The aim of this study was to evaluate whether SH is associated with higher EAT thickness. Subjects and Methods: Fifty-one consecutive patients with SH and 51 healthy control subjects were prospectively enrolled into this trial. Thyroid hormone levels, lipid parameters, body mass index, waist and neck circumference, and EAT thickness measured by echocardiography were recorded in all subjects. Results: Mean EAT thickness was increased in the SH group compared to the control group (6.7 +/- 1.4 mm vs. 4.7 +/- 1.2 mm, p<0.001). EAT thickness was shown to be correlated with thyroid stimulating hormone level (r=0.303, p=0.002). Multivariate logistic regression analysis revealed that EAT thickness was independently associated with SH \{odds ratio (OR): 3.87, 95\% confidence interval (Cl): 1.92-7.78, p<0.001
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    The Effect of Mild Left Ventricular Diastolic Dysfunction on Outcome After Isolated Coronary Bypass Surgery
    (2020-01-01) Degirmencioglu, Aleks; Senay, Sahin; Gullu, Umit; Karakus, Gultekin; Zencirci, Ertugrul; Buturak, Ali; Ugur, Murat; Gemici, Gokmen; Akyol, Ahmet; Celik, Seden Erten; Alhan, Cem