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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item Use of bone wax is related to increased postoperative sternal dehiscence(TERMEDIA PUBLISHING HOUSE LTD, 2014-01-01) Alhan, Cem; Ariturk, Cem; Senay, Sahin; Okten, Murat; Gullu, A. Umit; Kilic, Leyla; Karabulut, Hasan; Toraman, FevziAim: To investigate the relation between use of bone wax and postoperative sternal dehiscence after cardiac surgery. Material and methods: Five thousnad three hundred and eighteen consecutive patients who underwent cardiac surgery between 1999 and 2009 were evaluated prospectively. Perioperative use of bone wax, perioperative data and outcome parameters were recorded. Multivariate logistic regression analysis was performed to define independent risk factors for postoperative sternal dehiscence. Results: Bone wax was used in a total of 1151 (21\%) patients. Postoperative sternal dehiscence was detected in 88 (1.6\%) patients. The postoperative sternal dehiscence rate was 1.4\% in patients without bone wax and 2.5\% in patients with bone wax (p = 0.001). The rate of bone wax use was 36.4\% in patients with sternal dehiscence and 21.4\% in patients without sternal dehiscence (p < 0.001). Independent risk factors for postoperative sternal dehiscence were defined as: age > 70 (OR = 1.9, 95\% CI: 1.2-3.1, p = 0.005), chronic obstructive lung disease (OR = 2.4, 95\% CI: 1.5-3.9, p < 0.001), use of bone wax (OR = 1.6, 95\% CI: 1.03-2.5, p = 0.03), nonelective operation (OR = 2, 95\% CI: 1.1-3.4, p = 0.009), and body mass index > 30 (OR = 2.2, 95\% CI: 1.4-3.5, p < 0.001). Conclusions: Our findings suggest that use of bone wax may be associated with increased postoperative sternal dehiscence after cardiac surgery. Thus liberal use of bone wax should be restricted.Item A hybrid therapy as a third approach for type 1 proximal endoleak of thoracic endovascular aortic replacement: Caroticocarotid bypass and re-redo endovascular therapy(ELSEVIER SCIENCE BV, 2013-01-01) Ariturk, Cem; Okten, Murat; Dagdelen, Sinan; Toraman, Fevzi; Karabulut, HasanIntroduction: In selected cases with thoracic aortic aneurysm (TAA), thoracic endovascular aortic replacement (TEVAR) is commonly used and shall be proper therapy method. We are presenting a case of TAA previously treated twice by endovascular aortic approaches and complicated by type 1 endoleak. Case: A 67-year-old male patient was admitted to our clinic with back pain at rest. He underwent TEVAR five years ago, twice in 6 month. With contrasted computed tomography of chest and abdomen, a new type 1 proximal endoleak was diagnosed, and after routine preoperative follow up, the patient was operated on. At the same session right to left caroticocarotid bypass and re-redo TEVAR were performed. The new endovascular graft was placed as the proximal landing zone to be set between left carotid artery and brachiocephalic truncus. The patient was discharged on postoperative day 4 without any problems. Conclusion: As new techniques and methods have been developed, mortality rates have decreased to 2-3\% but in older and high risk patients, mortality rates still remain high {[}1]. TEVAR is a safe and effective treatment method in the proper and selected patients with thoracic artery aneurysm {[}2]. Moreover, TEVAR can also be performed as a part of hybrid procedures for arcus aortic aneurysms {[}3]. But it should be kept in mind that late secondary intervention rates are higher in TEVAR. (C) 2013 Production and hosting by Elsevier B.V. on behalf of King Saud University.Item A complex aortic arch anomaly: A rarely seen image(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2019-01-01) Ariturk, Cem; Baran, Reha; Kara, SimayItem Is the Nexfin finger cuff method for cardiac output measurement reliable during coronary artery bypass grafting? A prospective comparison with the echocardiography and FloTrac/Vigileo methods(TUBITAK SCIENTIFIC \& TECHNICAL RESEARCH COUNCIL TURKEY, 2016-01-01) Ariturk, Cem; Acil, Meltem; Ulugol, Halim; Ozgen, Zehra Serpil Ustalar; Okten, Eyup Murat; Dagdelen, Sinan; Karabulut, Esref Hasan; Alhan, Huseyin Cem; Toraman, FevziBackground/aim: The aim of the current study was to assess the accuracy of cardiac output (CO) measurements obtained by the Nexfin finger cuff method as compared with the FloTrac/Vigileo and echocardiography methods in coronary artery bypass grafting (CABG) patients. Materials and methods: First-time elective CABG patients were prospectively enrolled in this study and divided into three groups according to CO measurement method. CO measurements were performed simultaneously by three different contributors and were collected by the fourth one 24 h postoperative in the intensive care unit (ICU). Data were statistically analyzed. Results: Seventeen female and 13 male patients between 42 and 78 years of age (with a mean of 56 +/- 4) were the subjects of this study. The mean CO measurements were 5.9 +/- 1.4 L/min, 5.8 +/- 1.1 L/min, and 6.0 +/- 1.1 L/min for the Nexfin, FloTrac/Vigileo, and echocardiography methods, respectively (P > 0.05). The correlation values between Nexfin and FloTrac/Vigileo, Nexfin and echocardiography, and FloTrac/Vigileo and echocardiography were r = 0.445, r = 0.377, and r = 0.384, respectively (P < 0.05). Conclusion: Nexfin yielded results comparable to those obtained with FloTrac/Vigileo and echocardiography for the postoperative CO assessment of CABG patients. Nexfin may be used in uncomplicated, hemodynamically stable patients in ICU as a reliable and totally noninvasive method of CO measurement.