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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item Comparative Effects of Blood and Crystalloid Cardioplegia on Cellular Injury and Oxidative Stress in Cardiovascular Surgery(MEDICAL TRIBUNE INC, 2019-01-01) Ulugol, Halim; Aksu, Ugur; Kocyigit, Muharrem; Kilercik, Meltem; Karduz, Gulsum; Okten, Murat; Toraman, FevziPurpose: The purpose of this study was to evaluate the effect of different cardioplegic solutions on endothelial integrity and oxidative stress in cardiovascular surgery. Methods: In this randomized prospective study, after ethics approval and informed consent, 60 surgical patients were included. Patients undergoing coronary bypass surgery were randomized into two groups as warm blood cardioplegia (n = 30) and cold crystalloid cardioplegia (n = 30) following the cross-clamping. Measurements were performed at three time points: before induction of anesthesia (Ti), at admission to intensive care unit (ICU) (T2) and at the 24th postoperative hour (T3). Besides biochemical routine hemodynamic monitoring, patients were assessed for the sialic acid (SA), ischemic-modified albumin (IMA), advanced oxide protein products (AOPPs), total thiol (SH), and free hemoglobin (fHb) level. Results: Neither crystalloid nor blood cardioplegia led to significant changes in the AOPPs, T-SH, and SA level (p >0.05). Crystalloid cardioplegia, however, increased IMA level compared to both baseline (p <0.01) and blood cardioplegia group (p <0.05). fHb levels were transiently increased in both groups at the second-time point (p <0.001). fHb level was lower in the crystalloid group compared to that in the other group (p <0.05) at T2. Conclusion: Cardioplegia type creates similar effects on glycocalyx integrity. However, myocardial protection could be provided with warm blood cardioplegia.Item A simple method for occlusion of both venae cavae in total cardiopulmonary bypass for robotic surgery(OXFORD UNIV PRESS, 2012-01-01) Gullu, Ahmet Umit; Senay, Sahin; Kocyigit, Muharrem; Alhan, CemWe describe a novel surgical technique for occlusion of the superior and inferior venae cavae which allows opening of the right atrium safely during robotic cardiac surgery.Item Robotic-assisted beating heart surgery provides precise repair of periprosthetic mitral valvular leak(OXFORD UNIV PRESS, 2022-01-01) Kocyigit, Muharrem; Gullu, Ahmet Umit; Senay, Sahin; Alhan, CemThe prosthetic paravalvular leak is a rare but important complication following mitral valve replacement. Determining the location of the leak is almost always dependent on perioperative transoesophageal echocardiography and the considerable expertise of echo operators. Acoustic shadowing due to the prosthetic valve may create another important difficulty. In this report, we present a case with a paravalvular leak diagnosed 1 year after mitral valve replacement. Beating heart surgery and robotic 3D/high-resolution camera provided to localize the direct location of leak coherent with perioperative echocardiography and precise repair. The robotic approach prevented the potential complications of aortic cross-clamp and resternotomy. The paravalvular leak is one of the most important complications of mitral valve replacement surgery with a prevalence of 2-13\% {[}1, 2].Item Postoperative Atrial Fibrillation Reduced by Intraoperative and Postoperative Cell Saver System in Coronary Artery Bypass Graft Surgery(AVES, 2022-01-01) Kocyigit, Muharrem; Kocyigit, Ozgen Ilgaz; Gullu, Ahmet Umit; Senay, Sahin; Alhan, CemObjective: Postoperative atrial fibrillation is commonly seen after cardiac surgery. One of the contributing factors is mediastinal shed blood and inflammation. Cell salvage techniques can reduce allogenic blood transfusion and reduce inflammation. The aim of this study was to investigate the reduction of postoperative atrial fibrillation by using the cell-salvage system. Methods: Patients who underwent isolated coronary artery bypass graft surgery (n = 498) were analyzed retrospectively in 2 groups. Postoperative atrial fibrillation group (n = 75) and non-postoperative atrial fibrillation group (n = 423). Preoperative and postoperative demographic and clinical data were compared between the 2 groups, respectively. Postoperative atrial fibrillation and possible contributing factors were analyzed with multinomial logistic regression analysis. Results: In the postoperative atrial fibrillation group, the patients' age and European System for Cardiac Operative Risk Evaluation (Euroscore) were higher than in the non-postoperative atrial fibrillation group (P = .001 and P = .003, respectively). Postoperative intensive care unit stay and hospital stay were longer in the postoperative atrial fibrillation group than in the non-postoperative atrial fibrillation group (P =.001 and P = .046, respectively). There were no statistical differences in mortality between groups. The incidence of postoperative atrial fibrillation decreased with the use of cell saver system and low Euroscore. Conclusion: The use of a cell salvage device intraoperatively and during the early postoperative period can decrease the incidence of postoperative atrial fibrillation group.Item Aortic valve reconstruction with autologous pericardium in a patient with osteogenesis imperfecta(OXFORD UNIV PRESS, 2018-01-01) Gullu, A. Umit; Senay, Sahin; Ozkan, Basak; Kocyigit, Muharrem; Alhan, CemCardiac valve surgery for patients with osteogenesis imperfecta is associated with a high incidence of complications such as perioperative bleeding and valve detachment. In this report, we present a patient who was diagnosed with osteogenesis imperfecta and severe aortic insufficiency and also discussed treatment options.