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Item National guidelines on the management of venous thromboembolism: Joint guideline of the Turkish Society of Cardiovascular Surgery, National Society of Vascular and Endovascular Surgery, and Phlebology Society(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2021-01-01) Bozkurt, Ahmet Kursat; Akay, Hakki Tankut; Calkavur, Ismet Tanzer; Sirlak, Mustafa; Balkanay, Ozan Onur; Uguz, Emrah; Doganci, Suat; Polat, Adil; Bayrak, Serdar; Bozok, Sahin; Durukan, Ahmet Baris; Erdil, Nevzat; Erer, Dilek; Senay, Sahin; Unal, Ertekin Utku; Yavas, SonerThese evidence-based guidelines from the Turkish Society of Cardiovascular Surgery, National Society of Vascular and Endovascular Surgery, and Phlebology Society intend to support clinicians in best decisions regarding the treatment of venous thromboembolism (VTE). The Editor was selected by the three national societies and was tasked with the recruitment of the recognized panel. All financial support was solely derived from the sponsoring societies without the direct involvement of industry or other external stakeholders. The panel prioritized clinical questions and outcomes according to their importance for clinicians in terms of VTE. The panel agreed on 42 recommendations under 15 headings for the diagnosis, initial management, secondary prevention of VTE, and treatment of recurrent VTE events. Important recommendations included the use of ultrasonography, preference for home treatment over hospital treatment for uncomplicated VTE, preference for direct oral anticoagulants (DOACs) over vitamin K antagonists for primary treatment of cancer and non-cancer-related VTE, extended or indefinite anticoagulation with DOACs in selected high-risk patients. Early catheter-directed thrombectomy was recommended in only young symptomatic patients with a diagnosis of fresh iliofemoral deep vein thrombosis.Item Robot-assisted mitral valve surgery without aortic cross-clamping: An alternative technique(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2021-01-01) Alhan, Cem; Senay, Sahin; Kocyigit, Muharrem; Kilic, Leyla; Celik, Ozlem; Whitham, Tarik; Gullu, Ahmet UmitItem 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, CemItem Robotic mitral valve replacement(AME PUBLISHING COMPANY, 2022-01-01) Arslanhan, Gokhan; Senay, Sahin; Kocyigit, Muharrem; Gullu, Ahmet Umit; Alhan, CemBackground: This study evaluates the clinical outcome of patients with robotic mitral valve replacement (MVR).Methods: Between January 2010 and April 2022, 117 consecutive patients underwent robotic MVR with or without additional cardiac procedures. All procedures were completed by a single surgical team with Da Vinci Robotic Systems. Perioperative variables and early clinical outcomes were recorded.Results: Mean age and EuroScore II of the patients were 57.1 +/- 12.9 and 5.1 +/- 5.7, respectively. Isolated MVR was performed in 55 (47.0\%) patients and combined cardiac procedures were performed in 62 (53.0\%) patients. Additional procedures included: ablation for atrial fibrillation, tricuspid valve replacement, tricuspid valve repair, left atrial appendix ligation, patent foramen ovale closure, left atrial thrombectomy and septal myectomy for hypertrophic obstructive cardiomyopathy. Mean cardiopulmonary bypass time and cross clamp time were 143 +/- 54 and 93 +/- 37 minutes, respectively. Mean intensive care unit stay time was 26.5 +/- 26.0 hours. Postoperative stroke was observed in one (0.9\%) patient and new onset renal failure was observed in two (1.7\%) patients. Perioperative and postoperative early mortality was observed in three (2.6\%) patients, which was lower than expected.Conclusions: Robotic MVR is feasible and can be performed with good early postoperative outcomes. A majority of the patients require additional cardiac procedures.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 Long-term results of coronary surgery with endoscopic vein harvesting(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2021-01-01) Kilic, Leyla; Gullu, Ahmet Umit; Senay, Sahin; Ersin, Egemen; Celik, Ozlem; Guzel, Emine; Caliskan, Neriman Ozge; Kocyigit, Muharrem; Alhan, CemBackground: In this study, we aimed to evaluate early and long-term outcomes of both isolated or concomitant coronary artery bypass grafting with the endoscopic vein harvesting technique. Methods: Between November 2012 and May 2017, a total of 324 patients (259 males, 65 femalesItem Leyla loop: a time-saving suture technique for robotic atrial closure(OXFORD UNIV PRESS, 2013-01-01) Kilic, Leyla; Senay, Sahin; Gullu, A. Umit; Alhan, CemThe longer durations of cardiopulmonary bypass and aortic cross-clamp times remain the disadvantages of robotic or minimally invasive cardiac surgery. For this reason, every small contribution to speeding up these procedures is of the utmost importance. Here, we present a practical, easy and time-saving suture technique for atrial closure. It consists of a hand-made loop at one end of the suture and saves the time otherwise consumed by knotting. It may also be used during conventional or minimally invasive cardiac surgery.Item Replacement of the Ascending Aorta for Severe Atherosclerosis During Coronary Artery Bypass Surgery(WILEY, 2012-01-01) Gullu, Ahmet Umit; Okten, Eyup Murat; Akay, Mehmet Hakan; Senay, Sahin; Kocyigit, Muharrem; Toraman, Fevzi; Karabulut, E. Hasan; Alhan, CemBackground and Aim: In the present study, we investigated the benefit of ascending aorta replacement in patients with severe aortic atherosclerosis who undergo coronary artery bypass surgery (CABG). Methods: From January 2001 to April 2011, 3842 patients underwent CABG and in 36 of these patients (31 male, 5 female) the ascending aorta was replaced due to severe atherosclerosis. Total circulatory arrest was used in 22 patients (61\%). The patients were followed for 69 +/- 36 months (1-133 months) and compared to a control group of patients. The control group consisted of patients who underwent CABG with or without a concomitant procedure (n = 3806). Results: For the study group, the mean additive and logistic Euroscores of the patients were nine and 20, respectively. One stroke (2.8\%) was observed and this patient died in the early postoperative period. There were a total of four confirmed deaths (12\%) at any time point over the length of the follow-up among the patients who were discharged from the hospital. Two of them died of malignancy (lung and gastric tumors) and the other two from cardiac reasons. No patients had a stroke during follow-up. For the control group the mean age was 61 +/- 1, the stroke rate was 0.6\%, and the mortality rate was 0.96\%, and the mean logistic and additive Euroscores were 3.7 +/- 4.4, and 3.5 +/- 2.5, respectively. Conclusions: Replacement of highly calcified ascending aortas during CABG can be safely performed in selected patients with good long-term outcomes. doi: 10.1111/j.1540-8191.2012.01510.x (J Card Surg 2012Item Robotic mitral valve replacement for rheumatic mitral disease(AME PUBL CO, 2017-01-01) Senay, Sahin; Gullu, Ahmet Umit; Alhan, CemItem Hybrid treatment of type B aortic dissection with retrograde extension in a patient with anomalous aortic arch(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2018-01-01) Cacur, Orkun; Ozkan, Basak; Gullu, Ahmet Umit; Senay, Sahin; Alhan, CemHybrid treatment of aortic arch encompasses a combination of endovascular stenting with surgical revascularization of supra-aortic branches. Herein, we report a 53-year-old male case of type B aortic dissection with retrograde extension and anomalous aortic arch. The patient was successfully treated by hybrid treatment using bilateral carotico-subclavian bypass grafting and endovascular stent grafting.
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