Araştırma Çıktıları

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Author: search.filters.author.Alhan, Cem

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    Current state of the art and recommendations in robotic mitral valve surgery
    (OXFORD UNIV PRESS, 2022-01-01) Palmen, Meindert; Navarra, Emiliano; Bonatti, Johannes; Franke, Ulrich; Cerny, Stepan; Musumeci, Francesco; Modi, Paul; Singh, Sandeep; Sandoval, Elena; Pettinari, Matteo; Segers, Patrique; Gianoli, Monica; van Praet, Frank; de Praetere, Herbert; Vojacek, Jan; Cebotaru, Theodor; Onan, Burak; Bolcal, Cengiz; Alhan, Cem; Ouda, Ahmed; Melly, Ludovic; Malapert, Ghislain; Labrousse, Louis; Agnino, Alfonso; Phillipsen, Tine; Jansens, Jean-Luc; Folliguet, Thierry; Suwalski, Piotr; Cathenis, Koen; Doguet, Fabien; Tomsic, Anton; Oosterlinck, Wouter; Pereda, Daniel
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    Robotic Cardiac Surgery in Europe: Status 2020
    (FRONTIERS MEDIA SA, 2022-01-01) Cerny, Stepan; Oosterlinck, Wouter; Onan, Burak; Singh, Sandeep; Segers, Patrique; Bolcal, Cengiz; Alhan, Cem; Navarra, Emiliano; Pettinari, Matteo; Van Praet, Frank; De Praetere, Herbert; Vojacek, Jan; Cebotaru, Theodor; Modi, Paul; Doguet, Fabien; Franke, Ulrich; Ouda, Ahmed; Melly, Ludovic; Malapert, Ghislain; Labrousse, Louis; Gianoli, Monica; Agnino, Alfonso; Philipsen, Tine; Jansens, Jean-Luc; Folliguet, Thierry; Palmen, Meindert; Pereda, Daniel; Musumeci, Francesco; Suwalski, Piotr; Cathenis, Koen; van den Eynde, Jef; Bonatti, Johannes; CardioThoracic, European Robotic
    BackgroundEuropean surgeons were the first worldwide to use robotic techniques in cardiac surgery and major steps in procedure development were taken in Europe. After a hype in the early 2000s case numbers decreased but due to technological improvements renewed interest can be noted. We assessed the current activities and outcomes in robotically assisted cardiac surgery on the European continent. MethodsData were collected in an international anonymized registry of 26 European centers with a robotic cardiac surgery program. ResultsDuring a 4-year period (2016-2019), 2,563 procedures were carried out {[}30.0\% female, 58.5 (15.4) years old, EuroSCORE II 1.56 (1.74)], including robotically assisted coronary bypass grafting (n = 1266, 49.4\%), robotic mitral or tricuspid valve surgery (n = 945, 36.9\%), isolated atrial septal defect closure (n = 225, 8.8\%), left atrial myxoma resection (n = 54, 2.1\%), and other procedures (n = 73, 2.8\%). The number of procedures doubled during the study period (from n = 435 in 2016 to n = 923 in 2019). The mean cardiopulmonary bypass time in pump assisted cases was 148.6 (63.5) min and the myocardial ischemic time was 88.7 (46.1) min. Conversion to larger thoracic incisions was required in 56 cases (2.2\%). Perioperative rates of revision for bleeding, stroke, and mortality were 56 (2.2\%), 6 (0.2 \%), and 27 (1.1\%), respectively. Median postoperative hospital length of stay was 6.6 (6.6) days. ConclusionRobotic cardiac surgery case numbers in Europe are growing fast, including a large spectrum of procedures. Conversion rates are low and clinical outcomes are favorable, indicating safe conduct of these high-tech minimally invasive procedures.
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    Robotic coronary revascularization in Europe, state of art and future of EACTS-endorsed Robotic Cardiothoracic Surgery Taskforce
    (OXFORD UNIV PRESS, 2022-01-01) Pettinari, Matto; Gianoli, Monica; Palmen, Meindert; Cerny, Stepan; Onan, Burak; Singh, Sandeep; Segers, Patrique; Bolcal, Cengiz; Alhan, Cem; Navarra, Emiliano; De Praetere, Herbert; Vojacek, Jan; Cebotaru, Theodor; Modi, Paul; Doguet, Fabien; Franke, Ulrich; Ouda, Ahmed; Melly, Ludovic; Malapert, Ghislain; Labrousse, Louis; Agnino, Alfonso; Philipsen, Tine; Jansens, Jean-Luc; Folliguet, Thierry; Pereda, Daniel; Musumeci, Francesco; Suwalski, Piotr; Cathenis, Koen; Van Praet, Frank; Bonatti, Johannes; Oosterlinck, Wouter; ERCTS
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    Robotic Cardiac Surgery in Europe: Status 2020 (vol 8, 827515, 2022)
    (FRONTIERS MEDIA SA, 2022-01-01) Cerny, Stepan; Oosterlinck, Wouter; Onan, Burak; Singh, Sandeep; Segers, Patrique; Bolcal, Cengiz; Alhan, Cem; Navarra, Emiliano; Pettinari, Matteo; Van Praet, Frank; De Praetere, Herbert; Vojacek, Jan; Cebotaru, Theodor; Modi, Paul; Doguet, Fabien; Franke, Ulrich; Ouda, Ahmed; Melly, Ludovic; Malapert, Ghislain; Labrousse, Louis; Gianoli, Monica; Agnino, Alfonso; Philipsen, Tine; Jansens, Jean-Luc; Folliguet, Thierry; Palmen, Meindert; Pereda, Daniel; Musumeci, Francesco; Suwalski, Piotr; Cathenis, Koen; van den Eynde, Jef; Bonatti, Johannes; European Robotic Cardio Throcic Surgeons, E. R. T. C.
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    Microcirculatory Response to Blood vs. Crystalloid Cardioplegia During Coronary Artery BypassGrafting With Cardiopulmonary Bypass
    (FRONTIERS MEDIA SA, 2022-01-01) Aykut, Gueclue; Ulugoel, Halim; Aksu, Ugur; Akin, Sakir; Karabulut, Hasan; Alhan, Cem; Toraman, Fevzi; Ince, Can
    Background: Blood cardioplegia attenuates cardiopulmonary bypass (CPB)-induced systemic inflammatory response in patients undergoing cardiac surgery, which may favorably influence the microvascular system in this cohort. The aim of this study was to investigate whether blood cardioplegia would offer advantages over crystalloid cardioplegia in the preservation of microcirculation in patients undergoing coronary artery bypass grafting (CABG) with CPB.Methods: In this prospective observational cohort study, 20 patients who received crystalloid (n = 10) or blood cardioplegia (n = 10) were analyzed. The microcirculatory measurements were obtained sublingually using incident dark-field imaging at five time points ranging from the induction of anesthesia (T-0) to discontinuation of CPB (T-5).Results: In the both crystalloid {[}crystalloid cardioplegia group (CCG)] and blood cardioplegia {[}blood cardioplegia group (BCG)] groups, perfused vessel density (PVD), total vessel density (TVD), and proportion of perfused vessels (PPV) were reduced after the beginning of CPB. The observed reduction in microcirculatory parameters during CPB was only restored in patients who received blood cardioplegia and increased to baseline levels as demonstrated by the percentage changes from T-0 to T-5 (\%Delta)(T0-T5) in all the functional microcirculatory parameters {[}\%Delta TVDT0-T5(CCG): -10.86 +/- 2.323 vs. \%Delta TVDT0-T5(BCG): 0.0804 +/- 1.107, p < 0.001
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    Validation of the EuroSCORE risk models in Turkish adult cardiac surgical population
    (OXFORD UNIV PRESS INC, 2011-01-01) Akar, Ahmet Ruchan; Kurtcephe, Murat; Sener, Erol; Alhan, Cem; Durdu, Serkan; Kunt, Ayse Gul; Guvenir, Halil Altay; Cardiovasc, Working Grp Turkish Soc
    Objective: The aim of this study was to validate additive and logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) models on Turkish adult cardiac surgical population. Methods: TurkoSCORE project involves a reliable web-based database to build up Turkish risk stratification models. Current patient population consisted of 9443 adult patients who underwent cardiac surgery between 2005 and 2010. However, the additive and logistic EuroSCORE models were applied to only 8018 patients whose EuroSCORE determinants were complete. Observed and predicted mortalities were compared for low-, medium-, and high-risk groups. Results: The mean patient age was 59.5 years (+/- 12.1 years) at the time of surgery, and 28.6\% were female. There were significant differences (all p < 0.001) in the prevalence of recent myocardial infarction (23.5\% vs 9.7\%), moderate left ventricular function (29.9\% vs 25.6\%), unstable angina (9.8\% vs 8.0\%), chronic pulmonary disease (13.4\% vs 3.9\%), active endocarditis (3.2\% vs 1.1\%), critical preoperative state (9.0\% vs 4.1\%), surgery on thoracic aorta (3.7\% vs 2.4\%), extracardiac arteriopathy (8.6\% vs 11.3\%), previous cardiac surgery (4.1\% vs 7.3\%), and other than isolated coronary artery bypass graft (CABG
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    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 Umit
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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
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    Robotic mitral valve replacement
    (AME PUBLISHING COMPANY, 2022-01-01) Arslanhan, Gokhan; Senay, Sahin; Kocyigit, Muharrem; Gullu, Ahmet Umit; Alhan, Cem
    Background: 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.
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    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, Fevzi
    Aim: 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.