Araştırma Çıktıları
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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 Simultaneous endovascular stent and renal stent placement for acute type B aortic dissection with malperfusion of kidney(ELSEVIER SCIENCE BV, 2012-01-01) Dagdelen, Sinan; Aydin, Ebuzer; Karabulut, HasanAcute aortic dissection frequently causes life-threatening organ ischemia. The optimal therapy for acute type-B aortic dissection is still controversial. Surgery for acute dissection with organ malperfusion is known to carry a high morbidity and mortality