Araştırma Çıktıları

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Author: search.filters.author.Onalan, Mehmet AkifHas files: Yes

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    DETERMINATION OF LOWER EXTREMITY PERIPHERAL ARTERY DISEASE IN PATIENTS UNDERGOING CAROTID ENDARTERECTOMY
    (ISTANBUL UNIV, FAC MEDICINE, PUBL OFF, 2020-01-01) Onalan, Mehmet Akif; Bahseliyev, Siraslan; Beyaz, Metin Onur; Oztas, Didem Melis; Onal, Yilmaz; Ugurlucan, Murat; Tireli, Emin
    Objective: Atherosclerotic vascular disease is a systemic pathology. The aim of our study was to determine the frequency of lower extremity peripheral artery disease (PAD) in patients who underwent carotid endarterectomy (CEA) and to identify risk factors. Material and Method: The study included 65 patients who underwent carotid endarterectomy in Istanbul Medical Faculty, Department of Cardiovascular Surgery between January 2011 and January 2015. The medical history, physical examination, ankle brachial index and lower extremity duplex ultrasonography results were evaluated and the patients were examined for peripheral artery disease. Results: Among 65 patients, 47 of them were male and 18 of them were female. The patients' ages ranged from 48 to 88 years, with an average of 66.26 +/- 8.84 years. In our study, being above the age of 65 (ODDS ratio (OR) 4.65, 95\% CI: 1.61-13.4), male gender (OR 6.75, 95\% CI: 1.71-26.50), smoking (OR 10.50, 95\% CI: 2.15-51.13), the family history (OR 023, 95\% CI: 0.06-0,80), the presence of chronic renal failure (OR 0.41, 95\% CI: 0.30-0.56) were found to increase peripheral artery disease in patients who underwent carotid endarterectomy statistically significant. In cases with low HDL levels, the frequency of peripheral artery disease was found increased. In our study, peripheral artery disease was detected in 30 (46.2\%) of 65 patients who underwent carotid endarterectomy operation. Conclusion: Due to systemic involvement of atherosclerosis, lower extremity peripheral artery disease should be considered in patients who underwent carotid endarterectomy operation, and patients should be evaluated accordingly.
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    Outcomes of hybrid and Norwood Stage I procedures for the treatment of hypoplastic left heart syndrome and its variants
    (BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2020-01-01) Erek, Ersin; Aydin, Selim; Temur, Bahar; Onalan, Mehmet Akif; Suzan, Dilek; lyigun, Muzeyyen; Demi, lBrahim Halil; Odemis, Ender
    Background: In this study. we present the outcomes of hybrid and Norwood Stage I procedures for the treatment of hypoplastic left heart syndrome and its variants. Methods: In this study, a total of 97 pediatric patients who were operated due to hypoplastic left heart syndrome and its variants between March 2011 and October 2018 were retrospectively analyzed. Thirty-two of the patients (28 males, 4 females: median age 5 days: range, 1 to 25 days) underwent Norwood Stage I operation (Group N). while the remaining 65 patients (44 males, 21 females: median age 6 days: range, 1 to 55 days) underwent a hybrid procedure (Group H). Both treatment strategies were compared. Results: The median body weight in Group H was significantly lower and the number of patients with a low birth weight (<2,500 g) was significantly higher than Group N (p=0.002 and 0.004. respectively). The postoperative early mortality rate was similar between the groups. Univariate and multivariate analyses revealed that the need for preoperative mechanical ventilation was a significant factor for mortality (p=0.004 and 0.003, respectively). Syndromic appearance was also a significant factor the multivariate analysis (p=0.03). There was a statistically significant difference between the groups in terms of the inter-stage mortality rates (p=0.0045). Second-stage procedure was performed in 32 patients. The early mortality rate after the Glenn operation was 7.6\%. Six patients died after comprehensive Stage II operation. Five patients underwent biventricular repair and 8 patients had third-stage fenestrated extracardiac Fontan operation (Group N, n=7 and Group H. n=1). The Kaplan-Meier survival curve demonstrated that Group N had a higher survival rate at both one and five years than Group II. although the difference was not statistically significant (p=0.15). Subgroup analysis showed that the Norwood procedure with Sano modification had the highest survival rate with 40\% at five years. Conclusion: Our study results show that patients undergoing the Norwood procedure have a more uneventful course of inter-stage period and Stage II and III. despite drawbacks early after Stage I procedure. Based on our experiences, we recommend performing the hybrid intervention in patients with a poor clinical condition and a body weight of <2.500 g.
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    Complete sternal cleft treatment in a low birth weight patient
    (BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2020-01-01) Temur, Bahar; Mete, Sarper; Beken, Serdar; Onalan, Mehmet Akif; Erek, Ersin
    A complete sternal cleft is a very rare congenital anomaly causing severe respiratory compromise. Surgical reconstruction options are limited, particularly in low birth weight newborns. Herein, we report a case of low birth weight premature newborn with a complete sternal cleft and its surgical treatment.
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    Management of a primary cardiac leiomyosarcoma in a young woman
    (BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2021-01-01) Onalan, Mehmet Akif; Demirkaya, Ahmet; Behzatoglu, Kemal; Erek, Ersin
    Cardiac leiomyosarcoma is an extremely rare tumor with a poor prognosis. An 18-year-old female patient was admitted to our clinic with a left atrial leiomyosarcoma extending to the right lower pulmonary veins. We performed complete tumor excision by the right anterolateral mini-thoracotomy approach using minimally invasive techniques. After pathological confirmation of the tumor, right lower lobectomy was performed with the same incision one week later to prevent recurrence. Although no tumor remnant was found in the lobectomy specimen, adjuvant chemotherapy was started. No recurrence was detected during the 12-month follow-up. In conclusion, the right submammarian minithoracotomy approach has the advantages of its less invasive nature and suitability for complete tumor resection with lobectomy.