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    Effect of two different heparin neutralization methods on postoperative drainage in open heart surgery
    (Gulhane Askeri Tip Akademisi, 2002) Ege T.; Çikirikçio?lu M.; Arar C.; Acipayam M.; Duran E.
    Introduction and Aim: To define the changes in activated coagulation time (ACT) and postoperative drainage volume with two different heparin neutralization methods in patients who had coronary bypass surgery. Material and Methods: 53 patients who had coronary bypass surgery between January 1, 2002 and July 31,2002 at Trakya University Faculty of Medicine Department of Cardiovascular Surgery were taken into the study. Patients were separated into two groups randomly. The patients that were applied protamine, 1.3 folds of total heparin during the operation were as group 1 (n=29) and the patients that heparin neutralization was applied by the calculation of protamine dosage with a graphic at the end of cardiopulmonary bypass (CPB) were as group 2 (n=24). Postoperative ACT and drainage volumes of the groups were compared. Findings: Among groups there was no significent difference in terms of age, sex, body mass index, number of grafts, CPB time, cross clamp time, EF and use of LIMA. There was no significent difference in ACT values 5 minutes after protamine application (Group 1= 129.8± 12.6 sec, Group 2= 128.5± 14.1 sec). In group 1, ACT values at 2, 4 and 6 hours after protamine application (131.9± 19.2, 129.129.2± 11.5 and 127.0± 9.2 sec) were prominently higher than in group 2 (118.5± 13.5, 114.4± 9.6 and 111.9± 10.9 sec).
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    The efficacy of vitamin E in the prevention of lung ischemia-reperfusion injury after cardiopulmonary bypass in open heart surgery
    (Turkiye Klinikleri, 2013) Acipayam M.; Sunar H.; Canbaz S.; Hüseyinova G.; Erbaş H.; Erten O.; Duran E.
    Objective: The purpose of the study was to investigate the effects of vitamin E in the protection of the lung from potential ischemia-reperfusion injury during elective coronary artery bypass graft surgery. Material and Methods: This controlled randomized single-center study included patients who underwent elective coronary bypass grafting (CABG) operation. Forty-nine patients were randomly divided into 2 groups. Water soluble Vitamin E (100 mg) in tepid saline (n=25) or tepid saline alone (n=24) was administered via the jugular vein before the aortic cross clamping. Serum total antioxidant capacity (TAC) levels and serum malonedialdehyde levels (MDA) were measured. Pulmonary biopsies were obtained before the aortic cross clamping and 60 minutes after removing the cross clamp. Biopsies were examined histopathologically under electron microscopy. Results: Serum MDA levels at T1 (15 minutes after removal of the cross clamp) and T2 (30 minutes after removal of the cross clamp) were higher in the control group compared to the Vitamin group. Serum TAC levels at T1, T2 and T3 (60 minutes after removal of the cross clamp) were higher in the Vitamin E group compared to the control group. Histopathologic injury grade was lower in the Vitamin E group than in the control group. Conclusion: Vitamin E was found to be protective against reperfusion induced oxidative injury in the early operative period. © 2013 by Türkiye Klinikleri.
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    Our experiences with adult type aortic coarctation
    (2006) Duran E.; Canbaz S.; Acipayam M.; Gur O.
    Adult patients with coarctation of the aorta may require different treatment modalities and surgical methods from children. A total of five adult aorta coarctation cases who underwent operations in our clinic were reviewed. In this article, we describe five adult aortic coarctation cases between 22 and 62 years old (33.8±17) who underwent operations between 1998 and 2004. There was preoperative hypertension in all five cases. We performed patch plasty operations with PTFE grafts under aortic cross-clamping in three patients, and bypass operations with 8 mm PTFE grafts under aortic partial clamping in the other two. The mean aortic cross-clamp time of the patch plasty patients was 38,6±8,5 min, and the mean aortic partial clamping time of the bypass patients was 52±12 min. We found paradoxical hypertension 24 h after the operation in two cases (1st and 2nd patients), 48 h after the operation in the third and 72 h after the operation in the remaining two (4th and 5th patients). We observed no perioperative neurogenic complications or mortality. Surgical treatment of coarctation of the aorta in adults usually alleviates hypertension and reduces the need for antihypertensive drugs. A bypass between proximal and distal segments of the aorta that have normal wall structure is a reliable method, with lower morbidity and mortality rates in older patients.