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    Acetaminophen Mitigates Myocardial Injury Induced by Lower Extremity Ischemia-Reperfusion in Rat Model
    (Soc Brasil Cirurgia Cardiovasc, 2018) Geldi, Onur; Kubat, Emre; Unal, Celal Selcuk; Canbaz, Suat
    Objective: The injury-reducing effect of acetaminophen, an effective analgesic and antipyretic on ischemia-reperfusion continues to attract great attention. This study analyzed the protective effect of acetaminophen on myocardial injury induced by ischemia-reperfusion in an experimental animal model from lower extremity ischemia-reperfusion. Methods: Twenty-four Sprague-Dawley female rats were randomized into three groups (n=8) as (i) control group (only laparotomy), (ii) aortic ischemia-reperfusion group (60 min of ischemia and 120 min of reperfusion) and (iii) ischemia-reperfusion + acetaminophen group (15 mg/kg/h intravenous acetaminophen infusion starting 15 minutes before the end of the ischemic period and lasting till the end of the reperfusion period). Sternotomy was performed in all groups at the end of the reperfusion period and the heart was removed for histopathological examination. The removed hearts were histopathologically investigated for myocytolysis, polymorphonuclear leukocyte (PMNL) infiltration, myofibrillar edema and focal hemorrhage. Results: The results of histopathological examination showed that acetaminophen was detected to particularly diminish focal hemorrhage and myofibrillar edema in the ischemia-reperfusion + acetaminophen group (P<0.001, P=0.011), while there were no effects on myocytolysis and PMNL infiltration between the groups (P=1.000, P=0.124). Conclusion: Acetaminophen is considered to have cardioprotective effect in rats, by reducing myocardial injury induced by abdominal aortic ischemia-reperfusion.
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    Alt ekstremite derin ven trombozlarında abdominopelvik ultrasonografinin bilinmeyen maligniteleri saptamadaki yeri
    (2006) Halıcı, Ümit; Çıkırıkçıoğlu, Mustafa; Canbaz, Suat; Ketenciler, Serkan; Duran, Enver
    Amaç: Derin ven trombozu (DVT) tanısı alan hastalarda rutin abdominopelvik ultrasonografi (APUSG) yapılmasının önemi araştırıldı. Hastalar ve Yöntemler: Ocak 1999 - 2004 tarihleri arasında DVT tanısıyla kliniğimize yatırılan 212 olgu (105 erkek, 107 kadın; ort. yaş 55.2±16; dağılım 7-75) çalışmaya alındı. Derin ven trombozu tedavisi gören hastalarda tanı aşamasında abdominopelvik ultrasonografi yapıldı. Bulgular: Derin ven trombozu tanısı konan olgular arasında malignite %9.9 sıklıkta görülürken, en sık jinekolojik (%33.3) ve akciğer (%28.5) maligniteleri saptandı. Bunları gastrointestinal sistem (%14.3), ürolojik sistem, intrakraniyal ve meme (%4.8) kanserleri takip ediyordu. On beş hastada (%7) yatış sırasında malignite tanısı vardı. Altı hastada (%3) ise yatış sırasında APUSG ile yeni jinekolojik malinite tanısı kondu. Malignite saptanan olguların yaş ortalaması 57±10 (35- 72 yıl) ve erkek/kadın oranı 10/11 olarak bulundu. Jinekolojik maligniteler uterus (n=4), over (n=2) ve vulva (n=1) yerleşimliydi. Gastrointestinal sistem malignitelerinin tümü kalın bağırsak yerleşimliydi. Ürolojik malignitelerin ikisi renal (hipernefroma) ve biri prostat kaynaklıydı. Akciğer maligniteleri ise küçük hücreli (n=4) ve epidermoid hücreli kanser (n=2) olarak saptandı. Genç bir kadın hastada ise APUSG’de endometrial kavitede altı haftalık canlı fetus saptandı. Sonuç: Derin ven trombozu tanısı konulan hastalarda APUSG ile kitle saptanması durumunda tedavi planı değişebilmekte, daha önemlisi patoloji erken fark edilebilmekte ve buna yönelik tedaviye de erkenden başlanabilmektedir.
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    Avoiding Liver Injury with Papaverine and Ascorbic Acid Due to Infrarenal Cross-Clamping: an Experimental Study
    (Soc Brasil Cirurgia Cardiovasc, 2017) Huseyin, Serhat; Guclu, Orkut; Yuksel, Volkan; Erkul, Gulen Sezer Alptekin; Can, Nuray; Turan, Fatma Nesrin; Canbaz, Suat
    Objective: Ischemia-reperfusion injury after acute ischemia treatment is a serious condition with high mortality and morbidity. Ischemia-reperfusion injury may result in organ failure particularly in kidney, lung, liver, and heart. In our study, we investigated the effects of papaverine and vitamin C on ischemia-reperfusion injury developed in the rat liver after occlusion-reperfusion of rat aorta. Methods: 32 Sprague-Dawley female rats were randomized into four groups (n=8). Ischemia was induced with infrarenal aortic cross-clamping for 60 minutes; then the clamp was removed and reperfusion was allowed for 120 minutes. While the control group and the ischemia-reperfusion group did not receive any supplementary agent, two other groups received vitamin C and papaverine hydrochloride (papaverine HCL). Liver tissues were evaluated under the light microscope. Histopathological examination was assessed by Suzuki's criteria and results were compared between groups. Results: In ischemia-reperfusion group, severe congestion, severe cytoplasmic vacuolization, and parenchymal necrosis over 60% (score 4) were observed. In vitamin C group, mild congestion, mild cytoplasmic vacuolization and parenchymal necrosis below 30% (score 2) were found. In papaverine group, moderate congestion, moderate cytoplasmic vacuolization and parenchymal necrosis below 60% (score 3) were observed. Conclusion: An ischemia of 60 minutes induced on lower extremities causes damaging effects on hepatic tissue. Vitamin C and papaverine are helpful in reducing liver injury after acute ischemia reperfusion and may partially avoid related negative conditions.
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    Balloon Shaft Fracture: A Nightmare Scenario in the Setting of Percutaneous Coronary Intervention
    (H M P Communications, 2023) Akkus, Omer Ferudun; Gok, Murat; Karahan, Furkan; Canbaz, Suat; Yalta, Kenan
    [Abstract Not Available]
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    Basilic vein superficialization for hemodialysis vascular access
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Yuksel, Volkan; Halici, Umit; Huseyin, Serhat; Guclu, Orkut; Canbaz, Suat; Ege, Turan; Sunar, Hasan
    Background: This study aims to discuss the outcomes of superficialization of basilic vein technique in brachiobasilic arteriovenous fistula formation and to present our experience. Methods: Between January 2006 and January 2012, 170 patients (74 males, 96 females; mean age 60.7 +/- 9.1 years; range 31 to 83 years) who underwent basilic vein superficialization surgery in our clinic were included. All patients were examined under Doppler ultrasonography preoperatively. Demographic data of the patients, maturation time and complications were recorded. The mean follow-up was 12 months. Results: Non-dominant upper limb was preferred for surgery. Of the 170 patients who were operated, 166(97.6%) underwent hemodialysis. The mean maturation time was 61 days. Massive bleeding in the postoperative period occurred in two patients (1.2%). Wound infection was observed in eight patients (4.7%) in the early postoperative period. The most common reason for primary failure was thrombosis, which was observed in 48 patients (28.2%). The primary and secondary patency rates of the fistulas were 77% and 82%, respectively at one-year. Conclusion: Arteriovenous fistula formation through superficialization of the basilic vein offers satisfactory results in chronic hemodialysis patients with reasonable postoperative complication rate.
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    Body mass index as a determinant of postoperative morbidity
    (Cardiology Academic Press, 2013) Gurkan, Selami; Gur, Ozcan; Gur, Demet Ozkaramanli; Ege, Turan; Canbaz, Suat; Iscan, Sahin
    BACKGROUND: The impact of obesity on postoperative mortality and morbidity in coronary artery bypass grafting (CABG) operations is a widely studied but poorly defined topic. OBJECTIVE: To investigate the effect of body mass index (BMI) on in-hospital mortality and morbidity after isolated CABG surgery. METHODS: Prospectively collected data of a series of 1057 consecutive patients who underwent on-pump isolated CABG surgery were retrospectively analyzed. Patients were divided into five groups according to WHO BMI categorization (defined as underweight [BMI <20 kg/m(2)]; normal weight [BMI >= 20 kg/m(2) to <25 kg/m(2)]; overweight [BMI >= 25 kg/m(2) to <30 kg/m(2)]; obese, [BMI >= 30 kg/m(2) to <35 kg/m(2)]; and morbidly obese, [BMI >= 35 kg/m(2)]). RESULTS: Of 1057 patients, 13 patients (1.2%) were underweight, 298 (28.2%) were normal weight, 462 (43.7%) were overweight, 218 (20.6%) were obese and 66 (6.2%) were morbidly obese. The mean age was significantly lower in underweight patients, who were also more likely to be male. In contrast, obese and morbidly obese patients were older, and more likely to have comorbidities such as diabetes and hypertension. The incidence of postoperative bronchodilator use (P<0.001), leg wound infection (P=0.038), sternal dehiscence (P=0.039) and development of new-onset atrial fibrillation (P<0.001) was significantly higher in obese and morbidly obese groups. In contrast, postoperative prolonged ventilation (P<0.001), need for blood transfusions (P<0.001) and revision for bleeding (P=0.041), as well as gastrointestinal complications (P<0.001), were significantly higher in underweight patients. Multivariate logistic regression analysis showed that not BMI but female sex, older age and diabetes mellitis were independent risk factors for early mortality after CABG surgery. CONCLUSION: No effect of BMI on early postoperative mortality after CABG surgery could be demonstrated. However, in terms of morbidity, postoperative bleeding and revision for bleeding were increased in underweight patients while sternal dehiscence, wound infections and occurrence of atrial fibrillation were increased in obese and morbidly obese patients.
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    Clinical correlation of biopsy results in patients with temporal arteritis
    (Assoc Medica Brasileira, 2017) Yuksel, Olkan; Guclu, Orkut; Tastekin, Ebru; Halici, Umit; Huseyin, Serhat; Inal, Volkan; Canbaz, Suat
    Objective: Temporal arteritis is systemic vasculitis of medium and large sized vessels. The lowest incidence rates were reported in Turkey, Japan and Israel. We aimed to investigate the results of patients with biopsy-proven temporal arteritis and those classified according to the American College of Rheumatology criteria from a low-incidence region for temporal arteritis. The results of our study are noteworthy, since there is limited data on pathologic diagnosis of temporal arteritis in Turkey. Method: We studied the medical records, laboratory findings such as erythrocyte sedimentation rate and C-reactive protein levels, biopsy results, and postoperative complications of all the patients operated for temporal artery biopsy at our clinic. We used the computerized laboratory registry that keeps all records of 42 consecutive temporal artery biopsy results from January 2011 to December 2016. Results: The mean age was 66 +/- 12.5 years. The most common manifestations on admission were temporal headache, optic neuritis and jaw claudication, respectively. Temporal artery biopsy results confirmed tempoal arteritis in eight out of 42 (19%) patients. There was no statistically significant difference between biopsy-positive and biopsy-negative groups in terms of sex, age, erythrocyte sedimentation rate, C-reactive protein and biopsy length. Conclusion: We were not able to find a correlation between the analysis of biopsy results and clinical evaluation of patients with temporal arteritis. We suggest that diagnosis of temporal arteritis depends on clinical suspicion. Laboratory examination results may not be helpful in accurate diagnosis of tempoal arteritis.
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    Combined treatment of both arterial and deep venous thrombosis in a young adult with antiphospholipid syndrome: case report
    (2014) Gürkan, Selami; Gür, Özcan; Chouseın-Hüseyin, Serchat-Serhat; Yüksel, Volkan; Canbaz, Suat
    Antifosfolipid sendromu değişik tromboembolik olaylara sebep olabilen, otoimmün hiperkoagülabilite sendromudur. Olguların %35inde pulmoner emboli ve infarktla komplike olabilen derin ven trombozu görülebilir. Hastalığın klinik görünümleri arasında; venöz ve arteriyel trombozlarla birlikte emboliler, multiorgan iskemisi ve infarktına neden olabilen küçük ve yaygın büyük damar trombozları, prematür koroner arter hastalığı, strok ve düşükler sayılabilir. Bu yazıda 25 yaşındaki genç erkek hastada görülen arteriyel ve venöz trombozu ile cerrahi ve medikal tedavi birlikteliğini sunduk
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    Comparison of early period results of blood use in open heart surgery
    (Medknow Publications & Media Pvt Ltd, 2016) Huseyin, Serhat; Yuksel, Volkan; Guclu, Orkut; Turan, Fatma Nesrin; Canbaz, Suat; Ege, Turan; Sunar, Hasan
    Background: Various adverse effects of homologous blood transfusion detected particularly in open heart surgery, in which it is frequently used, lead researchers to study on autologous blood use and to evaluate the patient's blood better. Due to the complications of homologous blood transfusion, development of techniques that utilize less transfusion has become inevitable. We aimed to evaluate the effects of acute normovolemic hemodilution (ANH) in patients undergoing open heart surgery. Materials and Methods: In this study, 120 patients who underwent open heart surgery were included. Patients were grouped into three: Autologous transfusion group (Group 1), homologous transfusion group (Group 2), and those received autologous blood and homologous blood products (Group 3). Patient data regarding preoperative characteristics, biochemical parameters, drainage, extubation time, duration of stay at intensive care, atrial fibrillation (AF) development, and hospital stay were recorded. Results: A statistically significant difference (P < 0.005) was found in favor of autologous group (Group 1) with respect to gender, body surface area, European System for Cardiac Operative Risk Evaluation, smoking, hematocrit levels, platelet counts, urea, C-reactive protein levels, protamine use, postoperative drainage, frequency of AF development, intubation period, stay at intensive care and hospital stay, and amount of used blood products. Conclusion: The use of autologous blood rather than homologous transfusion is not only attenuates side effects and complications of transfusion but also positively affects postoperative recovery process. Therefore, ANH can be considered as an easy, effective, and cheap technique during open heart surgery.
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    Diyalize bağımlı kronik böbrek yetmezliği olan hastalarda açık kalp cerrahisi
    (2013) Güçlü, Orkut; Yazıcı, Süleyman; Demirtaş, Sinan; Çalışkan, Ahmet; Yavuz, Celal; Mavitaş, Binali; Canbaz, Suat
    Amaç: Kronik böbrek yetmezliği (KBY) olan hastalar çeşitli nedenlerle açık kalp cerrahisi için önemli bir risk grubunu oluşturmaktadırlar. Bu hastalarda kardiyak hastalıklar, normal popülasyona göre daha yüksek oranda görülür. Yapılan birçok çalışmaya göre kronik diyaliz bağımlılığı halen tek başına mortalite ve morbidite üzerine etkili bir risk faktörüdür. Bu çalışmada, kalp cerrahisi uygulanan KBY'li hastaların sonuçları retrospektif olarak değerlendirildi.Yöntem: Kardiyopulmoner bypass (KPB) altında kardiyak cerrahi uygulanmış olan hemodiyalize bağımlı son dönem böbrek yetmezlikli 36 hasta çalışmaya dahil edildi. Bu hastaların peroperatif bulguları hasta dosyalarından geriye dönük olarak incelendi.Bulgular: Hastaların 27'si (%75) erkek, dokuzu (%25) kadın, yaş ortalaması 58,3±8,5 yıl idi. Hastalardan 12'sine koroner bypass, 10'una koroner bypass ile beraber kapak replasmanı, beş hastaya izole kapak replasmanı, üç hastaya koroner bypass ile birlikte sol ventrikülotomi, dört hastaya tek kapak replasmanı ile birlikte bir veya iki kapak tamiri, iki hastaya asendan aorta replasmanı uygulandı. Ameliyatlarda ortalama kros klemp süresi 78,1±31,3 dakika, toplam perfüzyon süresi ise 158,8±92,2 dakika idi. Hastaların yoğun bakımda kalma süresi ortalama 60±41 saat, toplam hastanede yatış süresi 12±5 gün bulundu. Postoperatif mortalite %38,8 (n=14) idi.Sonuç: Kardiyak ve renal fonksiyonlar birbiriyle yakın ilişkilidir. Son dönem böbrek yetmezliği olan hastalara kabul edilebilir riskler altında kalp cerrahisi operasyonları uygulanabilmektedir. Uygun preoperatif hazırlık, iyi hasta takibi ile morbidite ve mortalite oranlarının kabul edilebilir düzeylerde olması mümkündür
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    Doppler Probe Is Helpful in Locating Embedded Coronary Arteries
    (Elsevier Science Inc, 2013) Yuksel, Volkan; Huseyin, Serhat; Sunar, Hasan; Canbaz, Suat
    [Abstract Not Available]
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    Early results of monopolar versus bipolar radiofrequency ablation for atrial fibrillation during open heart surgery
    (Cardiology Academic Press, 2013) Gur, Ozcan; Gurkan, Selami; Gur, Demet Ozkaramanli; Cakir, Habib; Yuksel, Volkan; Huseyin, Serhat; Canbaz, Suat
    BACKROUND: In patients with atrial fibrillation (AF) for whom open heart surgery is scheduled, it is suggested to treat AF by ablation. OBJECTIVE: To compare the efficacy of monopolar and bipolar surgical radiofrequency ablation systems in patients undergoing concomitant open heart surgery and reveal the factors affecting the conversion to sinus rhythm. METHODS: Forty-three patients (19 male and 24 female) who underwent irrigated monopolar or bipolar radiofrequency ablation for persistent AF at concomitant cardiac surgery between 2007 and 2012 were included in the study. RESULTS: Monopolar ablation was performed in 24 and bipolar ablation was performed in 19 patients. Twenty of the 24 patients who underwent monopolar radiofrequency ablation and 15 of the 19 patients in the bipolar ablation group were in sinus rhythm at the three-month follow-up. There was no statistically significant difference between the two ablation procedures on the conversion of AF to sinus rhythm. When the effect of left atrial diameter on conversion to sinus rhythm was compared, left atrial diameter >60 mm was found to have pronounced negative influence on procedural success, while left atrial diameter <60 mm had no effect. CONCLUSION: A concomitant monopolar or bipolar modified Cox maze procedure during open heart surgery is equally effective technique for AF ablation at three months of follow up. Left atrial diameters >60 mm significantly reduced the rate of conversion to sinus rhythm.
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    The effect of distension pressure on endothelial injury and vasodilatation response in saphenous vein grafts: conversion of a bypass graft to a dead pipe
    (Termedia Publishing House Ltd, 2014) Gurkan, Selami; Gur, Ozcan; Yuksel, Volkan; Tastekin, Ebru; Huseyin, Serhat; Gur, Demet Ozkaramanli; Canbaz, Suat
    Introduction: Endothelial damage caused by high pressure applied for spasm relaxation during graft preparation is one of the most plausible theories explaining early graft failure. Aim of the study: We aimed to demonstrate the extent of endothelial damage in saphenous vein grafts distended to different pressure levels by using immunohistochemical methods and in vitro tissue baths. Material and methods: Saphenous vein grafts (SVGs) of 25 patients who underwent isolated elective CABG surgery were used in this study. By using a specific mechanism, SVGs were distended to five different pressure levels for two minutes: 0 mmHg, 50 mmHg, 100 mmHg, 200 mmHg, 300 mmHg. In vitro tissue baths and immunohistochemical examinations were performed. Results: None of the grafts distended to 300 mmHg pressure were functional in the tissue bath system. The relaxation response to carbachol of SVGs distended to 0, 50, 100 and 200 mmHg was 97.87 +/- 4.47%, 98.52 +/- 3.95%, 93.78 +/- 3.64%, and 30.87 +/- 4.11%, respectively. There were no statistically significant differences in terms of relaxation responses between samples distended to 0, 50, and 100 mmHg (p = 0.490). The relaxation response of samples distended to 200 mmHg was significantly decreased (p = 0.021). The endothelia of samples distended to 0 mmHg were almost intact in CD31 staining. Endothelial cell loss occurred at all tested distension pressures at different degrees. Conclusion: In vitro and immunohistochemical studies revealed that distending an SVG used for coronary artery bypass grafting with pressures of 100 mmHg or less results in less endothelial damage and increases graft patency.
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    Effects of in vitro Amitriptyline, Fluoxetine, Tranylcypromine and Venlafaxine on Saphenous Vein Grafts
    (Soc Brasil Cirurgia Cardiovasc, 2019) Akinci, Melek; Karadag, Cetin Hakan; Huseyin, Serhat; Oltulu, Cagatay; Canbaz, Suat; Gunduz, Ozgur; Topuz, Ruhan Deniz
    Objective: In this study, we aimed to examine the effects of amitriptyline, fluoxetine, tranylcypromine and venlafaxine on saphenous vein grafts in coronary artery bypass graft surgeries. Methods: 59 patients (40 males and 19 females; mean age 65.1 years, distribution: 45-84 years) who had coronary artery bypass graft surgery between February 2014 and May 2016 were included in the study. After the saphenous vein grafts with intact and denuded endothelium were precontracted with 3x10(-6)M phenylephrine, amitriptyline, fluoxetine and tranylcypromine were cumulatively added to isolated organ baths in the range of 10(-11)-3x10(-5)M, while venlafaxine was added in the range of 10(-9)-3x10(-5)M. Then, the antidepressant-induced relaxation responses were recorded isometrically. Results: While the relaxation response of amitriptyline at -6.42 (Log M) was 74.6%, the response at -6.32 (Log M) was 75.5%. While the relaxation response at -6.46 (Log M) of fluoxetine was 68.02%, the response at -6.02 (Log M) was 72.12%. While the relaxation response of tranylcypromine at -7.53 (Log M) was 61.13%, the response at -7.23 (Log M) was 65.53%. While the relaxation response of venlafaxine at -6.21 (Log M) was 29.98%, the response at -5.90 (Log M) was 32.96%. Conclusion: The maximum relaxation at minimum and maximum therapeutic concentrations was obtained with amitriptyline, fluoxetine and tranylcypromine, and the minimum relaxation was obtained with venlafaxine. The relaxation responses were independent of the endothelium.
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    The effects of sildenafil and n-acetylcysteine on ischemia and reperfusion injury in gastrocnemius muscle and femoral artery endothelium
    (Sage Publications Ltd, 2015) Aksu, Volkan; Yuksel, Volkan; Chousein, Serchat; Tastekin, Ebru; Iscan, Sahin; Sagiroglu, Gonul; Canbaz, Suat
    Purpose We aimed to examine the effects of sildenafil and n-acetylcystein on ischemia/reperfusion injury in femoral artery endothelium and gastrocnemius muscle. Basic methods 32 rats of Sprague-Dawley breed were randomly divided into four groups (n=8). Median laparotomy was performed, then a 120-minute ischemia was created by microvascular clamping of infrarenal aorta, followed by the release of clamping. In sildenafil group, 1mg/kg of sildenafil infusion and in the n-acetylcystein group, 100mg/kg of n-acetylcystein infusion was administered after release of clamps. Blood samples and tissue samples of femoral artery and gastrocnemius muscle were extracted for a histopathological evaluation. Principal findings Serum levels of malondialdehyde in ischemia/reperfusion group (6.160.79) were higher compared to the control group (4.69 +/- 0.33), whereas a significant decrease was detected in sildenafil (5.17 +/- 0.50) and n-acetylcystein (4.96 +/- 0.49) groups. Femoral artery tissue sections of the control group, mean tumor necrosis factor alpha and hypoxy-induced factor-1 alpha immunoreactivity were found to be negative. In the ischemia/reperfusion group, mean tumor necrosis factor immunoreactivity was intense and mean hypoxy-induced factor-1 alpha immunoreactivity was 51-75%. In the ischemia/reperfusion+Sildenafil and ischemia/reperfusion+NAS groups, mean tumor necrosis factor immunoreactivity was slight and mean hypoxy-induced factor-1 alpha immunoreactivity was 26-50%. Conclusions In conclusion, sildenafil and n-acetylcystein may reduce femoral artery endothelium and gastrocnemius muscle injury following lower extremity ischemia/reperfusion.
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    Emergency reoperation after open heart surgery: ten years of experience
    (Termedia Publishing House Ltd, 2013) Yuksel, Volkan; Huseyin, Serhat; Canbaz, Suat; Ege, Turan; Sunar, Hasan
    Background: Postoperative bleeding is an important corn plication after open heart surgery. Resternotomy for bleeding is an important source of mortality and morbidity. Aim of the study: We aimed to identify the common sites of bleeding after open heart surgery and to present our results. Material and methods: We performed 2286 open heart operations from January 2003 to January 2013. Reoperation for bleeding was performed in the case of bleeding that exceeded 3 ml/kg/h in the first 3 hours, continued bleeding of more than 200 ml/h that did not cease, and in the event of clinical signs of tamponade. All patients were reoperated in the operating theatre. Patient data and bleeding sites were recorded. Results: 98 patients (4.3%) underwent reoperation for bleeding or tamponade. Non-surgical causes of bleeding were found in 44 patients (44.9%). The major sites of bleeding were the left side branch of the internal thoracic artery (17.4%) and the side branch of the saphenous vein graft (13.3%). Mortality occurred in 13 patients (13.3%). Conclusions: Emergency reoperation for bleeding or tamponade after open heart surgery is an important problem. A high percentage of reoperated cases were due to technical errors during graft harvesting. We cannot always avoid the hematologic factors causing bleeding, but we can reduce the number of correctable causes that are usually surgeon-related. This should also contribute to reducing mortality and morbidity after open heart surgery.
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    Emergency surgical treatment of a ruptured abdominal aortic aneurysm: a 10-year experience in diagnosis and treatment
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Halici, Umit; Yuksel, Volkan; Huseyin, Serhat; Okyay, Ahmet; Canbaz, Suat; Sunar, Hasan
    Background: This study aims to report the results of emergency operations of ruptured abdominal aortic aneurysm. Methods: Between February 2001 and February 2011, 20 patients (1 female, 19 males; mean age 64.9 +/- 9.4 years; range 50 to 77 years) who were admitted to the emergency department and underwent emergency operation for ruptured abdominal aort aneurysm were retrospectively analyzed. Combined left thoracotomy + median laparotomy was performed in one patient (5%), while median laparotomy alone was performed in others. Aaortic cross clamping was applied following heparinization. In patients in whom aortic cross clamping was not suitable (n=3), proximal bleeding control was performed through occlusion by endoclamping with a Foley catheter. Aneurysmectomy + aortobifemoral bypass was performed in six patients (30%), aneurysmectomy + aortobiiliac bypass in 10 (50%), aneursymectomy + abdominal aortic graft interposition in two (10%), explorative laparotomy in one (5%), and thoracic + abdominal exploration in one (5%). Polytetrafluoroethylene (PTFE) pant graft (80%) and Dacron tube graft (10%) were used as graft materials during surgery. Results: In the early postoperative period, ischemic colitis developed in one patient (5%), prolonged entubation (>72 hours) in four (20%), wound infection in one (5%), arrhythmia in two (10%), and disseminated intravascular coagulation in one (%5). The mean duration of intensive care unit and hospital stay were 3.8 +/- 2.1 days and 8.5 +/- 3.4 days, respectively. Total mortality was seen in four patients (20%). Conclusion: We believe that early diagnosis of a ruptured abdominal aort aneurysm and endoclamping with a Foley catheter or an intraaortic balloon occlusion in patients who are ineligible for aortic cross clamping may increase the success of an emergency operation.
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    The Evaluation of Arterial and Venous Grafts with Intraoperative Flowmeter Techniques in Coronary Artery Bypass Grafting Operations
    (Aves Yayincilik, Ibrahim Kara, 2010) Canbaz, Suat; Unal, Selcuk; Dikmengil, Murat; Duran, Enver
    Objective: The purpose of this study was to evaluate the coronary artery bypass grafts with Transit Time Flowmeter (TTFM). Material and Methods: Fifty-nine patients who were scheduled for coronary artery bypass graft (CABG) surgery were included in the study. Coronary artery bypass anastomoses were performed using the left internal mammary artery (LIMA) and saphenous vein. At the end of the cardiopulmonary bypass, graft flow (ml/min), pulsatility index (PI), flow curve and diastolic filling percentage (DF%) of each graft were assessed with TTFM. Results: Mean graft number of the patients was 3.25+/-0.8. We assessed the patency of a total of 187 grafts using TTFM. Highest mean flow was 55.5 ml/min in aorta-RCA grafts and lowest mean flow was 37.6 ml/min in aorta-diagonal grafts. Revision was required for two grafts (3.38%) in two patients based on inadequate TTFM findings. Conclusion: Transit time flowmeter is an important technique that provides the detection of technical errors during surgery. With the detection of graft failure intraoperatively, revision of the graft and restoration of blood flow could be performed.
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    Evaluation of R-R interval variability with electromyography following coronary artery bypass grafting
    (2005) Turgut, Nilda; Canbaz, Suat; Balcı, Kemal; Ege, Turan; Halıcı, Ümit; Duran, Enver; Yavuz, Ebru
    Amaç: R-R interval değişkenliği (RRİD) analizi kalbin otonomik fonksiyonu hakkında bilgi verir. Koroner arter bypass cerrahisi sonrasında RRİD belirgin olarak azalmaktadır. Çalışmamızda, koroner arter bypass cerrahisi uygulanan hastalarda alternatif bir yöntem olarak elektromiyografi (EMG) ile RRİD değerlendirildi. Çalışma planı: Çalışmaya koroner arter bypass cerrahisi yapılan 19 hasta (6 kadın, 13 erkek; ort. yaş 57.8±10.2) alındı. Tüm hastalarda istirahat ve hiperventilasyon sırasında olmak üzere, ameliyat öncesinde ve ameliyattan bir ve iki ay sonrasında EMG ile RRİD analizi yapıldı. Bulgular: Ameliyat öncesiyle karşılaştırıldığında, ameliyattan bir ay (R-R, istirahat, p=0.001; R-R, hiperventilasyon, p=0.009) ve iki ay (R-R, istirahat, p=0.001; R-R, hiperventilasyon, p=0.006) sonra istirahat ve hiperventilasyon sırasında elde edilen ortalama RRİD değerleri anlamlı derecede düşük bulundu. Ameliyattan bir ay sonraki ortalama RRİD değerleri, ikinci ay sonundaki değerlerden anlamlı derecede düşük idi (R-R, istirahat, p=0.01; R-R, hiperventilasyon, p=0.001). R-R interval değişkenliği ile yaş, cinsiyet, hipertansiyon, sigara içme, total kolesterol ve trigliserid düzeyleri, beden kütle indeksi; cerrahi, kardiyopulmoner bypass, kros klemp, mekanik ventilasyon ve yoğun bakımda kalma süreleri arasında ilişki görülmedi. Sonuç: Bulgularımız, koroner arter bypass ameliyatından sonraki ilk iki ayda RRİD değerlerinin anlamlı derecede düştüğünü, ikinci aydaki değerlerde kısmi düzelme meydana geldiğini gösterdi. R-R interval değişkenliğinin EMG ile analizi, koroner arter bypass ameliyatı uygulanan hastalarda zaman kaybına yol açmayan, EMG laboratuvarında kolaylıkla yapılabilen ve kalbin otonomik fonksiyonunu yansıtan bir seçenektir.
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    Factors affecting surgical outcomes after superior mesenteric artery thromboembolism
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2017) Yuksel, Volkan; Guclu, Orkut; Yilmaz, Elif Cicek; Huseyin, Serhat; Ozkara, Taha; Sezer, Yavuz Atakan; Canbaz, Suat
    Background: In this study, we aimed to evaluate the operative results of superior mesenteric artery thromboembolism and influential factors for mortality in patients undergoing surgery for acute mesenteric ischemia. Methods: Between January 2011 and December 2016, 28 consecutive patients (15 males, 13 females; mean age 71.2 +/- 10 years; range 48 to 89 years) diagnosed and operated for acute mesenteric ischemia were included in the study. The results of open revascularization procedures and influential factors for mortality were retrospectively analyzed. Results: Abdominal pain was the major complaint, followed by nausea and vomiting. The diagnosis was confirmed by computed tomography angiography and Duplex ultrasonography. Thromboembolectomy was performed in the majority of the patients, while autologous saphenous vein bypass and transposition were performed in eligible patients. Revascularization procedures prevented bowel resection in 10 patients. The mortality rate was 35.7% due to respiratory, renal, and cardiac pathologies. Postoperative respiratory failure and admission to hospital later than six hours after the onset of abdominal pain were identified as the factors affecting mortality. Conclusion: Our study results showed that postoperative respiratory failure and late admission after the onset of abdominal pain were associated with postoperative mortality, whereas intestinal resection requirement did not contribute to the mortality rates. Based on our study results, we suggest that exploratory laparotomy and thromboembolectomy are essential in evaluating the viability of the bowel and in continuation of the mesenteric perfusion.