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Öğe Comparison of the efficacy of the cardiac hypothermia and normothermia to myocardial damage in coronary artery bypass graft surgery with systemic normothermic cardiopulmonary bypass(Edizioni Minerva Medica, 2013) Cakir, H.; Gur, O.; Ege, T.; Kunduracilar, H.; Ketenciler, S.; Duran, E.Aim. The aim of our research is to investigate the cardiac damage formed by either local cardiac hypothermia or cardiac normothermia technique in patients who undergone isolated coronary artery bypass graft (CABG) surgery. Methods. The total of 40 patients who underwent isolated CABG operation under normothermic cardiopulmonary bypass (CPB) were studied. Patients were randomly divided into two groups as cardiac hypothermia and cardiac normothermia. Myocardial temperature was measured from the interventricular septum before aortic cross-clamp (ACC) (baseline), the ACC 20th minutes (ischemia) and after 20 minutes removal of the ACC (reperfusion). The coronary sinus blood samples were simultaneously obtained from the retrograde cardioplegia cannula while myocardial temperature was being measured. Complement component 3 (C3), complement component 4 (C4), troponin I and tumor necrosis factor-alpha (TNF-alpha) was measured from the coronary sinus blood samples. Results. Myocardial temperature was between 18-28 degrees C (deep hypothermia) during ACC in group 1. Myocardial temperature was over 34 degrees C (normothermia) during ACC in group 2. TNF-alpha values of group 1 for ischemia and reperfusion were higher than group 2, and it was found statistically significant (P<0.05). Conclusion. Myocardial damage was less than in normothermia group according to hypothermia group. The results show that ice-cold blood cardioplegia and local ice treatment of the heart during CPB seems to harm the heart more than warm blood cardioplegia.Öğe Evaluation of Iloprost to Prevent Vasospasm in Coronary Artery Bypass Grafts(Field House Publishing Llp, 2010) Ege, T.; Gur, O.; Karadag, C. H.; Duran, E.This study assessed the efficacy of iloprost in relieving vasospasm in coronary artery bypass grafts. Radial artery (RA), left internal thoracic artery (LITA) and saphenous vein (SV) grafts were taken from 20 patients (13 men and seven women, mean age 63.8 years [range 48 - 74 years]) scheduled to undergo coronary artery bypass grafting. Ten 3 mm vascular rings were cut from each graft and kept under tension for at least 60 min. They were kept alive with 37 degrees C oxygenated Krebs solution. Smooth muscle contraction was achieved with phenylephrine before iloprost was administered every 2 min, starting at a concentration of 10(-9) mol/l and increasing in logarithmic increments to a concentration of 10(-5) mol/l. The vasodilation response to iloprost started in all samples at a concentration of 10(-9) mol/l and increased with each incremental increase in iloprost concentration up to 10(-5) mol/l. These data suggest that local administration of iloprost has a role in relieving graft vasospasm during harvesting and preparation for coronary artery bypass grafting.Öğe Iatrogenic femoral arterio-venous fistula and pseudoaneurysm following catheter insertion for hemodialysis(Edizioni Minerva Medica, 2007) Gur, O.; Canbaz, S.; Karaca, O. G.; Duran, E.[Abstract Not Available]Öğe In vitro effects of lidocaine hydrochloride on coronary artery bypass grafts(Edizioni Minerva Medica, 2012) Gur, O.; Ege, T.; Gurkan, S.; Gur, D. Ozkaramanli; Karadag, H.; Cakir, H.; Duran, E.Aim. Coronary artery bypass grafting (CABG) is one of the most common procedures performed to improve blood supply to myocardium. The characteristics of grafts, mechanical stress and pharmacological agents have substantial influence on the short and long term graft patency. Lidocaine is among the most frequently used antiarrhytlunic agents perioperatively. The aim of this study was to evaluate the in vitro effects of lidocaine on internal mammarian artery (IMA), radial artery (RA) and saphenous vein (SV) grafts. Methods. Using standard tissue bath techniques, responses to increasing concentrations of lidocaine hydrochloride were obtained, in segments of IMA, RA and SV grafts. Twenty patients were enrolled in the study with a total number of 48 grafts (16 for IMA, RA and SV grafts each). In vitro lidocaine concentrations between 10(-9)M and 10(-3.5)M were studied to represent therapeutic plasma concentration of 1.5-5 mcg/mL. Results. In IMA and RA grafts, lidocaine hydrochloride caused vasodilatation (40.5 +/- 1.9% and 39.1 +/- 2.6 % respectively) at concentrations between 10(-9) to 10(-7.5) M while causing a dose dependent vasoconstriction response at concentrations above 10(-7.5)M. In SV graft samples, lidocain hydrochloride caused vasodilatation (24.4 +/- 1.9 %) at concentrations between 10(-9) to 10(-7.5) M while causing dose dependent vasoconstriction at concentrations above 10(-7) M. For vasoconstriction effect, mean +/- SD values for E-max were calculated as: 120.1 +/- 6.6% in IMA, 83.35 +/- 5.06% in RA, and 154.0 +/- 13.8% in SV. The vasoconstriction in the SV samples was higher than in the RA and IMA. The mean SD LogEC(50) values were -5.15 +/- 0.27, -5.76 +/- 0.11 and -5.56 +/- 0.19 for SV, IMA and RA grafts respectively.) There was a statiscally significant differences in the Log EC50 values between SV, IMA and RA (P<0.005) Conclusion. Based on the results of our study, we conclude that, increasing doses of lidocaine in the perioperative period may cause vasospasm in IMA, RA and SV grafts. Thus, avoiding high doses may have a role in improving perioperative and long term mortality.Öğe A splenic injury due to ruptured abdominal aortic aneurysm(Edizioni Minerva Medica, 2007) Gur, O.; Canbaz, S.; Halici, U.; Duran, E.[Abstract Not Available]Öğe Surgical management of iatrogenic femoral artery pseudoaneurysms: A 10-year experience(Lithographia, 2013) Huseyin, S.; Yuksel, V; Sivri, N.; Gur, O.; Gurkan, S.; Canbaz, S.; Ege, T.Background: Vascular complications of cardiac catheterization have increased in line with increasing number of percutaneous interventions. Open repair is the standard method of treatment for true and false aneurysms of femoral artery. We report results of patients operated due to femoral artery pseudoaneurysm after cardiac catheterization. Methods: Data from 12,261 patients who underwent percutaneous intervention for cardiac catheterization between January 2003 and January 2013 were evaluated. Diagnosis of pseudoaneurysm was established mainly by doppler ultrasonography in patients with complaints of pain and hematoma at the intervention site. Pseudoaneurysms less than 2 cm in diameter were treated non-operatively and were followed up by regular ultrasonographic examination at the outpatient clinic. Pseudoaneurysms with a diameter of 2 cm or more underwent primary repair. All patients were followed up for one year. Results: We detected 55 (0.44%) patients with femoral artery pseudoaneurysm and 42 of them were operated. The mean age was 60.7 +/- 6.3 years. Thirty nine (94.5%) patients underwent elective surgery, three (5.5%) patients were operated on under emergency conditions. Operation was performed under local anesthesia in 32 patients, under local anesthesia and sedation in eight patients, and under general anesthesia in three patients. Location of the pseudoaneurysm was the superficial femoral artery in 29 (69%), the common femoral artery in nine (21.4%), and the deep femoral artery in four (9.6%) patients. No limb loss occurred, no patient died and no recurrence was detected during the follow up. Conclusions: Performing vascular reconstruction before the rupture of pseudoaneurysm is important in terms of morbidity and mortality. We concluded that surgical repair in pseudoaneurysms larger than 20 mm is safe and essential.