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The Analysis of Patients Admitted to the Emergency Department Due to Complications Related to Warfarin Treatment
(Aves, 2014) Sayhan, Mustafa Burak; Oguz, Serhat; Yuksel, Volkan; Huseyin, Serhat; Sayhan, Esin Secgin; Yagci, Gokce
Objective: Warfarin is the most commonly used oral anticoagulant around the world. The most important complication of warfarin is bleeding. This study was conducted to evaluate the patients who were admitted to our emergency department due to complications related to warfarin treatment. Material and Methods: Eighty-nine patients (32 females, 57 males) were enrolled into this retrospective study. The patients were evaluated according to their age, gender, duration of therapy (year), co-administered drugs, bleeding localization, treatments, amount of blood transfusions, duration of bleeding, initial and after-treatment PT, INR, complete blood count, and aPTT. Results: Mean duration of anticoagulant use was 3.05 +/- 2.87 years. The most common indication of warfarin was atrial fibrillation. The most frequent bleeding localization was the upper gastrointestinal tract. Thirty-four (38.2%) of the patients had major bleeding, and 55 (61.8%) had minor bleeding. Age, co-administered drugs, amount of erythrocyte suspension transfusion, presence of previous warfarin overdose history, Hb levels at admission, and duration of follow-up in the ED were different between the bleeding types. Conclusion: In this study, we found that the bleeding complications of warfarin were associated with the aged population, presence of previous warfarin overdose history, and concomitant drug use.
Aortic Valve Regurgitation and Ventricular Septal Defect Diagnosed 5 Years after Penetrating Cardiac Injury
(Georg Thieme Verlag Kg, 2014) Ozdemir, Ahmet Coskun; Yuksel, Volkan; Huseyin, Serhat; Baltalarli, Ahmet
Despite high mortality rates for penetrating heart injuries, developments in transport, diagnosis, and surgical interventions have increased survival rates. In some cases, life-threatening complications may be misdiagnosed or remain asymptomatic and lead to loss of life. Herein, we report a patient with aortic valve regurgitation because of noncoronary cusp perforation and ventricular septal defect that remained asymptomatic and diagnosed 5 years after a penetrating heart injury.
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.
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.
Bilateral Brachial Artery Aneurysms with Distal Embolisms in a Patient with Prolonged Crutch Compression
(Korean Soc Vascular Surgery, 2021) Simsekl, Baran; Guclu, Orkut; Huseyin, Serhat; Yuksel, Volkan
Chronic axillary crutch use may lead to axillary or brachial artery aneurysms and associated axillobrachial thromboembolic complications. Most of these aneurysms remain asymptomatic and undiagnosed until a complication occurs. Early diagnosis and appropriate surgical management of the aneurysms is required for a favorable outcome. We report a case of bilateral brachial artery aneurysms with left radial and ulnar artery embolisms in a patient who had been using crutches for 33 years due to a congenital skeletal anomaly.
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.
Combined cardiac surgery and substernal thyroidectomy
(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2012) Gurkan, Selami; Huseyin, Serhat; Sarac, Atilla; Ege, Turan; Duran, Enver
Excessive growth of the thyroid gland is frequently associated with multinodular goiter. Shifting of mediastinal structures and large airway obstruction via extrinsic compression by a mass effect can lead to additional surgical problems. In November 2008, a 65-year-old male patient with unstable angina pectoris was admitted to our clinic for coronary artery bypass grafting. A retrosternal mass lying over the ascending aorta precluded cannulation. After the resection of retrosternal goiter, cardiopulmonary bypass was performed with single right atrial and ascending aortic cannulation. Combined cardiac surgery and thyroidectomy can be safely performed if the preoperative thyroid hormone levels are maintained in the euthyroid state.
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.
A comparison of thoracic or lumbar patient-controlled epidural analgesia methods after thoracic surgery
(Bmc, 2014) Sagiroglu, Gonul; Meydan, Burhan; Copuroglu, Elif; Baysal, Ayse; Yoruk, Yener; Karamustafaoglu, Yekta Altemur; Huseyin, Serhat
Background: We aimed to compare patient-controlled thoracic or lumbar epidural analgesia methods after thoracotomy operations. Methods: One hundred and twenty patients were prospectively randomized to receive either thoracic epidural analgesia (TEA group) or lumbar epidural analgesia (LEA group). In both groups, epidural catheters were administered. Hemodynamic measurements, visual analog scale scores at rest (VAS-R) and after coughing (VAS-C), analgesic consumption, and side effects were compared at 0, 2, 4, 8, 16, and 24 hours postoperatively. Results: The VAS-R and VAS-C values were lower in the TEA group in comparison to the LEA group at 2, 4, 8, and 16 hours after surgery (for VAS-R, P = 0.001, P = 0.01, P = 0.008, and P = 0.029, respectively; and for VAS-C, P = 0.035, P = 0.023, P = 0.002, and P = 0.037, respectively). Total 24 hour analgesic consumption was different between groups (175 +/- 20 mL versus 185 +/- 31 mL; P = 0.034). The comparison of postoperative complications revealed that the incidence of hypotension (21/57, 36.8% versus 8/63, 12.7%; P = 0.002), bradycardia (9/57, 15.8% versus 2/63, 3.2%; P = 0.017), atelectasis (1/57, 1.8% versus 7/63, 11.1%; P = 0.04), and the need for intensive care unit (ICU) treatment (0/57, 0% versus 5/63, 7.9%; P = 0.03) were lower in the TEA group in comparison to the LEA group. Conclusions: TEA has beneficial hemostatic effects in comparison to LEA after thoracotomies along with more satisfactory pain relief profile.
Doppler Probe Is Helpful in Locating Embedded Coronary Arteries
(Elsevier Science Inc, 2013) Yuksel, Volkan; Huseyin, Serhat; Sunar, Hasan; Canbaz, Suat
[Abstract Not Available]
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.
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.
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.
The efficacy of thoracic epidural and paravertebral blocks for post-thoracotomy pain management
(Termedia Publishing House Ltd, 2013) Sagiroglu, Gonul; Baysal, Ayse; Copuroglu, Elif; Karamustafaoglu, Yekta Altemur; Sagiroglu, Tamer; Yuksel, Volkan; Huseyin, Serhat
Introduction: The definition of pain focuses mainly on tissue damage and provides information regarding pathophysiological changes in the human being [1]. Patients experience pain as a response to this tissue damage after surgery and the pain intensity after thoracotomies is known to be severe [2]. Aim of the study: Our goal was to investigate the efficacy and adverse effects of thoracic epidural and paravertebral blocks for post-thoracotomy pain management. Material and methods: In a prospective, randomized double blinded study, patients were divided into thoracic epidural (EPI group, n = 30) and paravertebral (PVB group, n = 30) groups. A bolus dose of 10 ml of 0.25% bupivacaine was followed by a continuous infusion of 0.1 ml kg(-1) h(-1) for a total of 24 hours. A visual analog scale (VAS) was used to evaluate pain at rest (VAS-R) and after coughing (VAS-C) at baseline (after extubation), 2, 4, 12 and 24 hours after surgery. The duration of catheter insertion, morphine consumption, complications and side effects were collected. Results: In comparison of EPI and PVB groups, VAS-R and VAS-C scores were similar at baseline and at 2, 4, 12 and 24 hours after surgery (p > 0.05). The incidence of hypotension was higher and the duration of catheter insertion was longer in the EPI group in comparison to the PVB group (p = 0.038, p < 0.0001, respectively). Conclusions: For post-thoracotomy pain, both thoracic epidural analgesia and paravertebral block techniques provide sufficient pain relief. As paravertebral block is an easier and quicker technique with lower incidence of hypotension, it should be considered as a good alternative to thoracic epidural technique to establish postoperative analgesia.
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.
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.
Emergency surgical treatment of ruptured abdominal aortic aneurysm: a 10-year experience in diagnosis and treatment Response
(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Halici, Umit; Yuksel, Volkan; Huseyin, Serhat; Okyay, Ahmet; Canbaz, Suet; Sunar, Hasan
[Abstract Not Available]
Evaluation of Pericardial Fluid C-Type Natriuretic Peptide Levels in Patients Undergoing Coronary Bypass Surgery
(Georg Thieme Verlag Kg, 2017) Guclu, Orkut; Karahan, Oguz; Karabacak, Mustafa; Yuksel, Volkan; Huseyin, Serhat; Mavitas, Binali
Background Neurohumoral and hemodynamic mechanisms have an effect on cardiac activity. C-type natriuretic peptide (CNP) is accessible in the cardiovascular system. The aim of this study was to determine whether CNP concentrations in pericardial fluid and blood are related to cardiac dysfunction in patients undergoing coronary artery bypass graft surgery. Materials and Methods In this study, 40 patients undergoing coronary artery bypass grafting were enrolled. The patients were separated into two groups according to left ventricular (LV) ejection fraction (EF): group 1 contained 28 patients with normal LV systolic function (LVEF >= 50%) and group 2 contained 12 patients with impaired LV systolic function (LVEF < 45%). Plasma and pericardial fluid samples were acquired during surgery to measure CNP levels. Results In group 1, CNP levels were detected to be 0.46 +/- 0.10 ng/mL in plasma and 0.66 +/- 0.8 ng/mL in pericardial liquid. In group 2, these levels were 0.51 +/- 0.09 and 0.79 +/- 0.12 ng/mL, respectively. CNP levels were determined to be significantly higher in patients with low EF compared with those with normal EF in pericardial fluid concentrations (p = 0.013). Conclusions CNP level in pericardial fluid is a more sensitive and proper marker of LV dysfunction than CNP levels in plasma. To the best of our knowledge, this study is the first to examine pericardial fluid CNP levels in patients undergoing coronary artery bypass surgery. It may have a valuable role in organizing cardiac remodeling and hypertrophy.
An experimental model of aortic surgery and the effect of Iloprost on lung injury
(Informa Healthcare, 2013) Iscan, Sahin; Huseyin, Serhat; Ozdemir, A. Coskun; Yalta, Tulin; Yuksel, Volkan; Aksu, Volkan; Ege, Turan
Objectives. Ischemia/reperfusion (I/R) damage of the lung is a frequently encountered complication following aortic surgery. The aim of the present study is to investigate the histopathological effects of Iloprost on pulmonary damage developed after I/R. Design. Twenty-four Sprague-Dawley rats were randomly divided into 3 groups. In the control group, aortas were not clamped. In the I/R group, aortas were occluded, and after 1 h of ischemia, clamps were removed. After 2 h of reperfusion period, lungs of the rats were extracted. In the I/R + Iloprost group after 1 h of ischemia, Iloprost infusion was initiated, and maintained for the duration of 2 h reperfusion period. For histopathological scoring, density of polymorphonuclear leucocytes, congestion, interstitial edema, and bleeding were semiquantitatively evaluated, and histopathological changes were scored. Results. In the I/R group, multifocal-marked histopathological changes in 5 (62.5%), and multifocal-moderate histopathological changes in 3 (37.5%) rats were detected. In the I/R + Iloprost group, multifocal-moderate histopathological changes in 4 (50%), and multifocal-mild changes in 4 (50%) rats were detected. Conclusions. In the experimental rat model, administration of Iloprost has been shown to have preventive effects for pulmonary damage occurring after I/R generated by infrarenal aortic occlusion.
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.

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