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Öğe A Rare Case : Pulmonary Supravalvular Stenosis with Moderate Gradient Causing An Atrial Right To Left Shunt Across The Reopened Foramen Ovale(Çanakkale Onsekiz Mart Üniversitesi, 2014) Özcan, Sedat; Civan, Murat; Kurt, Tolga; Ekinci, Selim; Ziyrek, Murat; Toman, HüseyinSupravalvular pulmonary stenosis accompanied by a right to left shunt is a rare echocardiographic finding in adults. We report a case of adult pulmonary supravalvular membranous stenosis with an atrial right to left shunt developed through a previously undiagnosed patent foramen ovale (PFO).The peculiarity of our case is that foramen ovale reopened despite a moderate pulmonary trunk gradient over a six year period. This congenital anomaly is a condition to be differentiated from valvular pulmonary stenosis as both anomalies require different modalities of treatment (surgical or catheter).Öğe Comparison of the endovascular therapy with drug-coated balloon and bypass surgery for Trans-Atlantic Inter-Society Consensus II C and D femoropopliteal lesions(Bayrakol Medical Publishing, 2021) Özcan, Sedat; Khalil, EmcedAim: The optimal revascularization strategy with the greatest durability and the lowest morbidity in femoropopliteal artery occlusions still remains debated. This study aimed to compare 2-year follow up after endovascular therapy (EVT) and femoropopliteal bypass in subjects with TASC II C and D femoropopliteal artery occlusions. Material and Methods: This study included 92 patients with extensive (TASC II C and D) de novo femoropopliteal occlusion who underwent EVT or femoropop-liteal bypass surgery. Drug coated balloons competent with target vessel diameter were used for PTA interventions. Results: A total of 92 subjects with 92 limbs treated were included in the study. Fifty-one of the study subjects received EVT and 41 underwent femoropopliteal bypass surgery. The primary patency rate was higher in the femoropopliteal bypass group compared to the PTA group at 6th, 12th, and 24th -month follow-up studies. Discusion: We compared the early and mid-term clinical outcomes of EVT and femoropopliteal bypass for TASC II C and D lesions of the femoropopliteal artery. We hypothesized that, given the superiority of drug-coated balloons compared to uncoated balloons in terms of postoperative outcomes, EVT with drug-coated balloons would provide superior primary patency compared to femoropopliteal bypass in subjects with complex femoropopliteal artery disease. However, our findings failed to demonstrate the superiority of EVT with drug-coated balloons over femoropopliteal bypass. This result supports the evidence derived from previous studies comparing the two treatment strategies for TASC II C and D lesions of the femoropopliteal artery. Our results indicate that postoperative ABI is also higher in subjects undergoing femoropopliteal bypass than those receiving EVT. Femoropopliteal bypass surgery provides a higher primary patency rate and a more significant improvement in ABI in subjects with TASC II C and D femoropopliteal artery occlusions with similar complication rates for the two treatment strategies.Öğe Effects of perioperative statin treatment on postoperative atrial fibrillation and cardiac mortality in patients undergoing coronary artery bypass grafting: A propensity score analysis(Medical Association of Zenica-Doboj Canton, 2015) Kunt, Ayşegül; Özcan, Sedat; Küçüker, Aslihan; Odabaşi, Dolunay; Kunt, Alper SamiAim To evaluate the effect of perioperative statin treatment on postoperative atrial fibrillation and cardiac mortality in patients undergoing coronary artery bypass grafting. Methods A total of 1890 patients who underwent isolated coronary artery bypass were analyzed retrospectively, of which 425 patients (22.4%) older than 70 were included in the study. The demographic properties, preoperative, operative and postoperative data and other medications of these patients were recorded. Continuous preoperative and postoperative atorvastatin therapy were received by 124 (29.17%) patients; 301 (70.82%) patients were matched to a control group (no-statin group). The two groups were matched by propensity score analysis in terms of atrial fibrillation development and cardiac mortality. Results Medical history, medical treatment, cardiovascular history, and operative characteristics demonstrated significant heterogeneity in both groups. Postoperative atrial fibrillation was similar in both groups. Before propensity score matching, the percentages of patients in postoperative atrial fibrillation with respect to Ator- vastain-group and No-statin-group were 13.71 and 10.3 respectively; however, those were 13.71 and 14.51 after matching. In a multivariate regression analysis, five-vessel bypass (odds ratio OR, 2.354; 95% confidence interval CI, 0.99 to 5.57) was an independent predictor of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting. In-hospital mortality was higher in the Atorvastatin-group compared with the No-statin- group: 124 (8.9%) versus 301 (3.7%), respectively; p=0.027). Conclusion Perioperative atorvastatin treatment is not found to be associated with reduced postoperative atrial fibrillation and cardiac mortality in patients undergoing isolated coronary artery bypass grafting above the age of seventy years. © 2015, Medical Association of Zenica-Doboj Canton, All rights reserved.Öğe Efficacy of chronic statin therapy on major cardiac events after coronary artery bypass grafting: Low-dose versus high-dose(Medical Association of Zenica-Doboj Canton, 2015) Kunt, Ayşegül; Özcan, Sedat; Küçüker, Aslihan; Odabaşi, Dolunay; Kunt, Alper SamiAim To investigate whether chronic statin treatment after coronary artery bypass grafting (CABG) protects patients from major cardiac events and provides percutaneous coronary intervention (PCI) free survival. Methods A total of 232 patients with previous CABG and chronic statin therapy were selected retrospectively and were divided into two groups according to a dosage of atorvastatin per day, e. g., 20 mg or 40 mg. Groups were compared for the major cardiac events and freedom from PCI by Kaplan Meier analysis as the primary end point. Patency of grafts including left internal thoracic artery (LITA) and saphenous vein (SVG) and progression of non-grafted native vessel disease were also evaluated as secondary end points. Results Cardiac mortality, periprocedural myocardial infarction (MI), target vessel revascularization and percutaneous coronary intervention free survival were as follows: 2.9% versus 2.1% (p=1.000); 16.1% versus 21.1% (p=0.331); 56.93% versus 52.63% (p>0.005); 58.4% versus 63.2% (log-rank test; p= 0.347) in atorvastatin 20 mg and atorvastatin 40 mg groups, respectively. However, these results were not statistically significant between two groups (p>0.005). Patency of openness of grafts including LITA and SVG and progression of non-grafted native vessel disease were similar between groups (p=0.112, p=0.779, p=0.379 and p=0.663, respectively). Conclusion Low-dose long-term statin treatment had similar outcomes on major cardiac events and identical rate of freedom from percutaneous coronary intervention after coronary artery bypass grafting compared with high-dose long-term statin treatment. It is better to start from low dose statin treatment after surgical interventions. © 2015, Medical Association of Zenica-Doboj Canton, All rights reserved.Öğe Ender bir olgu: Yeniden açılan foramen ovale nedeniyle sağdan sola şanta yol açan orta düzeyde gradyanlı pulmoner supravalvuler stenoz(Çanakkale Onsekiz Mart Üniversitesi, 2014) Özcan, Sedat; Kurt, Tolga; Ekinci, Selim; Civan, Murat; Ziyrek, Murat; Toman, HüseyinSağdan sola şantın eşlik ettiği supravalvuler pulmoner stenoz erişkinlerde ender görülen bir ekokardiyografi bulgusudur. Önceden tanısı konmamış patent foramen ovaleden gelişen sağdan sola şantın eşlik ettiği supravalvuler pulmoner stenoz gelişen hastanın olgusu sunulmuştur. Bu konjenital anomali, valvuler pulmoner stenozdan tedavi yöntemlerinin ayrı olmasından dolayı ayırıcı tanısı yapılmalıdırÖğe Is cardiopulmonary bypass simulator efficient for perfusion training?(Anatolian Journal of Clinical Investigation, 2015) Özkan, M. Turgut Alper; Yener, Ali Ümit; Özcan, Sedat; Bekler, Adem; Toman, Hüseyin; Saçar, MustafaHeart-lung machine, used in open heart surgeries performed in cardiovascular surgery department, has been managed by professional groups defined as perfusionists. The preparation for the operation of the heart-lung machine used during open heart surgery, running the machine during operation, monitoring, maintenance, crisis management and use of the machine in a harmony with the team during cardiac surgery require a certain knowledge and experience. We aimed to evaluate the contribution of theoretical and practical training with the support of a heart-lung machine simulator to skills of the students during the associate degree program. First term perfusion undergraduate students who took the same curriculum and took same number of total practical lessons in different years were included in the study. Between 2012-2013, 18 students following 1st term curriculum who had taken practical training in the operating room (Group 1) and between 2013-2014, 18 students following 1st term curriculum who had taken practical training in the simulation laboratory (Group 2), were tested in 50 parameters through knowledge (17), skills (17) and attitude (16). Group 1 was successful in 40.72 ± 3.58 parameters of the 50 parameters, and Group 2 was successful in 42.17 ± 3.55 parameters of the 50 parameters. There was no statistically significant difference between the two groups (p> 0.05). In our study, we evaluated the effect of simulation training with the system we created , and we observed no significant difference between two groups. © 2015, Anatolian Journal of Clinical Investigation. All rights reserved.Öğe Kardiyopulmoner baypas sırasında spontan sağ ventrikül rüptürü(2015) Özcan, Sedat; Gür, Ali Kemal; Odabaşı, DolunayMiyokard enfarktüsü sonrası duvar rüptürleri nadirdir. Erken tanı ve tedavi mortaliteyi anlamlı olarak azaltmaktadır. Bu yazıda bir ay önce inferior miyokard enfarktüsü nedeniyle kardiyoloji kliniğimize başvuran, primer perkütan transluminal koroner anjiyoplasti ile sağ koroner artere başarıyla stent takılan 68 yaşında bir kadın hasta sunuldu. Hasta elektif şartlar altında ameliyat edildi. Sol koroner arter sistemine koroner arter baypas greft ameliyatı yapıldı. Greft için uygun olmayan şartlar nedeniyle sağ koroner arter distal yatağı ameliyat edilmedi. Venöz kanül çıkarılırken sağ ventrikül duvarı spontan şekilde rüptüre oldu. Tekrar kanülasyon yapıldı ve perikard yama kullanılarak rüptür tamir edildi. Hasta ameliyat sonrası yedinci günde sorunsuz bir şekilde taburcu edildi.Öğe Left atrial myxoma with atypical clinical presentation(Acta Medica Mediterranea, 2014) Kurt, Tolga; Özcan, Sedat; Temiz, Ahmet; Özbudak, Ersan; Gazi, Emine; Saçar, MustafaMyxoma is the most commonly seen primary cardiac tumour, with an incidence of 80-90% in the left atrium, followed by the right atrium and ventricle. Patients with atrial myxomas present with intracardiac obstruction, embolization to the pulmonary and systemic circulation, or constitutional symptoms. Hepatomegaly and increase of the liver transaminases levels' involvement in myxomas are rare, has been described to cause hepatic insufficiency. We describe an interesting case of a 47-year-old patient with systemic findings and symptoms, which was primary symptomatically treated for several months in psychiatry, neurology and chest diseases clinics in other centres but never diagnosed, and undergoing emergency surgery in our clinic following determination of left atrial myxoma at tests performed by our cardiology department. The patient had no symptoms at examinations performed 6 months and 1 year postoperatively, and no pathological findings were determined.Öğe Management of fracture and dislocation associated with vascular injuries(Anatolian Journal of Clinical Investigation, 2014) Kömürcü, Erkam; Özden, Raif; Kaymaz, Burak; Gölge, Umut Hatay; Göksel, Ferdi; Özcan, Sedat; Yener, Ali ÜmitThe purpose of this study is to identify the factors that affect mortality and morbidity and that contribute to disability in vascular injuries associated with fracture and dislocation. Ninety-seven patients with vascular injuries associated with orthopedic fracture and dislocation in the study by searching hospital files retrospectively.Sixtytwo and thirty-five patients were male and female, respectively. Mean age of the patients was 36.6±12.1 years. The time elapsed between injury and surgical intervention was 3.6±1.9 hours. Tibia, femur and humerus fractures were the most encountered injuries with MESS value of 6.2±2. 2. External fixation and internal fixation osteosynthesis were used in 76 and 12 patients respectively. Vascular injuries were localized most frequently in femoral artery, popliteal artery. Preoperative arteriography was performed in 22 patients. 41 patients had isolated arterial injuries, 54 patients both artery and vein injuries. Priority was given to vascular repair in 68 patients; orthopedic stabilization was performed before the vascular treatment only in 22 patients. Only 4 patients lost their life in the postoperative period. Vascular injuries associated with fracture and dislocation, are major pathologies that must be diagnosed without delay and repaired urgently. There are still disputed issues in the algorithm of the treatment of these injuries and prospective studies are needed with wide patient series. © 2014, Anatol J Clin Investig. All rights received.Öğe Our experiences in the surgical treatment of venous aneurysms appearing as secondary to the upper extremity arteriovenous fistula on patients with chronic renal failure(Acta Medica Mediterranea, 2014) Özcan, Sedat; Odabaşı, Dolunay; Kutay, VeyselBackground: Aneurysmal arterio venous fistulas used for hemodialyses for longer periods of time, but giant arteriovenous fistula aneurysms should be treated surgically to avoid the complications. In this report, we aimed to present our experiences in the surgical treatment of giant venous aneurysmal that is an important complication of arteriovenous fistulas, forming for the purpose of hemodialysis in the upper extremity. Material and methods: In 16 patients with chronic renal failure and developing giant venous aneurysm after arterio venous fistula, surgical intervention was planned. The diagnosis was confirmed by a detailed physical examination and arterial-venous color doppler ultrasonography Results: In our study, 10 male and 6 female patients were included. The average age of patients was 41.6 ± 11.4 (26-58). Plication process for aneurysmal dilatation was performed in 12 patients. Aneurysmal segment was resected in 3 patients for arterial repair process. Venous aneurysmal dilatations were resected, arterial aneurysms were repaired surgically. All patients have achieved significant declines in the sizes of venous dilatation. Any vascular complications were encountered during the postoperative period. Conclusion: After our surgical experiences, we think that plication is a safe and effective method in the control of venous dilatation and ensuring openness.Öğe Persistan Sol Süperior Vena Kava: Nadir Bir Olgu Sunumu(2016) Reşorlu, Mustafa; Aylanç, Nilüfer; Adam, Gürhan; Özcan, Sedat; Eker, NebilPersistan sol süperior vena kava, genel popülasyonda %0,3-0,5 prevalansa sahip nadir görülen vasküler bir anomalidir. Sol anterior kardinal venin obliterasyonundaki yetersizlik sonucunda meydana gelmektedir ve konjenital kalp hastalığı olanlarda sıklığı artmaktadır. Bu olgularda aynı zamanda sağ süperior vena kava da sıklıkla mevcuttur. Persistan sol süperior vena kava tanısı genellikle kardiyovasküler görüntüleme sırasında insidental olarak konulmaktadır.Öğe Preoperatif Bakılan Kan Parametreleri Koroner Baypas Komplikasyonları Hakkında Fikir Verir Mi?(Çanakkale Onsekiz Mart Üniversitesi, 2014) Yener, Ali Ümit; Bekler, Adem; Özkan, Muhammed Turgut Alper; Kiraz, Hasan Ali; Toman, Hüseyin; Çiçek, Ömer Faruk; Çokkalender, Ömer; Saçar, Mustafa; Özcan, Sedat; Kurt, TolgaKoroner baypas cerrahisi öncesi kan testlerinde bakılan parametrelerle koroner baypas cerrahisi sonrası görülen morbidite ve mortalite arasındaki ilişkinin ortaya konulması amaçlandı.Şubat 2013 - Haziran 2014 tarihleri arasında koroner baypas ameliyatı yapılan 181 hasta çalışmaya dahil edildi. Hastalardan alınan preoperatif hemogram değerleri ve komplikasyonlar kaydedildi.Hastalar NLR?2.78 ( n=60) ve NLR<2.78 (n=121) olacak şekilde iki gruba ayrıldı (NLR: Nötrofil lenfosit oranı). Univariate ve multivariate lojistik regresyon analizi ile mortalite belirteçleri bulundu.Tek yönlü regresyon analizi yapıldığında kros klemp süresi, PLR (platelet lenfosit oranı) ve NLR mortalite ile ilişkili bulunmuştur. Yapılan çoklu lojistik regresyon analizine göre kros klemp süresi, PLR ve NLR koroner baypas sonrası hastane içi mortalite için bağımsız birer risk faktörü olarak tanımlanmışlardır. Ameliyat öncesi bakılan basit kan testleri yardımıyla, koroner baypas cerrahisi geçirecek hastaların ameliyat sonrası morbiditeleri ve oluşabilecek mortaliteleri hakkında fikir sahibi olunabileceği çalışmamızla ortaya konulmuştur.Öğe Relationship between cardiovascular evaluation data on admission and secondary adverse cardiac event rate after acute coronary syndrome(Ondokuz Mayis Universitesi, 2014) Civan, Murat; Özcan, Sedat; Ziyrek, Murat; Can, Fatma; Gülbaran, MuratThe current study aimed to investigate the relationship of clinical data with mean platelet volume (MPV) and QT dispersion values on admission of acute coronary syndrome (ACS) patients to the adverse cardiac event rate in a follow-up period of 20 months after discharge. For this purpose demographic and clinical data with corrected QT dispersion on admission and MPV values of 97 consequtive patients with ACS were recorded, retrospectively. Their history of major adverse cardiac event (MACE) in a 20 months period after ACS was obtained from the hospital records, interviews with the attending physicians and telephone calls to patients. Demographic and clinical data with corrected QT dispersion on admission, and MPV values were compared between groups with and without MACE in terms of statistical significance. In our study, diabetesmellitus, left ventricular ejection fraction (EF) and wall motion score index (WMSI), corrected QT dispersion, total cholesterol, LDL, CK-MB and troponin levels were found significantly related to the secondary MACE rate (p values; 0.046, 0.0001, 0.0001, 0.032, 0.024, 0.002 and 0.0001, respectively). No significant relation was detected between groups with and without MACE in terms of conservative medical follow-up and revascularization history (p=0.774). In the comparison of mean MPV values, there was no statistically significant difference between MPV values of patients with MACE (10.4±1.8 fl) and without MACE (10.3±2 fl) (p=0.799). In addition, the subgroup analysis on acute ST-elevation myocardial infarction cases in our study group did not state a significant relationship between MPV values below/above 10.3 fl and MACE rates (p=0.774). Finally, this retrospective study showed that corrected QT dispersion, diabetes, contractile reserve of left ventricule, total and LDL-cholesterol and peak cardiac enzyme values assessed during ACS might predict MACE. © 2014 OMU.Öğe Süperior Mezenterik Arterin Ateşli Silah Yaralanmasının Ardından Safen Ven Grefti İle İnterpozisyonu(Çanakkale Onsekiz Mart Üniversitesi, 2014) Özcan, Sedat; Kurt, Tolga; Odabaşı, Dolunay; Gür, Ali Kemal; Toman, HüseyinÖzet Ateşli silah yaralanması nedeniyle değerlendirilen bir hasta multipl batın içi organ yaralanmasına ek olarak Arteria Mezenterica Superior yaralanması tespit edilmesi üzerine hasta serum seti ile geçici by-pass uygulanmış ve 100 km uzaklıktaki kardiyovasküler cerrahi merkezi olan bir kuruma sevk edilmiştir. Burada uygulanan safen ven grefti interpozisyonu ile ince bağırsakların canlılığı korunmuştur. Genel cerrahi pratiğinde çok önemli bir morbidite ve mortalitenin sebebinin multi disipliner bir yaklaşımla tedavi edilmesini sunmayı amaçladık.Öğe The comparison of radiofrequency and Cyanoacrylate embolization therapy in vena saphena magna ablation The comparison of radiofrequency and Cyanoacrylate embolization theraphy(Bayrakol Medical Publishing, 2021) Er, Zafer Cengiz; Destan, Buğra; Özcan, SedatAim: Chronic venous insufficiency is a frequent and disabling illness causing loss of life quality and labor. In this study, we aimed to compare the cyanoacrylate embolization and radiofrequency methods in vena saphena magna ablation therapy.Material and methods: Two hundred twenty patients with symptomatic venous insufficiency were involved in this study between November 2015 and January 2020 in Bozok University faculty of medicine cardiovascular surgery department. Patients were grouped into two groups. Group 1 included patients who were applied radiofrequency, and Group 2 included patients who underwent cyanoacrylate embolization. Preoperatively, Doppler ultrasound showed venous reflux and VSM diameter in all patients. Patient with non-tortuous veins and VSM diameter of more than 5.5 mm and a reflux duration of more than 0.5 seconds in the saphenofemoral junction were taken into consideration. This study included 110 cases in each group with similar demographic characteristics. After discharge, patients were called for control after one week, and in the first and sixth months they were evaluated with Doppler ultrasound.Results: A month later, during the procedure in Doppler USG control, we found o that VSM in 108 out of 110 patients (%98.18) was obliterated in the RF group. In the cyanoacrylate embolization (CAE) group, VSM was totally obliterated in all patients. Six months later, obliteration was 107 (%97.27) in RF and 109 (%99.09) in the cyanoacrylate group. In a month, %8.18 ecchymosis, %0.9 cellulitis and %1.81 thrombophlebitis were seen in the RF group. Complications in the cyanoacrylate group were ecchymosis in %10.9, cellulitis in %2.72 and trombophlebitis in %0.9. The duration of the procedure was 32.14 minutes in the RF group and 15.32 minutes in the CAE group. Preoperatively, the patients were asked 8 questions about the symptoms. After six months, the same questions were asked and answers were compared with the previous ones. In both groups, the recovery was similar. Discussion: Although the classical surgical procedure of venous insufficiency is a successful method, it has complications. When deciding the therapy method, cosmetic results should be kept in mind. Also, the short operation duration affects the choice. Frequently applied methods are EVLA, RFA, foam sclerotherapy, and CAE. RF and CAE technics were effective as classical surgery in chronic venous insufficiency. Effectiveness and complication rates were not different, but the shorter duration of procedure makes CAE more advantageous.Öğe The Effects of Low Tidal Volume and Ventilation on the Lungs in the Postoperative Period during Cardio Pulmonary Bypass in the Heart Surgery(Çanakkale Onsekiz Mart Üniversitesi, 2014) Gür, Ali Kemal; Özcan, Sedat; Kurt, Tolga; Eker, Esra; Odabaşı, Dolunay; Destan, Buğra; Candan, Mehmet Akif; Ekin, AhmetThe occurrence of respiratory problems in patients after the open heart surgery still continues to be a problem, which disturbs the comfort of surgery in the postoperative period. In this study, we aimed to prevent the sequestration, which might occur in the lungs within the continuous ventilation of the lungs that are disconnected as a routine during the cardiopulmonary bypass (CPB) under the low tidal volume; also aimed to reduce the edema in the lung tissue during the postoperative period and present these results along with the literature. For this purpose, 40 coronary artery bypass surgery patients are examined as two groups (Group 1, Group 2), which are planned under elective conditions as consecutive.40 patients who underwent coronary artery bypass surgery were divided into two groups and examined. 20 patients (group 1; 13 males, 7 females; average age is 58±8), who were normally disconnected during CPB; and 20 other patients, who are ventilated with low tidal volume during CPB (group 2; 12 males, 8 females; average age is 60±5) are taken into the study. Attention paid to not to have differences in preoperative characteristics of the patients. Lung ventilator modes, arterial blood gas levels, extubation times, preoperative pulmonary function tests (PFT) ve the postoperative day 7th and 1st month PFT’s of both groups are compared. There are some significant differences between the patients of group 1 and group 2 as follows; the average partial oxygen (PO2) amount in arterial blood gases during the intensive care period with 40% oxygen after the surgery at the 2nd hour SMIV mode are 105±10 mmHg and 120 ± 20 mmHg respectively; SO2 values are 92±4 and 94±4 respectively; the average intubation times are 5,3 ±0,4 hours and 4,2 ±0,3 hours respectively; and oxygen saturations of service are 83% ± 5 and 90% ± 3 respectively for the 1st group and the 2nd group.When the ventilation of the lung with low tidal volume during the CPB is compared with the disconnection method applied normally; we conclude that the first method protects the lung functions better than the second one. It was seen in the light of our study; the pulmonary functions are better after the ventilation with low tidal volume, and respiratory complications are less likely to be detected.
