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    Comparison of one- and two-stage basilic vein transposition for arterio-venous fistula formation in haemodialysis patients: preliminary results
    (Clinics Cardive Publ Pty Ltd, 2013) Ozcan, Sedat; Gur, Ali Kemal; Yener, Ali Umit; Odabasi, Dolunay
    Objective: This study aimed to compare the results of one-and two-stage basilic vein transposition (BVT) in haemodialysis patients. Methods: This was a non-randomised, retrospective study between January 2007 and January 2012 on 96 patients who were diagnosed with end-stage renal failure (ESRF) (54 males, 42 females; mean age 43.6 +/- 14 years) and underwent one- or two-stage BVT in our clinic. All patients who were not eligible for a native radio-cephalic or brachio-cephalic arterio-venous fistula (AVF) were scheduled for one-or two-stage BVT after arterial (brachial, radial and ulnar) and venous (basilic and cephalic) Doppler ultrasonography. Patients were retrospectively divided into two groups: group 1, basilic vein diameter > 3 mm and patients who underwent one-stage BVT; and group 2, basilic vein diameter < 3 mm and patients who underwent two-stage BVT. In group 1, the basilic vein with a single incision was anastomosed to the brachial artery, followed by superficialisation. In group 2, the basilic vein was anastomosed to the brachial artery and they underwent the superficialisation procedure one month postoperatively. Fistula maturation and postoperative complications were assessed. Results: The mean diameter of the basilic vein was statistically significantly higher in group 1 (3.46 +/- 0.2 mm) than in group 2 (2.79 +/- 0.1 mm) (p < 0.05). In terms of postoperative complications, thrombosis, haemorrhage and haematoma were significantly higher in group 1 (34, 36 and 17%, respectively) than in group 2 (23, 14 and 6%, respectively) (p < 0.05). The rate of fistula maturation was significantly lower in group 1 (66%), compared to group 2 (77%) (p < 0.05). Time to fistula maturation was significantly shorter in group 1 (mean 41 +/- 14 days), compared to group 2 (mean 64 +/- 28 days) (p < 0.05). Conclusion: Two-stage BVT was superior to one-stage BVT due to its lower rate of postoperative complications and higher fistula maturation, despite its disadvantage of late fistula use. Although the diameter of the basilic vein was larger in patients who underwent one-stage BVT, we observed that one-stage BVT was disadvantageous in terms of postoperative complications and fistula maturation.
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    Impact of elevated serum estradiol/free testosterone ratio on male varicose veins in a prospective study
    (Springer Wien, 2015) Ozcan, Sedat; Odabasi, Dolunay; Kurt, Tolga; Gur, Ali Kemal; Kunt, Aysegul; Balaharoglu, Yavuz; Kunt, Alper Sami
    Although some studies indicate an association between increased levels of estradiol and varicose veins in women, the role of sex hormones on varicose veins have a question mark in men. We investigated estradiol-2/free testosterone (E2/fT) ratio relationship on varicosity in 100 male patients dividing them into two groups. Group A (n = 46) had varicose veins with endocrinological problems, especially infertility, whereas group B (n = 54) also had varicose veins but no endocrinological problems. Venous blood samples were drawn from both groups in the morning to detect the levels of serum estradiol (E2), androstenedione, dehydroepiandrostenedione sulphate and free testosterone (fT). Patient history, physical examination, colour duplex ultrasound of both limbs and classification of CEAP were performed in both groups. Serum E2/fT ratio was calculated in correspondence with CEAP classification. CEAP classification is the varicosity classification, and it is concerned about the clinical class (C), etiology (E), anatomical distribution (A) and underlying pathophysiology (P). E2/fT ratio was significantly higher in group A (4.18 +/- A 0.54) compared with group B (2.98 +/- A 0.36). Moreover, there is a high correlation between serum E2/fT ratio and CEAP clinical classification in group A (4) compared with group B (2). Serum E2/fT ratio is associated with varicose veins in male patients.
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    Spontaneous rupture of the right ventricle on cardiopulmonary bypass
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2015) Ozcan, Sedat; Gur, Ali Kemal; Odabasi, Dolunay
    Wall ruptures after myocardial infarction are rare. Early diagnosis and treatment decrease mortality significantly. In this article, we present a 68-year-old female patient who admitted to our cardiology clinic due to inferior myocardial infarction one month ago and was placed a stent to right coronary artery with primary percutaneous transluminal coronary angioplasty. Patient was operated under elective conditions. Coronary artery bypass graft operation was performed to the left coronary arterial system. Right coronary artery distal bed was not operated due to ungraftable conditions. Right ventricular wall spontaneously ruptured during venous decannulation. Recannulation was performed and the ruptured area was repaired using pericardial mesh. Patient was discharged at seventh postoperative day without any problem.