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Öğe Atrial septal defect repair; our early and mid-phase results(Professional Medical Publications, 2014) Ozcan, Sedat; Yener, Ali Ümit; Ozkan, M. Turgut AlperObjective: Atrial septal defect is one of the most commonly encountered congenital heart diseases in adults. The effect of age of the patient to the surgery is disputable. The purpose of this report was to evaluate surgical repair in patients with ASD who are operated in our clinic. Methods: Total 40 patients were subjected to surgical repair due to ASD in Van Yuksek Ihtisas Education and Research Hospital between February 2006 and April 2009. Twenty seven of the patients were female and 13 were male, their ages differed between 8 and 71 and mean age of the patients was 33.70±14.04. Result: Operative mortality did not occur. Two of our patients had coronary arterial disease in addition to ASD. ASD repair was performed together with coronary bypass surgery. Closing of ASD resulted in an increase in left ventricular ejection fraction, and a decrease in pulmonary arterial pressure and cardiothoracic ratio. Recovery in the functional capacity was observed post-surgery according to NYHA. Conclusion: In this series, surgical results of the patients of various ages, with ASD closed were positive.Öğe Can the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) be new early stage markers of subclinical atherosclerosis in patients with rheumatoid arthritis?(Springer Wien, 2015) Kurt, Tolga; Temiz, Ahmet; Gokmen, Ferhat; Adam, Gurhan; Ozcan, Sedat; Ozbudak, Ersan; Sacar, MustafaIt takes years for atherosclerosis to manifest symptoms. However, it needs to be identified earlier because of the premature cardiovascular risk factors in patients with rheumatoid arthritis (RA). In this study, we aimed to investigate the effect of atherosclerosis on the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) in patients with RA. RA patients attending the rheumatology clinic were examined retrospectively; then we called them for the measurements of ABPI and CIMT prospectively. Subjects were divided into four groups, as follows (Table 1): group 1 comprised RA patients with an ABPI less than 0.9; group 2 included RA patients with an ABPI between 0.9 and 1.2; group 3 was made up of RA patients with an ABPI greater than 1.2; and group 4 included patients without RA with an ABPI between 0.9 and 1.2 as a control group. Patients' demographic data were recorded. Hypertension (HT), diabetes mellitus, ABPI and CIMT measurements were taken by specialists. Duration of RA and disease scores (disease activity score-28, health assessment questionnaire score and visual assessment score) were recorded. The prevalence of peripheral vascular disease in patients with RA was twice as high as that in the normal population of equivalent age. Patients in group 2, with RA and normal ABPI, exhibited a significant higher mean in CIMT (mm) compared with the control group (p < 0.01), despite having normal ABPI. This confirms that these patients have a higher risk of stroke compared with the control group. Group 1's newly diagnosed HT (p < 0.01) and systolic blood pressure (SBP) values (p < 0.01) were higher and statistically significant when compared with the group 4 (control group); in addition, significant plaque levels were observed in the carotid arteries (p < 0.01). Group 3 patients had a similar history of HT and increased SBP compared with patients in group 4 (p < 0.01), and had similar characteristics to with group 1. No statistically significant differences were found between the groups in terms of inflammatory markers such as C-reactive protein and rheumatoid factor, anti-cyclic citrullinated peptide and white blood cell counts. Based on the present findings, patients with RA need to be evaluated in the early stage of the disease for subclinical peripheral artery disease using the ABPI, as well as CIMT, which is also a non-invasive technique, in terms of cerebrovascular events. Inflammatory markers exhibited no statistically significant difference. We think that the atherosclerotic process stems not only from the inflammatory effects of RA, but also perhaps from its immunological nature.Öğe 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, DolunayObjective: 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.Öğe COMPARISON OF THE NUMBER OF CARDIOVASCULAR ADMISSIONS BEFORE AND AFTER COVID-19: EXPERIENCE FROM TURKEY(Carbone Editore, 2020) Khalil, Emced; Ozcan, SedatBackground: The frequency of cardiovascular problems in patients with COVID-19 could be interpreted to suggest an increase in the number of cardiovascular admissions in the COVID-19 era. However, almost all countries announced social restrictions and distancing measures which could unintentionally lead to a decline in admissions to the hospital for acute disorders other than those associated with pneumonia. This study aimed to compare cardiovascular admissions before and after COVID-19 at the emergency department of secondary and tertiary centers in Turkey. Methods: We analyzed emergency department referrals to secondary and tertiary centers in Ordu province, Turkey for subjects with acute chest pain, shortness of breath, palpitation, leg swelling, and acute limb ischemia from March 10, 2020 to April 30, 2020. Also, we recorded the number of diagnostic coronary angiographies, peripheral endovascular interventions, and cardiac surgeries performed at our institute. The difference in the frequency of emergency department referrals due to acute cardiovascular disorders before and after COVID-19 was the primary outcome measure of this study. Results: Our findings show that, following the establishment of social restrictions 1918 patients were admitted to the emergency department with acute chest pain, shortness of breath, palpitation, leg swelling, and acute limb ischemia. Compared to the last five years (2105-2019) there was a decline in numbers of the patients admitted to the emergency department with acute coronary syndromes, and acute heart failure. There was also a dramatic decline in number of diagnostic coronary angiographies, peripheral interventions and cardiac surgeries. Finally, the number of lower extremity amputations from peripheral artery disease was increased. Conclusion: Our findings show that, compared to the same intervals in the last five years, a critical decline has occurred in the number of patients admitted to our emergency department with cardiovascular symptoms, acute heart failure, acute coronary syndrome, STEM1, while the number of diagnostic angiographies, peripheral endovascular interventions and cardiac surgeries were also decreased. The state of alarm declared by many countries may have caused a higher threshold for hospital application in patients with cardiovascular problems, possibly due to social distancing measures and concerns of contracting COVID-19 in the hospital.Öğe Health-related quality of life after vascular surgery and endovascular treatment in subjects with critical limb ischemia(Professional Medical Publications, 2020) Khalil, Emced; Ozcan, SedatBackground & Objective: Revascularization of the target vessel and restoration of distal flow is critical not only to reduce mortality and morbidity but also improve health-related quality of life (HRQoL) in patients with critical limb ischemia. However, data concerning the impact of surgical bypass and percutaneous transluminal angioplasty (PTA) on HRQoL is limited. This study aimed to compare the impact of surgical bypass and PTA on HRQoL in subjects undergoing superficial femoral artery (SFA) or popliteal artery revascularization. Methods: Seventy-one subjects who underwent successful revascularization of the SFA or popliteal artery either with surgical revascularization or PTA were enrolled in this study. Three months after revascularization, all subjects underwent ankle-brachial index (ABI) measurement, 6-minute walking test and completed the Nottingham Health Profile (NHP) questionnaire. The NHP score differences (measured at the post-procedural 3rd month) between subjects undergoing surgical or endovascular (PTA) revascularization subjects was the primary outcome measure of the study. Results: Both groups experienced significant improvements in ABI and 6-minute walking distance at post-procedure three months. NHP total scores of Part I and Part II at post-procedural six months were similar in the two groups. However, social isolation [77.98 (0 - 85) vs. 22.53 (0 - 100), p=0.002] and physical abilities [78.7 (30.31 - 87.7) vs. 54.47 (0 - 100), P=0.014] domain scores of the surgical revascularization group were significantly higher than that of the endovascular treatment group. Conclusion: This study shows that total scores obtained from the NHP questionnaire applied three months after revascularization of SFA stenosis are similar in subjects undergoing surgical revascularization or PTA. However, the social isolation and physical abilities domains of the NHP are significantly higher in subjects receiving surgical revascularization compared to those receiving PTA.Öğe HOW IMPORTANT IS EARLY DIAGNOSIS OF SUBCLINICAL ATHEROSCLEROSIS IN PRIMARY SJOGREN'S SYNDROME PATIENTS?(Carbone Editore, 2015) Kurt, Tolga; Gokmen, Ferhat; Adam, Gurhan; Ozcan, Sedat; Ozbudak, Ersan; Akbal, Ayla; Temiz, AhmetIntroduction: Cardiovascular (CV) disease is observed with increasing frequency in patients with systemic vasculitis. The use of carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) may help to identify high-risk primary Sjogren's syndrome (PSS) patients. The objective of this study is to determine abnormal ABPI and CIMT values in the patient group with PSS and compare them clinically and serologically with a control group. Materials and methods: Our study comprised a total of 124 patients who were diagnosed with PSS according to the American-European Consensus Group Sjogren's syndrome classification criteria and monitored for more than 3 years, and a control group. CIMT and ABPI measurements were completed by specialists. The patients were also evaluated serologically. Results: All of the PSS patients had xerophthalmia findings, the second most common symptom was xerostomia. The mean disease duration was 80.4 +/- 25.6 months. Nine PSS patients (41%) had ABPI less than 0.9. In the control group II (II%) patients had ABPI less than 0.9. When the two groups were compared, the difference was found to be significant (p<0.05). PSS patients also exhibited a statistically significant increase in mean CIMT values (mm; p<0.05). When the PSS patients with ABPI less than 0.9 were compared with other PSS patients and the control group, there was no significant difference in terms of anti-Sjogren's syndrome related antigen A (anti-SSA) and anti-Sjogren's syndrome related antigen B (anti-SSB), C-reactive protein (CRP), rheumatoid factor (RF) or Anti-Cyclic Citrullinated Peptide (anti-CCP) positivity (p>0.05). Conclusion: Similar to patients with systemic vasculitis, PSS patients should be assessed for subclinical peripheral arterial diseases in the early stage and monitored closely with ABPI and CIMT measurements. The atherosclerotic process observed in PSS patients may be due not only to the inflammatory effect, but to many multifactorial issues such as immunological and genetic effects.Öğe How important is early diagnosis of subclinical atherosclerosis in primary Sjogren's syndrome patients?(Acta Medica Mediterranea, 2015) Kurt, Tolga; Gokmen, Ferhat; Adam, Gurhan; Ozcan, Sedat; Ozbudak, Ersan; Akbal, Ayla; Temiz, AhmetIntroduction: Cardiovascular (CV) disease is observed with increasing frequency in patients with systemic vasculitis. The use of carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) may help to identify high-risk primary Sjogren's syndrome (PSS) patients. The objective of this study is to determine abnormal ABPI and CIMT values in the patient group with PSS and compare them clinically and serologically with a control group. Materials and methods: Our study comprised a total of 124 patients who were diagnosed with PSS according to the American-European Consensus Group Sjogren's syndrome classification criteria and monitored for more than 3 years, and a control group. CIMT and ABPI measurements were completed by specialists. The patients were also evaluated serologically. Results: All of the PSS patients had xerophthalmia findings, the second most common symptom was xerostomia. The mean disease duration was 80.4±25.6 months. Nine PSS patients (41%) had ABPI less than 0.9. In the control group 11 (11%) patients had ABPI less than 0.9. When the two groups were compared, the difference was found to be significant (p<0.05). PSS patients also exhibited a statistically significant increase in mean CIMT values (mm; p<0.05). When the PSS patients with ABPI less than 0.9 were compared with other PSS patients and the control group, there was no significant difference in terms of anti-Sjogren's syndrome related antigen A (anti-SSA) and anti-Sjogren's syndrome related antigen B (anti-SSB), C-reactive protein (CRP), rheumatoid factor (RF) or Anti-Cyclic Citrullinated Peptide (anti-CCP) positivity (p>0.05). Conclusion: Similar to patients with systemic vasculitis, PSS patients should be assessed for subclinical peripheral arterial diseases in the early stage and monitored closely with ABPI and CIMT measurements. The atherosclerotic process observed in PSS patients may be due not only to the inflammatory effect, but to many multifactorial issues such as immunological and genetic effects.Öğe 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 SamiAlthough 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.Öğe Is hyperbaric oxygen or ozone effective in experimental endocarditis?(Academic Press Inc Elsevier Science, 2016) Ozkan, Muhammed Turgut Alper; Vural, Ahmet; Cicek, Omer Faruk; Yener, Ali Umit; Ozcan, Sedat; Toman, Huseyin; Unver, AhmetBackground: Infective endocarditis, a disease with high mortality and morbidity, is most commonly caused by Staphylococcus aureus; mortality and morbidity further increase in the presence of methicillin-resistant strains of S. aureus. Linezolid is the first of the oxazolidinones, a new antibiotic group that has been approved for the treatment of infections caused by gram-positive cocci. Linezolid reduces the quantity of microorganisms in vegetation to some extent; in addition, the use of hyperbaric oxygen (HBO) and ozone (O-3) therapies is likely to improve targeted antibacterial effect. Materials and methods: Fifty-six adult male Wistar rats weighing 300-350 g were used. The subjects were divided into groups as follows: Group 1 (n = 8): control group that was not inoculated with microorganisms and was untreated; Group 2 (n = 8): control group that was inoculated with microorganisms but was untreated; Group 3 (n = 8): linezolid treatment group; Group 4 (n = 8): O-3 therapy group; Group 5 (n = 8): HBO therapy group; Group 6 (n = 8): linezolid + O-3 therapy group; Group 7 (n = 8): linezolid + HBO therapy group. Results: In terms of reducing the number of colonies in the aortic valve, linezolid + HBO therapy was found to be the most effective treatment. Then, respectively linezolid + O-3, linezolid, HBO, and O-3 were found to be effective. Conclusions: We found that linezolid significantly reduced the number of bacteria in the vegetation in the experimental endocarditis model, and HBO therapy increases the effectiveness of linezolid and makes this better than O-3. (C) 2016 Elsevier Inc. All rights reserved.Öğe Late thoracic endovascular stent graft repair after complicated acute type B dissection(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2016) Ozcan, Sedat; Kunt, Aysegul; Odabasi, DolunayThoracic endovascular stent repair is a life-saving treatment option for patients with complicated type B aortic dissection. In this article, we present a 32-yearold male case referred with ruptured acute type B aortic dissection after injury. Thoracic endovascular stent graft repair was successfully performed 72 hours following the onset of complicated acute type B aortic dissection.Öğe LEFT ATRIAL MYXOMA WITH ATYPICAL CLINICAL PRESENTATION(Carbone Editore, 2014) Kurt, Tolga; Ozcan, Sedat; Temiz, Ahmet; Ozbudak, Ersan; Gazi, Emine; Sacar, 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 symptomatially 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 OUR EXPERIENCES IN THE SURGICAL TREATMENT OF VENOUS ANEURYSMS APPEARING AS SECONDARY TO THE UPPER EXTREMITY ARTERIOVENOUS FISTULA ON PATIENTS WITH CHRONIC RENAL FAILURE(Carbone Editore, 2014) Ozcan, Sedat; Odabasi, 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 Predictive value of elevated neutrophil-lymphocyte ratio for left ventricular systolic dysfunction in patients with non ST-elevated acute coronary syndrome(Professional Medical Publications, 2015) Bekler, Adem; Erbag, Gokhan; Sen, Hacer; Gazi, Emine; Ozcan, SedatObjective: We aimed to study the predictive value of the neutrophil-lymphocyte ratio (NLR) for left ventricular systolic dysfunction (LVSD) in patients with non ST-elevated acute coronary syndrome (NST-ACS). Methods: A total of 405 patients (mean age 62 years and 75% male) with NST-ACS were included in the study. The study population was divided into tertiles based on admission NLR values. The low, medium and high tertiles defined as NLR <= 1.81 (n=135), 1.81<=.3.2 (n=135) and NLR>3.2 (n=135), respectively. Results: The patients in the high NLR group were older (p<0.001), have higher rate of diabetes mellitus (p=0.028) and non-ST elevated myocardial infarction (NSTEMI) (p<0.001) and have lower left ventricular ejection fraction (LVEF) (p<0.001). Baseline WBC (p=0.02) and neutrophil (p<0.001) levels and NLR (p<0.001) were significantly higher, baseline hemoglobin (p=0.044), hematocrit (p=0.019) and lymphocyte (p<0.001) levels were significantly lower in the high NLR group. NLR was negatively correlated with LVEF in correlation analysis. An NLR >3.2 and age >= 70 were found to be an independent predictor of systolic dysfunction in multivariate analyses. Conclusion: An NLR >3.2 is a useful predictor for LVSD in patients with NST-ACS. The practice of using an NLR count on admission may be useful for identifying high-risk patients and their associated treatment methods.Öğe Relationship between atrial fibrilation and coronary bypass surgery(Professional Medical Publications, 2014) Ozcan, SedatObjective: Atrial fibrillation (AF) is the most common arrhythmia seen after coronary artery surgery. The purpose this study was to determine incidence of AF that develops after coronary surgery and the factors affecting its development. Methods: Four hundred and forty eight patients who had coronary bypass surgery between February 2007 and September 2011 in the Cardiovascular Surgery Clinic were included in the study. Patients with history of chronic renal failure, redo coronary bypass surgery, valvular disease, thyroid disease, ventricular aneurysm and treatment with beta-blockers were excluded from the study of EF. Results: Two hundred and ninety nine patients were male and 149 were female and their age varied between 38 and 85 and their mean age was 61±5. Surgery was performed on beating heart on 178 patients and the others were operated with cardiopulmonary bypass (CPB). Advanced age, male sex and history of hypertension was more in AF developed patient group. There was no difference between AF developed group and the other group in terms of diameter of left atrium, ejection fraction (EF), CPB time and cross clamp time. Conclusion: Advanced age, male sex, hypertension and prolonged P-wave duration are the factors that are associated with AF after coronary surgery. Avoidance of CPB does not decrease AF development.Öğe Relationship between fragmented QRS and paradoxical septal motion in coronary artery bypass graft patients(Springer, 2015) Barutcu, Ahmet; Ozdemir, Semra; Tan, Yusuf Ziya; Yener, Ali Umit; Ozcan, Sedat; Gazi, EmineParadoxical septal motion (PSM) can cause confusion in the assessment of ventricular function with scintigraphy even in the absence of ventricular septal damage and ischemia. Fragmented QRS (fQRS) is associated with various cardiac disorders. In this study, we aimed to determine the correlation between paradoxical septal motion and fQRS after coronary artery bypass grafting (CABG). We retrospectively reviewed the hospital records showing scintigraphic images and electrocardiograms (ECG) of the patients who had undergone CABG. The patients were classified based on the evaluation of motion and thickening of the septal wall. The patients with regular thickening of the septal wall and abnormal motion were classified as PSM (+) group. The patients with normal motion and thickening of the septal wall were classified as PSM (-) group. fQRS complexes are defined as various RSR patterns either with or without Q-waves on a 12-lead resting ECG. PSM was found to be more common in fQRS patients (p < 0.001). PSM was seen in 91.4 % of cases with fQRS and in 79.8 % of cases without fQRS. No significant differences were found in the phase analysis parameters. A correlation was found between septal wall motion values and the presence of fQRS (r = 0.197, p = 0.012). fQRS was associated with PSM. fQRS may cause PSM in patients with CABG without left bundle branch block due to a conduction defect. PSM and fQRS are predictive of cardiac mortality. Patients diagnosed with PSM and fQRS, should be monitored closely.Öğe Retrograde Versus Antegrade Approach for the Endovascular Treatment of Symptomatic Femoropopliteal Disease: Results of the 2-Year Follow Up(Forum Multimedia Publishing, Llc, 2020) Khalil, Emced; Ozcan, SedatObjective: To compare the antegrade and retrograde approaches, in terms of access site complications and long-term patency in subjects undergoing EVT for symptomatic SFA or popliteal artery stenosis or occlusions. Methods: All consecutive patients who underwent retrograde recanalization for partial stenosis or chronic total occlusion of the SFA or PA at 2 centers were enrolled in this retrospective analysis. Subjects were divided into 2 groups, according to the approach selected for EVT as antegrade approach group or retrograde approach group. The rate of primary patency, which was defined as the lack of restenosis at the target lesion, was the primary outcome measure, during the follow-up evaluations. The rate of procedural complications, including hematoma, bleeding, and distal embolism, were secondary outcome measures. Results: A significant improvement occurred in ABI, following the intervention in both the antegrade approach group [0.7 (0.3 - 1.1) versus 0.85 (0.4 - 1.3), P < 0.001] and retrograde approach group [0.5 (0.3 - 1.1) versus 0.8 (0.3 - 1.3), P < .001]. The primary patency rate at the 1st, 6th, 12th and 24th months of the intervention in the antegrade approach group were 94.85%, 83.82%, 74.26%, and 66.91%, respectively. The primary patency rate at the 1st, 6th, 12th, and 24th months of the intervention in the retrograde approach group were 93.33%, 86.67%, 84.44%, and 71.11%, respectively. The groups were similar with respect to the primary patency rates. The rate of complications, including hematoma, bleeding, and distal embolization was similar in the 2 groups. Conclusion: Antegrade approach and retrograde approach provide a similar safety profile in the EVT of SFA and popliteal artery stenosis and occlusion. The primary patency rates at the 1st, 6th, 12th, and 24th months of follow up also were similar in the 2 groups. However, the significant difference in the lesion characteristics of the subjects undergoing retrograde or antegrade approach complicates the ability to reach a clear conclusion, regarding the superiority of one technique over the other.Öğe Spontaneous rupture of the right ventricle on cardiopulmonary bypass(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2015) Ozcan, Sedat; Gur, Ali Kemal; Odabasi, DolunayWall 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.Öğe Surgical management of axillosubclavian vascular injuries(Professional Medical Publications, 2015) Akyuz, Muhammet; Gokalp, Orhan; Ozcem, Barcin; Ozcan, Sedat; Besir, Yuksel; Gurbuz, AliObjective: Complex surgical exposures to upper extremity injuries required for conventional surgery correlate with a high morbidity and mortality. We present our results with conventional surgery following injuries of the subclavian and axillary vessels. Methods: Between November 2007 and March 2012, 29 cases with subclavian-axillary vascular injury were operated. Diagnostic and treatment methods, associated organ injury, morbidity and mortality rates in these cases were respectively reviewed. Results: The causes of injuries were stab wounds in 11 cases (37.9%), gunshot wounds in 9 cases (31%), iatrogenic injuries in 5 cases (17.2%) and blunt trauma 4 cases (13.7%). Eight patients (27.5%) had isolated arterial injury while 21 patients (72.4%) had coexisting organ injury (vein, bone, soft tissue, nerve). Primary repair and usage of saphenous vein were the most common surgical methods. One patient died due to myocardial infarction. (Mortality 3.4%) Conclusions: Vascular injuries of axillosubclavian are frequently associated with neurogenic, osseous and soft tissue injuries and should have early intervention. Conventional surgery remains the choice of treatment in patients with poor status and urgency.Öğe The effects of 21 and 23 milimeter aortic valve prosthesis on hemodynamic performance and functional capacity in young adults(2014) Yener, Ali Umit; Ozcan, Sedat; Budak, Ali Baran; Genc, Serhat Bahadir; Ozkan, Turgut; Cicek, Omer FarukObjective: Early and medium-term improvement of functional capacity and regression of left ventricular hypertrophy was evaluated in the young adult patient group following application of 21 mm or 23 mm bileaflet aortic mechanical valve prosthesis due to aortic stenosis. Methods: Twenty two patients (10 male, 12 female; mean age 27+-8.2 (19-43)) who underwent isolated aortic valve replacement due to rheumatic aortic stenosis, were included in the study. 21 mm and 23 mm bileaflet mechanical prosthesis was used respectively in eight and fourteen patients. The mean body surface area was 1.86 m2 and 1.68 m2 respectively in 23 mm and 21 mm prosthesis while 1.73 ±0.25 m2 for the whole group. Functional capacity was New York Heart Association (NYHA) class II in 9 patients and class III in thirteen patients. Implantation was performed without enlarging the aortic root in all except four patients. In all patients transvalvular gradients, effective orifice area and the diameter of left ventricle were measured with transthoracic echocardiography during rest and after maximal exercise. Mean followup was 34±12 months (range 11-57 months). Results: There were no postoperative complications or deaths. All the patients were assessed as NYHA class I with regards to functional capacity (p=0.01). Significant improvements were determined in postoperative mean transvalvular gradient (p=0.005) and left ventricular mass index (p=0.01) when compared with preoperative values. Conclusion: Our findings show that replacement with 21 mm and 23 mm mechanical prosthesis provides a significant improvement in regression of symptoms and increase of functional capacity in young adults in early and mid-period without increasing mortality and morbidity.Öğe The safety and efficacy of pharmaco-mechanical thrombolysis in lower-extremity deep venous thrombosis(Clinics Cardive Publ Pty Ltd, 2020) Khalil, Emced; Ozcan, SedatObjectisve: The aim of this study was to investigate the impact of accelerated pharmaco-mechanical thrombolysis (PMT) with low-dose second-generation urokinase for the management of cases with lower-extremity deep venous thrombosis (DVT), and to compare its efficacy in subjects with acute and subacute DVT. Methods: Thirty-five patients with acute (< 15 days) or subacute (15 30 days) DVT who underwent PMT in a tertiary centre were enrolled in this single-arm, prospective study. Following the placement of a temporary Sena cava filter, urokinase (200 000 IU) was administered into the occlusion through a multi-hole catheter for 15 to 20 minutes. Control venography was performed to assess venous flow and the rate of acute recanalisation. Percutaneous balloon dilatation and stent placement were carried out in case of a residual iliac vein stenosis of > 50%. Any residual thrombi were suctioned with an aspiration catheter. The primary outcome measures of this study were the percentages of vessel potency and PTS in the third month after PMT. Results: Complete recanalisation was noted in 23 (66% patients, while two (6%) had poor recanalisation. The rate or minor complications was 14%. None of the subjects exper ienced major complications, such as intracranial haemorrhage or pulmonary embolism. No mortality was recorded during the three months of follow up. Control duplex ultrasonography in the third month revealed that the target vein was patent in all subjects. None of the subjects experienced PTS during follow up. In addition, the percentage of acute complete recanalisation was significantly higher in subjects with acute DVT compared to those with subacute DVT (95 vs 27%, p < 0.001). Conclusion: PMT with an accelerated regimen of low-dose urokinase provided excellent efficacy in the resolution of thrombus and prevented the development of PTS in the mid-term when used for the management of lower-extremity DVT.
