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    Atrial septal defect repair; our early and mid-phase results
    (Professional Medical Publications, 2014) Ozcan, Sedat; Yener, Ali Ümit; Ozkan, M. Turgut Alper
    Objective: 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.
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    Öğe
    The impact of coronary artery endarterectomy on mortality and morbidity during coronary artery bypass grafting
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Yener, Ali Umit; Kervan, Umit; Korkmaz, Kemal; Gedik, Hikmet Selcuk; Budak, Ali Baran; Genc, Serhat Bahadir; Ozkan, M. Turgut Alper
    Background: This study aims to investigate the effect of coronary endarterectomy (CE) on morbidity and mortality in patients undergoing concomitant coronary artery bypass grafting (CABG). Methods: We retrospectively reviewed 587 patients who underwent CABG surgery with concomitant CE (CABG+CE group) and patch plasty between March 2000 and April 2010. We compared these patients with randomly selected 600 patients who had undergone CABG surgery without CE (CABG only group) in the same period. A comprehensive evaluation of the groups was achieved by subgroup analysis with large series of parameters from patient files. Results: The patients in the CABG+CE group were older than the patients in the CABG only group (59.6 +/- 10.3 vs. 61.3 +/- 7.3; p<0.001). The incidence of atherosclerotic risk factors, triple-vessel disease, and complaints of unstable angina pectoris were slightly higher in CABG+CE group (p<0.05). Concomitant CE prolonged cross-clamp and cardiopulmonary bypass time. Also, postoperative total entubation time (12 +/- 10.3 vs. 12 +/- 7.4 hours; p<0.05) was significantly longer (p<0.05). The rates of myocardial infarction (p=0.006) and intra-aortic balloon pump requirement (p<0.001) were significantly higher in the CABG+CE group. The mortality rate did not differ between the two groups. Conclusion: Indication for CE must still be handled restrictively. Endarterectomy should be performed only on occluded, nearly occluded, and/or severely calcified vessels with long-range stenosis if regular anastomoses to these vessels seem to be technically impossible. Endarterectomy should not be considered as a substitute for CABG, and should be performed by an experienced surgical team. However, CE might not be associated with additional mortality compared to conventional coronary bypass surgery.