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Öğe An effective treatment for prevention and impediment of atrial fibrillation after cardiac surgery(Pulsus Group Inc., 2014) Yener, Ali Umit; Ozkan, Turgut; Cicek, Mustafa Cuneyt; Cicek, Tugba; Baysal, Erkan; Genc, Bahadir; Dogan, EmreAtrial fibrillation is a common rhythm disorders after open heart surgery and associated with increased morbidity and mortality. Advanced age, hypertension, COPD are known to be the causes of postoperative atrial fibrillation. However, reactive oxygen radicals formed after open heart surgery have been shown to be involved in the etiology of AF. Besides its expectorant feature, NAC is a molecule known to be an antioxidant. In this retrospective study, we compared the incidence of postoperative AF and onset time of AF in patients who used preoperatively NAC because of COPD and who did not use NAC. In this study, the incidence of atrial fibrillation was significantly lower in patients using NAC preoperatively. Also onset time of AF was significantly longer in patients who used NAC.Öğe Application of radiofrequency ablation procedure on a morbidly obese patient with a venous ulcer and large saphenous vein(Clinics Cardive Publ Pty Ltd, 2015) Yener, Ali Umit; Yener, Ozlem; Gedik, Hikmet Selcuk; Korkmaz, Kemal; Ozkan, Turgut; Lafci, Ayse; Cagli, KerimVenous ulcers that occur due to chronic venous insufficiency are seen on the upper medial malleol of the ankle. Treatment of venous ulcers is protracted and generally the success rate is low. Co-morbid factors play an important role in the success of treatment of venous ulcers. In this case report, we demonstrate successful venous ulcer treatment in a morbidly obese patient with co-morbid conditions.Öğe DOES A BASIC BLOOD TEST TELL THE LOCATION OF PERIPHERAL ARTERIAL LESIONS?(Carbone Editore, 2015) Yener, Ali Umit; Cicek, Omer Faruk; Cicek, Mustafa Cuneyt; Ozkan, Turgut; Korkmaz, Kemal; Yener, Ozlem; Genc, BahadirAim: In this retrospective study, We investigated if neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) can suggest at hospital admission the location of lesion according to TASC 2 classification, in patients with peripheral arterial disease(PAD). Methods: In patients who underwent peripheral angiography, the routine blood tests performed before the procedure were collected. 241 patients between January 2010 and March 2013 were included in the study. The relationship between blood parameters and the location of peripheral arterial lesions was investigated. The patients were divided into 4 groups according to their TASC 2 (Trans-Atlantic Inter-Society Consensus Document on Management of Peripheral Arterial Disease)classification; group A,B,C and D. Results: According to blood tests of patients, NLR and PLR were 3.47 +/- 2.69 and 154.1 +/- 71.2, respectively. When NLR and PLR values were evaluated separately in each group, in patients of Group D according to TASC 2. median NLR and PLR values were significantly higher compared to other groups. In high PLR group, concomitant coronary artery disease was observed in 30.9% of patients, and this difference was statistically significant compared to the low PLR group. Conclusion: Widespread of the PAD may be predicted with the help of a simple blood test at the limited conditions of outpatient clinics and time will be saved in terms of prevention of PAD.Öğe Does a basic blood test tell the location of peripheral arterial lesions?(Acta Medica Mediterranea, 2015) Yener, Ali Umit; Cicek, Omer Faruk; Cicek, Mustafa Cuneyt; Ozkan, Turgut; Korkmaz, Kemal; Yener, Ozlem; Genc, BahadirAim: In this retrospective study, we investigated if neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) can suggest at hospital admission the location of lesion according to TASC 2 classification, in patients with peripheral arterial disease(PAD). Methods: In patients who underwent peripheral angiography, the routine blood tests performed before the procedure were collected. 241 patients between January 2010 and March 2013 were included in the study. The relationship between blood parameters and the location of peripheral arterial lesions was investigated. The patients were divided into 4 groups according to their TASC 2 (Trans-Atlantic Inter-Society Consensus Document on Management of Peripheral Arterial Disease )classification; group A,B,C and D. Results: According to blood tests of patients, NLR and PLR were 3.47 ± 2.69 and 154.1 ± 71.2 , respectively. When NLR and PLR values were evaluated separately in each group, in patients of Group D according to TASC 2 , median NLR and PLR values were significantly higher compared to other groups. In high PLR group, concomitant coronary artery disease was observed in 30.9% of patients, and this difference was statistically significant compared to the low PLR group. Conclusion: Widespread of the PAD may be predicted with the help of a simple blood test at the limited conditions of outpatient clinics and time will be saved in terms of prevention of PAD.Öğe Effect of acetyl salicylic acid resistance on saphenous vein graft occlusion in patients with metabolic syndrome who had coronary bypass surgery(Pulsus Group Inc., 2014) Baysal, Erkan; Yener, Ali Umit; Ozkan, Turgut; Karan, Adnan; Astan, Ramazan; Keskin, Gokhan; Yener, OzlemPURPOSE: The goal of this study was to investigate the effect of acetyl salicylic acid (ASA) resistance on saphenous vein graft occlusion in saphenous vein graft used patients with metabolic syndrome who had CABG. ASA resistance may be higher in patients with metabolic syndrome and saphenous vein graft occlusion and this may result in adverse coronary events. MATERIAL-METHOD: 41 patients with metabolic syndrome who had previously CABG operation for whom saphenous vein graft was used and who currently used 100-300 mg/day ASA, who had postoperative angina pectoris, whose ischemia was determined by noninvasive tests and to whom coronary angiography were performed, were included in our study. The patients were divided into two groups as patients with saphenous vein graft occlusion (n:18) and the patients without saphenous vein graft occlusion (n:23). FINDINGS: In both groups with similar demographic characteristics while ASA resistance was determined in 10 patients with saphenous vein graft occlusion, 7 patients without saphenous vein graft occlusion had ASA resistance. This statistics showed us that in the patients with metabolic syndrome and who had ASA resistance, saphenous vein graft occlusion developed more. CONCLUSION: Although it is important to check ASA resistance in patients with metabolic syndrome, to whom CABG are intended, it is not checked routinely. In patients with metabolic syndrome who have ASA resistance, if CABG is planned high dose ASA treatment can be applied in early period, additional antithrombocyte treatment may be added or arterial graft may be used.Öğe Magnesium; the electrolyte that delays the formation of atrial fibrillation(Pulsus Group Inc., 2014) Yener, Ali Umit; Ozkan, Turgut; Cicek, Mustafa Cuneyt; Baysal, Erkan; Dogan, Emre; Cicek, Omer Faruk; Genc, BahadirAtrial fibrillation is one of the most common undesirable situation seen after open-heart surgery because of increasing the length of hospital stay, morbidity and mortality. It is revealed that atrial fibrillation may occur as a result of various electrolyte deficiencies such as magnesium. In this retrospective study, we aimed to compare the rhythm outputs of different cardiopulmonary bypass protocols,magnesium included in study group and without magnesium used patients was inserted in control group. The incidence of atrial fibrillation between 2 groups was not statistically significant. Furthermore magnesium treatment delayed the onset of atrial fibrillation in patients after coronary bypass graft surgery.Öğe Protective role of heparin in the injury of the liver and kidney on the experimental model of ischemia/reperfusion(BMC, 2014) Yener, Ali Umit; Cicek, Mustafa Cuneyt; Genc, Serhat Bahadir; Ozkan, Turgut; Dogan, Emre; Bilgin, Bulent Caglar; Akin, TezcanBackground: Surgery of thoracoabdominal aortic aneurysms (TAAA) is associated with high incidence of serious complications. Ischemia/reperfusion (I/R) injury may be responsible for these complications. We investigated the effect of degree of anticoagulation on remote organ I/R injuries and whether heparin is protective against I/R injury in addition to its anticoagulant properties. Methods: Spraque Dawley rats were used to determine both liver and kidney concentrations of HSP-70, IL-6, MPO in four groups: ischemic control (operation with cross-clamping and intraperitoneal administration of 0.9% saline, n = 7), sham (operation without cross-clamping, n = 7), heparin (ACT level about 200), and high dose heparin (ACT level up to 600). Histological analyses of the organs were performed. Results: Histopathological evaluation of kidney presented significant differences between groups with regards to the cytoplasmic vacuole formation, hemorrhage, tubular cell degeneration and tubular dilatation while heparinized group had best results. The kidney MPO and HSP-70 levels significantly decreased (p < 0.05), but IL-6 level was not significant (p > 0.05) in heparinized group when compared to ischemic control group. No statistically significant intergroup differences were detected in the tissue samples of liver. Immunohistochemical markers of the liver were compared and no statistically significant difference was found among the groups. Conclusion: Heparin is an important anticoagulation agent in TAAA surgical procedures but the use of higher levels of heparin in the present study revealed no beneficial effects. Bleeding complications is much less when heparin is used in the real-world clinical practice as ACT levels of 200.Öğe Radiofrequency ablation of the great saphenous vein in an elderly patient with co-morbid disease(Clinics Cardive Publ Pty Ltd, 2013) Yener, Ali Umit; Yener, Ozlem; Gedik, Hikmet Selcuk; Korkmaz, Kemal; Ozkan, Turgut; Lafci, Ayse; Cagli, KerimAn 86-year-old male patient with hypertension, Parkinsonisrn, benign prostatic hyperplasia, cataract and chronic obstructive pulmonary disease had a history of coronary bypass surgery in two veins due to anterior myocardial infarction one year earlier. He presented with pain and feelings of paresthesia below the knee of his left leg, and had fallen twice. He had used compressions and venoprotective medication for two years and had also received physiotherapy but it had not alleviated the symptoms. He had varicose dilatations in the left leg and pigmentation and a recovered venous ulcer scar were present on the medial malleolus. The patient was classed as grade 4 according to the CEAP classification. Because there was no deficiency in the superficial femoral and popliteal Veins, the patient was taken for endovenous ablation. He had no pain or sensation of heaviness in the legs on postoperative day 10, and the first, third and sixth months of check up. Endovenous ablation is a procedure that increases the quality of life and comfort in elderly patients, with minimal pain. Radiofrequency catheter procedures have proven to be more successful in patients of all age groups than procedures such as standard surgery and foam therapy.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.
