Browsing by Author "Bayramoğlu, Zehra"

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Citation Count: 0
Açık kalp cerrahisi sonrası vertebral osteomiyelit mediastinitin önemli bir komplikasyonu
(2001) Güden, Mustafa; Akpınar, Belhan; Sağbaş, Ertan; Sanisoğlu, İlhan; Şirvancı, Mustafa; Bayramoğlu, Zehra; Çaynak, Barış; Yüksel, Alper
[Abstract Not Available]
Citation Count: 36
Does off-pump CAPG reduce gastrointestinal complications?
(Elsevier Science Inc, 2004) Sanisoğlu, İlhan; Güden, Mustafa; Bayramoğlu, Zehra; Sağbaş, Ertan; Dibekoğlu, Cengiz; Sanisoğlu, S. Yavuz; Akpınar, Belhhan
Background. The aim of this study was to compare gastrointestinal complications and associated risk factors among patients undergoing cardiac surgery using off- and on-pump revascularization techniques. Methods. A total of 1146 adult patients who underwent coronary artery surgery during a 6-year period were evaluated retrospectively. Group 1 consisted of 546 patients operated using off-pump techniques and group 2 consisted of 600 cases operated with cardiopulmonary bypass. Patients were compared and evaluated for gastrointestinal complications and possible associated risk factors using univariate and multivariate logistic regression analysis. Results. Overall mortality was 1.6% in group 1 and 2.2% in group 2 (p = 0.523). Mortality due to gastrointestinal complications was 38.5% and 35.7% respectively in group 1 and group 2. The mean EuroSCORE value was 5.1 +/- 2.8 in group 1 and 3.8 +/- 2.4 in group 2 (p < 0.001). The most common gastrointestinal complication in the off-pump group was gastrointestinal bleeding. The leading complication in group 2 was intestinal ischemia. Conclusions. The incidence rates of gastrointestinal complications were similar in the on- and off-pump coronary artery bypass groups the type of gastrointestinal complications however was different. Mortality rate due to these complications was also similar and remained high regardless of the type of surgery. Cardiopulmonary bypass did not emerge as a risk factor for gastrointestinal complications but prolonged cardiopulmonary bypass (longer than 98 minutes) resulted in a high incidence of such complications. Old age and advanced arteriosclerosis emerged as risk factors in both groups resulting in gastrointestinal complications suggesting the ischemic nature of the injury. (C) 2004 by The Society of Thoracic Surgeons.
Citation Count: 8
Does off-pump coronary artery bypass surgery reduce mortality in high risk patients?
(Forum Multimedia Publishing LLC., 2001) Akpınar, Belhhan; Güden, Mustafa; Sanisoğlu, İlhan; Sağbaş, Ertan; Caynak, Barış; Bayramoğlu, Zehra; Bayındır, Osman
Background: The aim of this retrospective study was to compare outcome in two groups of patients who were classified according to their risk groups and underwent coronary revascularization with or without cardiopulmonary bypass. Material and Methods: Between January 1996 and July 2000 480 cases that underwent coronary artery bypass surgery (CABG) were included in a retrospective nonrandomized manner for study. Group I included 210 patients who were revascularized using off-pump techniques. Octopus 2 and 3 (Medtronic Inc. Minneapolis MN) were used for tissue stabilization. Group 2 included 270 cases who underwent CABG using CPB. Emergency cases combined operations reoperations and patients in cardiogenic shock were excluded. Demographic variables were comparable between two the groups. Using the Allegheny Clinic Risk Scoring Scale [Magovern 1996] patients in both groups were scored as low moderate and high risk. In Group 1 37% of patients consisted of high risk patients while Group 2 had 14% (p < 0.05) Student's t-test and chi-square test were used for statistical analysis and alfa < 0.05 was considered significant. Results: Mortality was 1.4% in Group 1 and 1.5% in Group 2 (p = ns). Mean anastomosis per patient was 2.6 +/- 0.6 in Group 1 and 3.2 +/- 0.5 in Group 2 (p < 0.05). Patients in Group I needed less blood transfusions and less inotropic support postoperatively (p < 0.05). There were also fewer minor neurological events (p < 0.05) and pulmonary complications (Type 2) in Group 1. Atrial fibrillation rate infection and major neurological deficit (Type 1) were similar in both groups. Mortality was less among Group 1 high risk patients (3.9%) in comparison to Group 2 high risk patients (7.9%) but this did not reach statistical significance. Conclusions: In low or moderate risk patients CABG can be performed safely with or without CPB. In high risk patients with several comorbidities off-pump CABG seems to be a safe and efficient method that can improve outcome.
Citation Count: 0
Video yardımı ile minimal invazif "port-akses" kalp cerrahisi erken dönem sonuçları
(Kare Yayıncılık, 2003) Güden, Mustafa; Sağbaş, Ertan; Sanisoğlu, İlhan; Kazımoğlu, Kamran; Özbek, Uğur; Bayramoğlu, Zehra; Oral, Kerem; Akpınar, Belhhan
Amaç: Bu çalışmada video yardımıyla minimal invazif yöntemle yapılan mitral kapak ve atriyal septal defekt (ASD) kapatılması ameliyatlarının erken dönem sonuçları değerlendirildi. Yöntem: Ocak - Aralık 2002 tarihleri arasında video yardımıyla 8 ASD 'nin kapatılması, 38 mitral kapak değişimi ve 16 mitral kapak tamiri ameliyatları gerçekleştirildi (n=62). Bu ameliyatlara ek olarak 31 hastada atriyal fibrilasyon tedavisi için radyofrekans ablasyon işlemi, 7 hastada triküspit kapak tamiri ameliyatları yapıldı. ASD grubunda yaş ortalaması 27 ±10 iken mitral kapak değişimi grubunda 51,8± 11 ve mitral kapak tamiri grubunda 48.2+12.5 idi. ASD grubunda kadın/erkek oranı 6/2 iken mitral kapak değişimi grubunda 28/10, mitral kapak tamiri grubunda 10/6 idi. Ortalama ejeksiyon fraksiyonu (EF) %45±7 idi. Perkutan internal juguler ven, femoral ven kanülasyonu ve femoral arter kanülasyonu ile kardiyapulmoner bypass' a geçildi. Ameliyatlar 5mm-lik endoskop yardımı ile 4-6 cm-lik sağ anterolateral mini torakotomiden gerçekleştirildi. Aort transtorasik aort klempi (Chitwood) ile klemplendi ve kardiak koruma için antegrad kan kardioplejisi kullanıldı. Bulgular: ASD grubunda iskemi süresi 39.1 ± 14.2 dak iken mitral kapak değişimi grubunda 102.2+29.4 dak ve mitral tamir grubunda 111 .1 ± 23.3 dak idi. ASD grubunda pompa süresi 93.3 ±24. l dak iken mitral kapak değişimi grubunda 158+30.8 dak ve mitral kapak tamir grubunda 166.6+24. 1 dak idi. Yoğun bakımda ve hastanede kalış süreleri ASD grubunda 1 ile 5±0.9 gün, mitral kapak değişimi grubunda l .7+1.2 ile7. l ±1 .2 gün, mitral kapak tamiri grubunda 1,8 ± 1.3 ile 8 ±I .7 gün idi. Mitral kapak tamiri yapılan bir hasta akciğer enfeksiyonu nedeni ile kaybedildi. (% l .6). Miyokard enfarktüsü, nörolojik hadise ve periferik kanülasyona bağlı komplikasyon gözlenmedi. Kanama nedeni ile 2 hasta (% 3.2) revizyona alındı. Uygulanan prosedüre bağlı herhangi bir komplikasyon gözlenmedi. Ameliyat sonunda vapılan transözofajial ekokardiografik tetkiklerde kapak tamiri yapılan 14 vakada kaçak yokken, iki vakada minimal kaçak mevcuttu. ASD grubunda ve mitral kapak replasınanı yapılan grubda kaçak tespit edilmedi. Sonuç: Video yardımı ile minimal invazif mitral kapak ve ASD 'nin kapatılması ameliyatları güvenli ve iyi sonuçlar göstermektedir. Hasta konforunun iyi olması, kozmetik yönü ve sonuçlarının güvenilir olması nedeııivle bu tekniğin belli hasta grubunda tercih edilebileceği düşünülebilir.