Browsing by Author "Sanisoğlu, İlhan"

Now showing 1 - 20 of 22

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: 0
Aortanın ileri derecede aterosklerozunda koroner arter cerrahisi
(1999) Akpınar, Belhhan; Güden, Mustafa; Polat, Bülent; Sağbaş, Ertan; Sanisoğlu, İlhan; Sönmez, Bingür; Demiroğlu, Cemşid
Açık kalp cerrahisinde tekniklerin ilerlemesine rağmen nörolojik komplikasyonların görülme sıklığı azalmamıştır ve inme (stroke) morbidite ve mortaliteyi önemli ölçüde artırmaktadır. Bu yazıda çıkan aortada ileri derecede kalsifikasyon bulunan vakalarda hipotermik fibrilasyon tekniği kullanılarak aortaya dokunulmadan ve kross klemp konulmadan yapılan koroner by-pass ameliyatları anlatıldı. 2 yıl içinde aortada ileri derecede kalsifikasyon bulunan 23 olguda bu teknik kullanıldı. Yaş ortalaması 65 + 3 yıl idi. Kardiopulmoner bypass için femoral arter ve sağ atrium kullanıldı. Tüm hastalar 26-28 ºC'de ventriküler fibrilasyon ile ameliyat edildi ve internal torasik arterler ve gastroepiploik arter ve bu greftlerin kombinasyonu kullanıldı. Aortaya klemp uygulanmadı ve proksimal anastomoz yapılmadı. 30 günlük ölüm oranı 0 idi. Hiçbir olguda nörolojik komplikasyon, alt ekstremite iskemisi ve hemodinamik problem gözlenmedi. Sadece 1 olgu kanama nedeniyle tekrar ameliyata alındı ve eksik revaskülarizasyon yapılan 1 vakada peroperatif miyokard enfarktüsü görüldü, fakat hemodinamik olarak bir problem olmadı. Bu teknik iyi miyokard korunması sağladığı, uygun revaskülarizasyonu engellemediği ve emboliye bağlı nörolojik komplikasyonları önemli ölçüde engellediği için tercih edilebilir.
Citation Count: 0
Atriyal fibrilasyonun cerrahi tedavisi
(Türk Kardiyoloji Derneği / Kare Yayıncılık, 2007) Akpınar, Belhhan; Sağbaş, Ertan; Güden, Mustafa; Sanisoğlu, İlhan
Teknolojideki hızlı gelişmeler atriyal fibrilasyonun (AF) cerrahi tedavisinde birçok yenili¤i beraberinde getirmiştir. Maze III operasyonu, AF’nin cerrahi tedavisinde altın standart olarak kabul edilmekle beraber teknik zorluk ve baz› komplikasyonlar nedeniyle yayg›n kullanım alanı bulamamıştır. Alternatif enerji kaynaklarının kullanıma girmesi ile orijinal yöntem ile kesip dikerek oluşturulan lezyonlar bu enerji kaynaklarıyla çok daha kısa sürede emniyetle oluşturulmaktadır. Bu işlemlerle %70-98 arasında değişen oranlarda başları elde edilmektedir. İki bin beş yılı Haziran ayı itibariyle dünyada otuz binin üzerinde hastaya cerrahi ablasyon işlemi yapıldığı bildirilmektedir. Ancak yaygın uygulama bazı komplikasyonlar› beraberinde getirse de cerrahi ablasyonun yaygın kabul görmesine engel olamamıştır. Öte yandan tek başına AF’li olgularda minimal invazif tekniklerle cerrahi ablasyon, perkütan tekniklere önemli bir alternatif oluşturmaktadır. Bu derlemede atriyal fibrilasyonun cerrahi tedavisinin tarihsel geliflimi ve güncel klinik uygulamalar üzerinde durulacakt›r. (Anadolu Kardiyol Derg 2007; 7: 65-73)
Citation Count: 3
Combined radiofrequency ablation and myxoma resection through a port access approach
(Elsevier Science Inc, 2004) Güden, Mustafa; Akpınar, Belhhan; Ergenoğlu, Mehmet U.; Sağbaş, Ertan; Sanisoğlu, İlhan; Özbek, Uğur
Myxornas are common cardiac tumors that are traditionally managed by complete excision through a median sternotorny approach with the use of cardiopulmonary bypass. We discuss a patient with left atrial myxoma and chronic atrial fibrillation who underwent surgical excision and combined irrigated radiofrequency ablation for atrial fibrillation through a Port Access approach. Minimally invasive operations constitute an expanding field for the treatment of many cardiac diseases and may be an alternative for the treatment of this pathology because of less surgical trauma and cosmetic superiority. In this case both excision of the myxoma and radiofrequency ablation were feasible through this minimally invasive approach. The combination of direct and endoscopic views enabled both procedures to be performed safely and efficiently. (C) 2004 by The Society of Thoracic Surgeons.
Citation Count: 71
Combined radiofrequency modified maze and mitral valve procedure through a port access approach: early and mid-term results
(Oxford University Press, 2003) Akpınar, Belhhan; Güden, Mustafa; Sağbaş, Ertan; Sanisoğlu, İlhan; Özbek, Uğur; Caynak, Barış; Bayındır, Osman
Objective: The aim of this study was to assess the feasibility and effectiveness of irrigated radiofrequency (RF) modified Maze procedure through a port access approach during mitral valve surgery and evaluate early and mid-term results. Material and method: During a 16 months time period 67 patients with chronic atrial fibrillation (AF) eligible for port access mitral valve surgery were randomly assigned to either Group A in which they underwent a combined procedure (N = 33) or Group B in which a valve procedure alone was performed (N = 34). Both groups were similar in terms of age sex valve pathology duration of AF left atrial diameter and left ventricle function (P > 0.05). Four had undergone previous operations. Results: Median follow-up was 10 months for both groups 95% CI (9.18-10.8). One patient in each group died early postoperatively (3 and 2.9%). Two patients required reoperation for bleeding one in each group (3 and 2.9%). There were two conversions to right thoracotomy. In Group A freedom from AF was 100% at the end of the operation (76% sinus 24% pacemaker) Six and twelve months freedom from AF was 87.2 and 93.6% respectively. In Group B freedom from AF at the end of operation was 41%. At the end of 6 and 12 months freedom from AF was 9.4% (P = 0.0001). One patient in Group A required a permanent pacemaker (3%). During follow-up one patient in Group A died of non-cardiac causes (3%). In Group B there were two late deaths: one cardiac (2.9%) and one neurologic (2.9%). There were no thromboembolic events detected in Group A during follow-up whereas two patients in Group B suffered this complication (6% P = 0.081). At 12 months functional capacity had improved for patients in both groups (P < 0.0001). Conclusion: The combination of mitral valve surgery and irrigated RF Maze procedure was safe and efficient through a port access approach. There were no procedure related complications like esophageal or coronary artery injury. Early and mid-term results were favourable with 93.6% of patients free of AF at 1 year in comparison to the 9.4% of the control group. The data is not sufficient to reach any conclusions in terms of thromboembolic rates despite favourable results for the RF Maze group. Nevertheless in terms of feasibilty sinus rhythm restoration and overall outcome early results are encouraging and we advocate the use of the combined procedure through a port access approach. (C) 2003 Elsevier Science B.V. All rights reserved.
Citation Count: 9
Comparison of intraoperative transit-time flow measurement with early postoperative magnetic resonance flow mapping - in off-pump coronary artery surgery
(Texas Heart Inst., 2003) Sanisoğlu, İlhan; Güden, Mustafa; BalcI, Cem; SaĞbaŞ, Ertan; Duran, Cihan; AkpInar, Belhhan
The purpose of this prospective study was to evaluate graft patency of off-pump coronary artery surgery intraoperatively by transit-time flow measurement and to compare this technique with postoperative magnetic resonance flow mapping. Twenty patients (13 men and 7 women
Citation Count: 0
Does different orientation of the Medtronic Hall tilting disc valve in the aortic position effect transvalvuler pressure gradients?
(Medimond Srl, 2000) Güden, Metin; Akpınar, Belhhan; Sağbaş, Ertan; Sanisoğlu, İlhan; Arpaz, M.; Bayındır, Osman
The effect of valve orientation during aortic valve replacement (AVR) with the Medtronic Hall (MH) tilting disc valve on transvalvuler pressure gradients was evaluated. 30 patients (pts) undergoing isolated AVR received a MH which was oriented so that the greater opening of the valve faced the non coronary aortic sinus. There were 12 male and 8 female pts in this group with a mean age of 59 +/- 5.2 years. An echocardiographic examination was performed 6 days after the operation and resting transvalvuler gradients were measured (Group 1). The gradients were compared with the results of 30 pts. who had undergone AVR with the same valve previously but with the orientation of the greater opening towards the left or the right coronary sinus (Group 2). In Group 1 the mean valve size was 22 mm. and the measured mean valvuler gradient was 24/13 mmHg (peak/mean). In Group 2 the mean valve size was 22.1 mm. and the measured mean valvuler gradient was 31/20 mmHg (peak/mean). Student's t test was used for statistical analysis and transvalvular gradients in Group 1 were found to be significantly lower than Group 2 (p>005). Implantation with greater opening of the tilting mechanical valve facing the non-coronary sinus seems to result in lower transvalvuler gradients than other orientations.
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: 25
Effects of intravenous triiodothyronine during coronary artery bypass surgery
(Asia Publishing Exchange Pte Ltd, 2002) Güden, Mustafa; Akpınar, Belhhan; Sağbaş, Ertan; Sanisoğlu, İlhan; Cakali, Emine; Bayındır, Osman
A prospective randomized and double-blind study was performed to evaluate whether perioperative triiodothyronine administration has any effect on cardiovascular performance after coronary artery bypass surgery. Sixty patients were assigned to 2 groups of 30 each. When crossclamping ended group A received an intravenous bolus of triiodothyronine followed by infusion for 6 hours. Group B received a placebo. Serum triiodothyronine levels and hemodynamic parameters were serially measured. Mean postoperative cardiac index was slightly but not significantly higher in group A whereas systemic vascular resistance was significantly lower in group A. Compared with preoperative values serum triiodothyronine levels dropped significantly in group B at the end of cardiopulmonary bypass and remained low 12 hours postoperatively while levels rose significantly in group A. No significant differences were detected between the groups in the incidence of arrhythmia the need for inotropic support intensive care unit stay mortality and morbidity. Perioperative administration of triiodothyronine increased cardiac output slightly and decreased systemic vascular resistance but it had no effect on operative outcome. Routine use after coronary surgery is thus not recommended.
Citation Count: 5
Hemodilution during off-pump coronary artery bypass grafting: Can we improve flow and reduce hypercoagulability?
(Forum Multimedia Publishing LLC., 2003) Güden, Mustafa; Sanisoğlu, İlhan; Sağbaş, Ertan; Ergenoğlu, Mehmet U.; Özbek, Uğur; Akpınar, Belhhan
Background: The aim of this study was to compare intraoperative coronary graft flows performed on pump and off pump and to evaluate the effects of hemodilution on coronary graft flows in off-pump coronary artery bypass grafting (CABG) patients by using transit time flow measurements (TTFM). Methods: Three hundred patients undergoing only CABG procedures were enrolled in a prospective randomized manner into 3 groups. Group 1 consisted of 100 patients undergoing operations with standard cardiopulmonary bypass techniques. Group 2 consisted of 100 patients scheduled for revascularizations using off-pump techniques. Group 3 consisted of 100 patients who underwent operations with off-pump techniques under controlled hemodilution (hematocrit levels kept between 25% and 28%). TTFM were performed with the coronary Flometer system. Mean flows pulsatility indices and flow patterns were evaluated. Twenty-five patients in each group were randomly assigned for control angiography 6 days postoperatively. Thromboelastographic (TEG) measurements were performed for each patient before and after surgery to evaluate the patient's coagulation status. Results: The mean number of anastomoses was higher in group 1 than in groups 2 and 3 (P < .05). Mean arterial pressures and heart rates were similar between groups during measurements. Hematocrit values were higher in group 2 than in groups 1 and 3 (P < .05). Mean flows for left anterior descending coronary artery and right coronary artery territories were significantly lower in group 2 patients (P < .05). For the circumflex artery territory mean flows did not reach statistically significant levels despite lower flows again in group 2. The pulsatility indices were similar in all 3 groups for all 3 coronary territories. Postoperative coronary angiographic results revealed similar graft patencies among the 3 groups (not significantly different). Postoperative TEG patterns failed to show a hypercoagulable state in off-pump patients. Conclusion: Off-pump CABG patients with hemodilution had significantly higher graft flows than off-pump CABG patients without hemodilution. Although we failed to show the existence of a hypercoagulable state for patients in the off-pump group an examination of the TTFM findings suggests that hemodilution may help to improve graft patency in off-pump CABG patients during the early postoperative period.
Citation Count: 44
Intraoperative saline-irrigated radiofrequency modified maze procedure for atrial fibrillation
(Elsevier Science Inc, 2002) Güden, Mustafa; Akpınar, Belhhan; Sanisoğlu, İlhan; Sağbaş, Ertan; Bayındır, Osman
Background. This study was conducted to evaluate the effectiveness of the saline-irrigated radiofrequency modified Maze operation for treatment of chronic atrial fibrillation and to compare the results of the left and biatrial procedures. Methods. During a period of 11 months 62 patients with chronic atrial fibrillation who were having concomitant cardiac surgery underwent the procedure. The mean age of the patients was 52 +/- 14 years. Patients underwent either a biatrial (group A
Citation Count: 0
Koroner cerrahisinde tek klemp tekniğinin nörolojik ve kardiyak sonuçlar üzerine etkisi
(2001) Güden, Mustafa; Sağbaş, Ertan; Sanisoğlu, İlhan; Akpınar, Belhhan; Yılmaz, Oğuz
Amaç: Koroner bypass cerrahisi sırasında tek ve çift klemp tekniklerinin kardiyak ve nörolojik sonuçları retrospektif olarak araştırıldı. Materyal ve Metod: 680 olguda (Grup 1) distal ve proksimal anastomozlar aortada kros klemp kaldırılmadan (tek klemp) tamamlandı. 820 olguda ise konvansiyonel yan klemp tekniği (çift klemp) kullanıldı ve distal anastomozlar tamamlandıktan sonra kros klemp kaldırılarak proksimal anastomozlar için yan klemp yerleştirildi (Grup 2). Acil girişimler çalışma dışı bırakıldı. Bulgular: Gruplar arasında yaş, cins, greftlenen damar sayısı ve sol ventrikül fonksiyonları açısından fark yoktu (p = 0.18). Ancak Grup 1'de komorbid faktörler (reoperasyon, kronik obstruktif akciğer hastalığı, aterosklerotik aorta, karotis arter hastalığı ve geçirilmiş serebral hadise daha fazla idi (p = 0.05). Her iki grupta da miyokard koruması antegrad-retrograd izotermik kan kardiyoplejisiyle sağlandı. Grup 1'de ortalama anastomoz sayısı 2.9 ± 0.7, Grup 2'de 3.0 ± 0.7 idi (p = 0.2). Her iki grup arasında iskemik süre açısından anlamlı fark saptanmazken, Grup 1'de kardiyopulmoner bypass (KPB) zamanı ve iskemi sonrası KPB'den çıkma süresi Grup 2'ye göre daha kısa bulundu (p = 0.03). KPB sonrası inotrop ihtiyacı yönünden iki grup arasında anlamlı fark yoktu. Postoperatif CPK değerleri Grup 1'de daha yüksek bulundu. Ancak CPK-MB değerleri ve peroperatif miyokard infarktüsü oranları arasında anlamlı fark bulunmadı. Grup 1'de 5 (%0.9), Grup 2'de 8 (%1) olgu erken dönemde kaybedildi. Grup 1'de 5, Grup 2'de ise 18 olguda majör nörolojik hasar gelişti (p = 0.018) ve Grup 2'de olgulardan dördü nörolojik komplikasyon nedeniyle kaybedildi. Sonuç: Tek klemp tekniği aortada embolizasyonu en aza indirme ve nörolojik komplikasyonların azaltılması, klempin kaldırılmasından sonra tam revaskülarizasyon sağlamak ve dolayısıyla iskemik süreyi kısaltmak gibi sebeplerle tercih edilebilir. Sonuçlarımız yöntemin miyokard koruma yönünden belirgin bir avantajını gösterememiş, ancak nörolojik komplikasyonlar ve mortalite tek klemp tekniği uygulanan grupta anlamlı olarak az bulunmuştur
Citation Count: 21
Left versus bi-atrial intraoperative saline-irrigated radiofrequency modified maze procedure for atrial fibrillation
(2003) Güden, Mustafa; Akpınar, Belhhan; Çaynak, Barış; Türkoğlu, Çavlan; Özyedek, Zeki; Sanisoğlu, İlhan; Sağbaş, Ertan; Aytekin, Saide; Oztekin, Seher Deniz
Background: This study was conducted to evaluate the effectiveness of the saline-irrigated radiofrequency modified maze operation for the treatment of chronic atrial fibrillation (AF) and compare the results of the left and bi-atrial procedures. Material and method: During a period of two years 105 patients with chronic AF having concomitant cardiac surgery underwent the procedure. Patients underwent either a bi-atrial (n = 48) or left atrial (n = 57) maze procedure. The first twenty patients underwent a bi-atrial maze procedure regardless of the pathology. In the following patients we adopted the bi-atrial approach in patients with a history of atrial flutter and where the right atrium has to be opened. Otherwise the procedure is restricted to the left atrial side. Mean age was 52 ± 11 years in bi-atrial group and 54 ± 9 years in left atrial group. Results: Three patients died early postoperatively (2.9%). There were 4 revisions for bleeding (3.8%). Two patients in bi-atrial group received a permanent pacemaker (4.1%). Patients in both groups were free of AF at the end of the procedure. (Bi-atrial group: sinus: 79.2% pacemaker: 20.8%) (Left atrial group: sinus: 82.5% pacemaker: 17.5%) (p > 0.05). During the last follow-up sinus rhythm was maintained in 79.6% of cases in bi-atrial group while this rate was 75.6% in left atrial group (p > 0.05). Conclusion: Saline irrigated radiofrequency modified maze procedure was performed safely and efficiently. Both the left and bi-atrial procedures were successful in terms of restoring sinus rhythm. Our current policy is to adopt the bi-atrial approach in patients with a history of atrial flutter and where the right atrium has to be opened. Otherwise the procedure is restricted to the left atrial side. © 2003 Kluwer Academic Publishers.
Citation Count: 17
Off-pump coronary artery bypass grafting with use of the octopus 2 stabilization system
(2000) Akpınar, Belhhan; Güden, Mustafa; Sağbaş, Ertan; Sanisoğlu, İlhan; Aytekin, Vedat; Bayındır, Osman
Background: The treatment of coronary artery disease has evolved rapidly over the last two decades. The gold standard of surgical revascularization, the on-pump coronary artery bypass graft, has been challenged by the development of percutaneous transluminal coronary angioplasty. Our experience with the alternative of the off-pump ("beating heart") coronary artery bypass (OPCAB) technique during a period of 18 months suggests that OPCAB avoids the complications of cardiopulmonary bypass and offers patients the benefit of long-term graft patency that greatly exceeds that of current endovascular technologies. Methods: The early results of 126 OPCAB procedures performed through a medial sternotomy incision during a period of 18 months were evaluated. There were 80 male and 46 female patients, with a mean age of 69 +/- 4.3 years. Emergency cases and reoperations were not included. A total of 268 anastomoses were performed, with a mean number of 2.12 anastomoses per patient. Conduits used, with their percentage of use, were: left internal thoracic artery (LITA) (100%), right internal thoracic artery (11.1%), greater saphenous vein (84%), and radial artery (31%). In 72% of the cases, off-pump surgery was chosen because of patient risk factors such as atherosclerotic aortic disease, previous cerebrovascular accident or carotid artery disease, renal dysfunction, malignancy or poor left ventricular function. Results: There was no operative mortality. One-month postoperative mortality was three patients (2.3%). Two died because of mesenteric ischemia, and the other death was due to cardiac failure. Seventy-one patients had a control angiogram before discharge. The patency of LITA anastomosis was 100% while overall patency rate was 95%. In 43 patients for whom an angiogram could not be performed, a Thallum 201 stress test was performed three months postoperatively. Thirty-eight patients had a normal test while five patients showed signs of ischemia. These patients had a control angiogram: in four patients anastomoses were patent, but in one patient there was a severe narrowing of a venous anastomosis to the distal right coronary artery (RCA) which was corrected with angioplasty. In the whole series eight patients (6.3%) refused to have any control examination. Conclusions: Our early results suggest that off-pump CABG with Octopus 2 (Medtronic, Inc., Minneapolis, MN) can be a good alternative in high risk patients who need multiple vessel revascularization.
Citation Count: 20
Ondansetron hydrochloride for the treatment of delirium after coronary artery surgery
(Mosby Inc, 2001) Bayındır, Osman; Güden, Mustafa; Akpınar, Belhhan; Sanisoğlu, İlhan; Sağbaş, Ertan
[Abstract Not Available]
Citation Count: 7
A Radiofrequency modified maze and valve procedure through a port-access approach
(Forum Multimedia Publishing LLC., 2003) Güden, Mustafa; Akpınar, Belhhan; Sağbaş, Ertan; Sanisoğlu, İlhan; Ergenoğlu, Mehmet U.; Özbek, Uğur
Background: The aim of the study was to assess the feasibility and effectiveness of the irrigated radiofrequency modified maze procedure through a port-access approach during mitral valve surgery. Methods: Forty-three patients with atrial fibrillation (AF) and mitral valve disease underwent a combined procedure through a port-access approach. The indication was a history of continuous AF for more than 6 months in patients eligible for minimally invasive mitral valve surgery. Results: The incidence of early mortality was 1 patient (2.3%) and that of freedom from AF was 100% at the end of the operation (70% of patients with normal sinus rhythm 30% with a pacemaker). One patient (2.3%) required permanent pacemaker implantation after surgery. One patient (2.3%) required reoperation for bleeding. There were no reoperations for failed valve repairs. The incidences of freedom from AF were 87% and 92% at 6 and 12 months respectively. At 12 months functional capacity had improved significantly (P < .05). There were no procedure-related complications. No thromboembolic events were detected during follow-up. Conclusion: The port-access approach provided a good access for both valve surgery and the radiofrequency maze procedure. The combination of direct and videoscopic vision allowed an adequate view and led to a safe and efficient combined procedure. Short- and intermediate-term follow-up results were favorable.
Citation Count: 5
The surgical treatment of atrial fibrillation
(Turkish Soc Cardiology, 2007) Akpınar, Belhhan; Sağbaş, Ertan; Güden, Mustafa; Sanisoğlu, İlhan
The surgical treatment of atrial fibrillation (AF) has entered a new era with the development of new tools and advanced techniques. The Maze III operation remains as the gold standard for the surgical treatment of AF. However new energy sources have been adopted for treating this arrhythmia in an effort to reduce the invasiveness and technical concerns with the original procedure. Success rates ranging between 70-98% have been reported using these new techniques. On the other hand interventional cardiologists have further improved their techniques so that percutaneous techniques are competing with minimally invasive ablation techniques for the treatment of drug resistant and symptomatic lone AF. These developments have aroused the interest of cardiac surgeons in AF surgery and have found themselves a wide application. It has been estimated that thirty thousand patients have undergone surgical ablation for AF so far. Inevitably procedure related complications have occurred and caused skepticism by some groups. However surgical ablation has become a widely accepted treatment modality for AF patients undergoing concomitant cardiac surgery. The aim of this text is to make an overall review of the surgical treatment of AF and evaluate the current situation in view of the literature and the personal experience of the authors.
Citation Count: 5
The surgical treatment of atrial fibrillation [Atriyal fibrilasyonun cerrahi tedavisi]
(2007) Akpınar, Belhhan; Sağbaş, Ertan; Güden, Mustafa; Sanisoğlu, İlhan
The surgical treatment of atrial fibrillation (AF) has entered a new era with the development of new tools and advanced techniques. The Maze III operation remains as the gold standard for the surgical treatment of AF. However new energy sources have been adopted for treating this arrhythmia in an effort to reduce the invasiveness and technical concerns with the original procedure. Success rates ranging between 70-98% have been reported using these new techniques. On the other hand interventional cardiologists have further improved their techniques so that percutaneous techniques are competing with minimally invasive ablation techniques for the treatment of drug resistant and symptomatic lone AF. These developments have aroused the interest of cardiac surgeons in AF surgery and have found themselves a wide application. It has been estimated that thirty thousand patients have undergone surgical ablation for AF so far. Inevitably procedure related complications have occurred and caused skepticism by some groups. However surgical ablation has become a widely accepted treatment modality for AF patients undergoing concomitant cardiac surgery. The aim of this text is to make an overall review of the surgical treatment of AF and evaluate the current situation in view of the literature and the personal experience of the authors.
Citation Count: 0
Time flow measurements (TTFM) differ between grafts do transit performed on and off-pump CABG? a comparitive study
(Forum Multimedia Publishing LLC., 2002) Güden, Mustafa; Akpinar, Belhhan; Sağbaş, Ertan; Sanisoğlu, İlhan; Bayındır, Osman
Background: The aim of this study was to compare intraoperative coronary graft flows performed on and off-pump and to evaluate the effects of hemodilution on coronary graft flows in off-pump CABG patients by using TTFM. Materials and Methods: During a one year period 150 patients undergoing a CABG only procedure were enrolled in a prospective randomized manner. Group 1 consisted of 50 patients undergoing CABG using standard CPB techniques. Group 2 consisted of 50 cases who were planned to undergo revascularization using off-pump techniques. Group 3 consisted of 50 patients undergoing CABG using off-pump techniques under controlled hemodilution. (Htc% levels were kept between a range of 25-28%.) TTFM were performed using the CTS (Cardiothoracic Systems) - USA flometer. Mean Flows (Qmed) Pulsatile _ndex (PI) and flow patterns were evaluated. Twenty-five patients in each group were randomly assigned for control angiography 6 days postoperatively. Reoperations combined cases and emergency operations were not included. Patients requiring high doses of vasoactive drugs were also excluded for the benefit of a controlled vascular resistance. Results: The mean number of anastomoses were higher in Group 1 when compared to Group 2 and 3. (p < 0.05) Mean Arterial Pressure (MAP) heart rate (HR) were similar between groups during measurements. Hematocrit values in Group 2 were higher than Group 1 and Group 3 (p < 0.05). Mean flows (Qmed) for LAD and RCA territories were significantly lower in Group 2 patients (p < 0.05) For the circumflex artery territory despite lower flows again in Group 2 this did not reach significant levels. The pulsatile index were similar in all three groups for all three coronary territories. Postoperative coronary angiography revealed similar graft patencies among three groups (p = ns). All values are shown as mean + SD unless expressed otherwise. The Kruskal-Wallis H test was used for analysing differences between three groups. Dunn's Multiple Comparison test was used for sub-group analysis p < 0.05 was considered significant. Conclusions: Off-pump CABG patients with hemodilution had significantly higher graft flows compared to off-pump CABG patients without hemodilution. It can be hypothesed that hemodilution may help to improve graft patency during the early postoperative period in off-pump CABG patients.