Browsing by Author "Kan, İrem İris"
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Item Alt ve üst ekstremite damar yaralanmaları: On iki yıllık deneyimimiz(Bursa Uludağ Üniversitesi, 2020-11-09) Yolgösteren, Atıf; Yalçın, Mustafa; Kan, İrem İris; Tok, Mustafa; Sığnak, Işık Şenkaya; Biçer, Murat; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisi Anabilim Dalı.; 0000-0002-4467-3915; 0000-0003-0134-3163; 0000-0002-1600-9531; 0000-0001-9656-537X; 0000-0001-8813-4481; 0000-0002-9011-2609Ekstremite damar yaralanması nedeniyle merkezimize başvuran hastaları değerlendirme protokollerimizi, tedavi yöntemlerimizi ve sonuçlarımızı literatür eşliğinde retrospektif olarak değerlendirmeyi amaçladık. Ocak 2007-Aralık 2019 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Kliniğinde periferik damar yaralanması nedeniyle ameliyat edilen hastaların yaş ve cinsiyet bilgileri, yaralanma ile ameliyata alınma arasında geçen süre, preoperatif değerlendirme bilgileri, yaralanan damar segmentleri, yaralanma mekanizmaları, damar onarım teknikleri, postoperatif erken dönem ve 30. günde ki kontrol bilgileri retrospektif olarak incelendi. Çalışmaya 102 hasta dahil edildi (%9.8’i kadın, %90.2’si erkek; yaş ortalaması 28.9). Hastaların 28’si ateşli silah yaralanması (%27.4), 37’si delici-kesici alet yaralanması (%36.3), 37’si künt yaralanmaydı (%36.3). Hastaların iskemi süreleri 1-8 saati. Seksen dört hastaya otojen greft ile (vena safena magna) baypas (%82.4), 7 hastaya PTFE sentetik ringli damar grefti ile baypas (%6.8), 10 hastaya uç-uca anastomoz, 1 hastaya da safen ven greftiyle patch-plast yapıldı (%1). Yirmi iki hastaya fasyatomi açıldı (%21.5). Beş hastaya amputasyon uygulandı (%4.9). İki hasta ex oldu (%1.9). Ekstremite damar yaralanmalı hastaları değerlendirme ve tedavi protokollerimiz ile cerrahi sonuçlarımız literatürdekilerle benzerlik göstermektedir Periferik damar yaralanmalarında mortalite ve morbidite oranlarını azaltmak için multidisipliner yaklaşımın, hızlı tanı ve tedavinin en önemli faktörler olduğunu düşünüyoruz. Ayrıca preoperatif görüntüleme gereken hastalarda ilk tercihin BT anjiografi olması gerektiğini, damar onarımında mümkün olan tüm hastalarda otojen greft kullanılmasının en doğru yaklaşım olduğunu ve uzun süreli iskemilerde ampütasyon oranlarını düşürmek için fasyatomi yapılması gerektiğini düşünüyoruz.Item Are really the early postoperative outcomes of coronary artery bypass grafting surgery in elderly women worse compared to men?(Elsevier, 2017-04-15) Yüksel, Ahmet; Velioğlu, Yusuf; Cayır, Mustafa Çağdaş; Kumtepe, Gencehan; Kan, İrem İris; Yolgösteren, Atıf; Biçer, Murat; Tok, Mustafa; Şenkaya, Işık; Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisi Anabilim Dalı.; AAG-2372-2021; ABC-2231-2020Item Are the early postoperative outcomes of coronary artery bypass grafting surgery in elderly women worse compared to men’s?(Social Brasileira Cirurgia Cardiovascular, 2017-06) Yüksel, Ahmet; Velioğlu, Yusuf; Çayır, Mustafa Çağdaş; Gürbüz, Orçun; Kumtepe, Gencehan; Kan, İrem İris; Yolgösteren, Atıf; Akarsu, Serkan; Biçer, Murat; Tok, Mustafa; Şenkaya, Işık; Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisi Anabilim Dalı.; AAG-2372-2021; ABC-2231-2020; 7004267827; 57193236800; 57190135053; 6507770944; 6506976035; 6603498369Abstract Objective: To investigate the impact of gender difference in early postoperative outcomes in elderly patients (aged 70 or older) undergoing coronary artery bypass grafting surgery. Methods: Between October 2009 and December 2013, a total of 223 elderly patients (aged 70 or older) undergoing isolated primary coronary artery bypass grafting surgery were included in this retrospective observational cohort study. Patients were divided into two groups according to their gender. The patients' medical records were collected, their baseline preoperative characteristics, operative data, and postoperative outcomes were retrospectively reviewed, and the effect of gender difference in the early postoperative outcomes was analyzed. Results: Group 1 (female patients) and Group 2 (male patients) consisted of 71 and 152 patients, respectively. Mean age of patients was 74.4±3.6 years (range: 70-84 years). The level of EuroSCORE I, the incidence of hypertension and hyperlipidemia were significantly higher in Group 1, while the rate of smoking was significantly higher in Group 2. Mean postoperative intubation time, length of intensive care unit and hospital stay were longer in female patients than in male patients, but these differences were not statistically significant. No statistically significant difference between two groups in terms of the transfusion of blood products was observed. The rates of in-hospital mortality and major postoperative complications were statistically similar between the two groups. Conclusion: In conclusion, the female gender was not associated with worse early postoperative outcomes in elderly patients undergoing coronary artery bypass grafting surgery.Item Düşük-akım, düşük gradientli ciddi aort darlığı olan yaşlı hasta: transkateter aort kapak replasmanı (TAVİ) sonrası sol ventrikül sistolik disfonksiyonunun düzelmesi(Uludağ Üniversitesi, 2015-05-07) Güngören, Fatih; Sağ, Saim; Özdemir, Bülent; Yeşilbursa, Dilek; Biçer, Murat; Kan, İrem İris; Girgin, Nermin Kelebek; Serdar, Osman Akın; Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Kalp Damar Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.Yaşlanan nüfus ile birlikte aort darlığı, hipertansiyon ve koroner arter hastalığından sonra en sık görülen kalp hastalığıdır. Düşük ejeksiyon fraksiyonlu (EF) ve düşük akım / düşük gradientli (DA/DG) aort darlığı, aort darlığı olan hastaların %5’inde görülmektedir. Bu hastaların konservatif tedavi ile prognozları kötüdür. Benzer şekilde bu hastalarda yapılacak cerrahi aort kapak replasmanın (AVR) mortalitesi yüksektir. Cerrahi AVR sonrasında sol ventrikül EF’sindeki düzelme değişkendir ve genellikle düşük olarak kalmaya devam etmektedir. Dahası düşük EF’li ciddi aort darlığı olan hastalarda AVR operasyonu belirgin derece artmış mortaliteyle ilişkili görülmüştür. Son zamanlarda transkateter aort kapak implantasyonu (TAVİ) ciddi komorbiditesi olan yüksek cerrahi riske sahip hastalarda AVR operasyonuna alternatif olarak ortaya çıkmıştır. Biz bu yazımızda oldukça ileri yaşta düşük EF ve DA/DG’li ciddi aort darlığı hastasına yapılan TAVİ sonrası, erken dönemde EF düzelmesini rapor ettik.Item Effect of body mass index on mortality and morbidity in patients undergoing coronary artery bypass grafting surgery(Forum Multimedia Publishing, 2016-09-27) Akarsu, Serkan; Kan, İrem İris; Sevingil, Tolunay; Tok, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisi Anabilim Dalı.; 57190135053; 7004267827; 55567342700; 6506976035Background: This study aims to investigate the effect of body mass index (BMI) on mortality and morbidity in patients undergoing coronary artery bypass grafting (CABG) surgery. Methods: We retrospectively evaluated the medical records of 403 patients undergoing coronary artery bypass surgery in our center. The patients were divided into 5 groups according to their BMI values. Preoperative demographic characteristics, operative data, and postoperative complications during the six-month follow-up period were compared between the groups. Results: There were no statistically significant differences between the groups except the coexistence of peripheral artery disease (P = .009), ejection fraction (P = .021) and chronic obstructive pulmonary disease (P = .044). There were no statistically significant differences between the groups in terms of postoperative complications. No relationship was found between postoperative complications and the implemented surgical procedures. An overall 30-day mortality rate of 1.48% was observed, and the six-month mortality rate was 1.7%. Conclusion: According to this study, obesity does not lead to an increased risk of mortality and other adverse outcomes after CABG surgery. However, obesity may prolong hospital stay and increase the cost of CABG operation.Item Extracorporeal membrane oxygenation support after pediatric cardiac surgery: Our single-center experience(Bayçınar Medical, 2016-10-24) Güneş, Mustafa; Yüksel, Ahmet; Yolgösteren, Atıf; Kan, İrem İris; Uysal, Fahrettin; Çăglayan, Mehmet Hadi; Sığnak, Şenkaya Işık; Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Kardiyolojisi Anabilim Dalı.; AAG-2372-2021; AAH-4421-2021; 56985589300; 57193236800; 7004267827; 24469008200; 57194137534; 56495079800Background: In this study, we present our five-year extracorporeal membrane oxygenation experiences in patients requiring mechanical support after pediatric open heart surgery. Methods: We retrospectively reviewed the medical records of 29 children (16 males, 13 females; mean age 21.6 months; range 5 days to 162 months) who underwent open heart surgery and required extracorporeal membrane oxygenation support due to postcardiotomy circulatory failure between February 2010 and March 2015. Results: The most common diagnosis was tetralogy of Fallot in eight patients (27.5%). The most common extracorporeal membrane oxygenation indication was failure to wean from cardiopulmonary bypass in 12 (41%) patients. The mean duration of extracorporeal membrane oxygenation support was 6.9 days (range 14 hours to 32 days). The most common complication related to extracorporeal membrane oxygenation support was renal insufficiency in 14 patients (48.3%). Fourteen patients (48%) were able to be successfully weaned from extracorporeal membrane oxygenation support, while six patients (20.7%) were discharged without any neurological sequelae. No significant predictor of mortality was found. Failure to wean from cardiopulmonary bypass resulted improved outcomes than other extracorporeal membrane oxygenation indications. Conclusion: Extracorporeal membrane oxygenation provides an effective cardiopulmonary support for cardiopulmonary failure after pediatric open heart surgery. Careful patient selection, and correct timing and appropriate management of extracorporeal membrane oxygenation are crucial for optimal outcomes.Item Is 100% beating heart coronary by-pass justified?(Elsevier Science, 2002-12) Davit, S.; Şenkaya, Işık; Kan, İrem İris; Özkan, Hayati; Ercan, Abdülkadir; Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; 55987378200; 6603498369; 55398003800; 7004267827; 7103355993Coronary by-pass on a beating heart may provide a safer form of surgical revascularization by avoiding the well-documented side effects of cardiopulmonary by-pass. In addition, off-pump bypass is suggested to be a good alternative to on-pump especially in high risk patients. This study reviews the feasibility of coronary by-pass on the beating heart in all patients referred to surgery. Two hundred and ninety-four patients operated on the beating heart were prospectively followed and compared to the control group of 100 consecutive patients operated with the conventional method. There were no significant differences between the groups with respect to risk factors, except the incidence of chronic obstructive pulmonary disease and ejection fraction which were higher in the conventional group, whereas peripheral vascular disease was higher in the beating heart group. There was more distal anastomosis in the conventional group. Postoperative inotrope requirement, peak creatine phosphokinase-MB, ventilation time, blood loss in the first 24 h, transfusion needs, new atrial fibrillation and length of hospital stay were significantly lower in the beating heart operations. However, there were no significant differences between the groups in terms of neurological complications, chest infection, intraaortic balloon pump usage and mortality. In conclusion, multivessel off pump coronary by-pass is feasible with the same or better results as it is observed in the conventional technique when postoperative bleeding, neurogenic complications, arrythmias, hospital stay, overall morbidity and mortality are compared.Item The largest reported giant ascending aortic aneurysm presented with superior vena cava syndrome(Soc Brasil Cirurgia Cardiovasc, 2020) Yüksel, Ahmet; Biçer, Murat; Kan, İrem İris; Uludağ Üniversitesi/Tıp Fakültesi/Kalp Damar Cerrahisi Anabilim Dalı.; CGY-9884-2022; CXL-9128-2022; 6507770944; 57219423035Giant ascending aortic aneurysm is a rare condition. In this paper, we present an uncommon case of giant ascending aortic aneurysm with a maximal diameter of 14 cm in a 77-year-old woman presenting with unusual symptoms. The patient underwent a successful surgery involving ascending aortic replacement, and was discharged without any complication. After discharge, she was followed regularly and no major problem was observed in her control visits. To the best of our knowledge, our case is the largest ascending aortic aneurysm reported to date in the existing literature.Item Percutaneous coil embolization for the treatment of a giant brachial artery pseudoaneurym in a child(Elsevier, 2017-11) Yüksel, Ahmet; Kan, İrem İris; Tok, Mustafa; Erdoğan, Cüneyt; Nas, Ömer Fatih; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisi Anabilim Dalı.; 51864050100; 7004267827; 6506976035; 8293835700Brachial artery pseudoaneurysm is a rare phenomenon. When a diagnosis of brachial artery pseudoaneurysm is established, early and appropriate treatment should be performed as soon as possible to prevent possible complications, such as hemorrhage, rupture, and upper limb and finger losses. Open surgical repair is usually the cornerstone of treatment; however, we here report a case of giant brachial pseudoaneurysm in a 2-year-old girl, which was successfully treated with percutaneous coil embolization.Item Pericardiopleural window creation with a small anterior thoracotomy(Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2015-05-25) Biçer, Murat; Özdemir, Bülent; Kan, İrem İris; Melek, Hüseyin; Bayram, Ahmet Sami; Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; 0000-0003-1822-8153; 0000-0003-0684-0900; AAI-5039-2021; ABB-7580-2020; ABC-2231-2020; 6507770944; 7004168959; 7004267827; 9639938400; 8347194000Background: This study aims to investigate the efficacy of pericardiopleural window created by small anterior thoracotomy in the treatment and diagnosis of the pericardial effusion. Methods: Between January 2006 and January 2011, data of a total of 52 patients (27 males, 25 females; mean age 61.8 years; range 45 to 78 years) underwent pericardiopleural window due to pleural effusion were retrospectively analyzed. Pericardial effusion was diagnosed with echocardiography or computed tomography. A pericardiopleural window was created via a small anterior thoracotomy in the right or left sixth or seventh intercostal space according to the main pathology. Incisions were about 5 to 7 cm long. A 2x2 cm window in size was created from anterior surface of the pericardium to the phrenic nerve. Results: Indications for pericardiopleural window creation were malignant effusions in 20 patients, idiopathic causes in 20 patients, infective causes in nine patients and previous cardiac surgery in three patients. The mean duration of surgery was 42.2 minutes (range, 32 to 65). No intraoperative and postoperative mortality and morbidity was seen. The mean length of hospital stay was 5.6 (range 2 to 15) days. Conclusion: Pericardiopleural window creation with small anterior thoracotomy is an effective technique for drainage of the pericardial fluid and pericardial biopsy.Item Venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: Our single-center experience(Bayçınar Tıbbi Yayıncılık, 2016-07-15) Tecimer, Mehmet Ergün; Özgöz, Haluk Mevre; Yüksel, Ahmet; Yolgösteren, Atıf; Kan, İrem İris; Doğan, Ali İmran; Sığnak, Işık Şenkaya; Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisi Anabilim Dalı.; AAG-2372-2021; 56985589300; 57193236800; 7004267827; 57193235120; 56495079800Background: In this study, we present our five-year experience with venovenous extracorporeal membrane oxygenation for the treatment of acute respiratory distress syndrome. Methods: Between November 2010 and November 2015, 33 patients (24 males, 9 females; mean age: 48.6 +/- 14.7 years; range 19 to 76 years) with acute respiratory distress syndrome refractory to conventional therapy were supported with venovenous extracorporeal membrane oxygenation. The general indication for venovenous extracorporeal membrane oxygenation support was refractory hypoxia, hypercapnia, and respiratory acidosis, despite the optimization of conventional therapy. Detailed clinical data of the patients were retrospectively analyzed. Results: Cannulation was achieved via femoral-femoral veins in 24 patients (73%) and jugular-femoral veins in nine patients (27%). The median duration of venovenous extracorporeal membrane oxygenation support was 17 (range, 1 to 52) days. The most common complication was minor bleeding in six patients (18%). Eighteen patients (54.5%) were successfully weaned from venovenous extracorporeal membrane oxygenation support. Of these patients, 13 (39.4%) survived and were discharged from the hospital. Conclusion: Venovenous extracorporeal membrane oxygenation can be a life-saving treatment modality in patients with severe acute respiratory distress syndrome. Improved results may be provided with increased experience and an established standard protocol for the management of venovenous extracorporeal membrane oxygenation.