Yazar "Ayik, F." seçeneğine göre listele
Listeleniyor 1 - 7 / 7
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Ege University Experience in Cardiac Transplantation(Elsevier Science Inc, 2011) Ozbaran, M.; Yagdi, T.; Engin, C.; Nalbantgil, S.; Ayik, F.; Oguz, E.; Zoghi, M.Background. End-stage heart failure can result from many cardiac and noncardiac entities that produce a poor prognosis. Medical and interventional modalities are widely used to treat this condition, although the ultimate therapy remains heart transplantation. Herein we present our clinical experience with 140 patients who underwent orthotopic heart transplantation. Methods. Between February 1998 and September 2010, we transplanted 140 patients with a mean age of 40 +/- 13 years, including 109 men (77.8%) and 31 women (22%). There were 101 patients (73%) with dilated cardiomyopathy and 39 (27%) with ischemic cardiomyopathy. Two patients were retransplanted owing to graft failure. Sixteen patients on assist device support were successfully bridged to transplantation. Results. Eighteen patients (12.8%) died within 30 days with the most common causes being right ventricular failure (8/18, 44%) and infection (4/18, 22%). Overall mortality of 39% (55/140) was most commonly caused by infection (29%, 16/55) or right ventricular failure (20%, 11/55). Nine patients (16%) died suddenly outside of the hospital. Three patients died of rejection; 4 of graft failure, and 4 of malignant disease. Conclusions. Heart transplantation remains the standard treatment modality for end-stage cardiac failure. But significant waiting list mortality rates are due to the worldwide shortage of donors. Heart transplantation in Turkey is feasible for a small and strictly selected number of patients with nonreversible congestive heart failure. In recent years, ventricular assist device applications have successful bridged subjects to transplantation, saving many patients on active waiting lists.Öğe Left Ventricular Assist Device Implantation in Heart Failure Patients With a Left Ventricular Thrombus(Elsevier Science Inc, 2013) Engin, C.; Yagdi, T.; Balcioglu, O.; Erkul, S.; Baysal, B.; Oguz, E.; Ayik, F.; Ozturk, P.; Ozbaran, M.Background. In this report, we share our experience with left ventricular assist device (LVAD) implantation in cases with a left ventricular (LV) thrombus. Method. Over the 3 years, more than 100 end-stage heart failure cases have been treated with LVAD implantation in our center, including 6 patients with a LV thrombus. Three were detected using preoperative transthoracic echocardiography. Fifty percent of the patients had dilated cardiomyopathy and the remaining cases had an ischemic etiology. Double inotropic support with dopamine and dobutamine was used in all, with 3 drugs with the addition of adrenaline in 2 patients. In 4 cases we implanted the Heart Ware Ventricular Assist System (Heart Ware, Inc., Miramar, Fla, United States) and in the remaining 2 patients, the Berlin Heart EXCOR ventricular assist device (Berlin Heart AG, Berlin, Germany) for biventricular support. In 1 patient the apical ventriculotomy was extended to remove an intertrabecular thrombosis and ventricular septal surface covered with a dacron patch to minimize the thrombogenic potential. Results. Two patients died due to sepsis and multiorgan failure. None of the patients experienced a neurological event, pump thrombosis, or pump malfunction. Two subjects underwent re-explorations due to hemorrhage. Two candidates underwent successfull transplantation without any evidence of thrombosis in the explanted heart or device. Conclusion. We believe that patients with a LV thrombus and preserved right ventricular function are good candidates for implantation of a LVAD after removing the intracavitary thrombus.Öğe Long-term Results of Autologous Stem Cell Transplantation in the Treatment of Patients With Congestive Heart Failure(Elsevier Science Inc, 2011) Oguz, E.; Ayik, F.; Ozturk, P.; Engin, C.; Nalbantgil, S.; Yagdi, T.; Ozbaran, M.Background. The aim of this study was to assess the long-term efficacy of stem cell transplantation with revascularization for patients with ischemic cardiomyopathy. Methods. We enrolled 17 patients with ischemic cardiomyopathy who had undergone autologous stem cell treatment. To assess myocardial ischemia and viability they underwent coronary angiography, stress tests with dobutamine, echocardiography, and positron emission tomography. Peripheral stem cells mobilized using granulocyte colony-stimulating factor (G-CSF) were collected by aphseresis for transplantation transmyocardially into the areas of injury during coronary artery bypass surgery to increase blood flow to the engrafted areas. Results. Three patients died in the early follow-up period and 4 patients with cardiac failure died during mid-term follow-up; they all underwent stem cell transplantation at 6 months after acute myocardial infarction. The mean follow-up period of the remaining 10 patients was 85.8 +/- 9.2 months (range, 70-100). Mean left ventricular ejection fraction improved to 30.0 +/- 6.7, whereas the preoperative mean left ventricular ejection fraction of the surviving patients was 25.6 +/- 4.5 (P = .035). Mean New York Heart Association (NYHA) functional class decreased from 3.2 to 1.5 (P = .006). When the study population was divided into 2 subgroups according to the interval between acute myocardial infraction and surgery, the patients who underwent autologous stem cell transplantation within the first 6 months after myocardial infraction (Group 1) showed significantly lower NYHA scores at the last follow-up (P = .024 in Group 1 and P = .102 in Group 2). No side effects were observed to be due to the stem cell or G-CSF injections. Conclusion. Treatment of ischemic cardiomyopathy with autologous stem cell transplantation is easy and safe, opening a new window in the treatment of "no hope" patients.Öğe Novel non-synonymous polymorphisms in the COX-1 gene in Turkish pediatric patients with cardiovascular anomalies(Funpec-Editora, 2014) Coskun, I.; Colkesen, Y.; Ayik, F.; Berdeli, A.; Atay, Y.Variation in the gene encoding cyclooxygenase-1 (COX-1) is involved in the process of aspirin resistance. This study investigated the genetic variations in the COX-1 gene. The 4 coding regions of the human COX-1 gene in 90 pediatric patients (median age of 6.5 months, 55% males) with cardiovascular anomalies were screened using DNA sequencing. Twenty coding-region variants causing amino acid substitutions as well as 2 new non-synonymous polymorphisms were identified. All variants were compared with an independent Caucasian population (N = 24 unrelated individuals). Most of the discovered polymorphisms were rare, although some variants resulted in amino acid changes occurring at a frequency >5% (W8R, P17L, Q41Q, Q240Q, D189E, and P188P). In addition, 2 new non-synonymous polymorphisms (F200L and D189E) were identified. These findings demonstrated novel genetic variants of the human COX-1 gene. Future studies characterizing the functional impact of these variants are warranted.Öğe Surgical Therapy of End-Stage Heart Failure in Pediatric Patients(Elsevier Science Inc, 2011) Ayik, F.; Oguz, E.; Engin, C.; Yagdi, T.; Ulger, Z.; Atay, Y.; Ozbaran, M.Objective. We herein review our experience with ventricular assist device (VAD) implantation and heart transplantation in children with end-stage heart failure. Methods. We performed a retrospective nonrandomized review of all patients who underwent insertion of a Berlin Heart Excor VAD or heart transplantation in our clinic. The study spans from July 2005 to July 2010. We transplanted 11 patients of mean age 11.8 +/- 4.49 years, 3 of whom with critical hemodynamic situations were bridged to heart transplantation by VAD implantation. Despite the poor right ventricular systolic functions, they did not require right rVAD. In addition, 2 patients who underwent VAD implantation are still awaiting a donor heart. The mean follow-up was 825.27 +/- 630.23 days (range, 21-1,888 days). Results. There was no serious complication during VAD support. The overall heart transplantation mortality rate was 9.1% (1/11). In all patients, impaired end-organ functions were improved by VAD implantation before the heart transplantation. Cardiac biopsies revealed 4 grade 2R rejection episodes, which were successfully controlled in 3 patients. Conclusion. Heart transplantation is highly effective therapy for pediatric patients with end-stage heart failure. Pediatric VAD implantation provided satisfactory safe circulatory support for small children in poor condition on the waiting list. This option should be considered for all pediatric candidates who show a poor hemodynamic status.Öğe Ventricular Assist Device as a Bridge to Heart Transplantation in Adults(Elsevier Science Inc, 2011) Engin, C.; Ayik, F.; Oguz, E.; Eygi, B.; Yagdi, T.; Karakula, S.; Ozbaran, M.Background. Because of the shortage of donor hearts, various ventricular asist devices (VAD) have been used in decompensated patients to prolong patient survival until a suitable heart becomes available. In this paper, we present our single-center report of adult patients in whom bridging was used with VAD. Methods. We performed a retrospective review of 14 adult patients who underwent heart transplantation after insertion of a long-term VAD. The study spans from February 2006 until September 2010. The mean patient age was 44.28 +/- 11.06 years. We used the Berlin Heart EXCOR VADs (n = 11; Berlin Heart AG Berlin, Germany), or the Berlin Heart Incor (n = 2), or the Abiomed AB500 (n = 1). Preimplantation status of the subjects were critical cardiogenic shock (n = 6), deterioration on inotropes (n = 3), or stable but inotrope-dependent (n = 5). Results. Mean VAD support time was 153.71 days (range, 25-517). Major adverse events during VAD support included reexploration for bleeding (n = 3; 21.4%), neurologic events (n = 2; 14.3%), left VAD-related infection (n = 2; 14.3%), pneumonia (n = 1; 14.3%), or primary device failure (n = 1; 7.1%). One (7.1%) patient showed evidence of human leukocyte antigen sensitization. There were 2 deaths (14.3%) over a mean of 324 days follow-up after heart transplantation: One due to biventricular failure in the early postoperative period and the other, at 69 days from pneumonia. Rejection was observed in 2 patients who had International Society for Heart and Lung Transplantation grade 2R without hemodynamic deterioration. In our series, the 1-year mortality was 14.4% among heart transplantations without VAD implantation and 14.2% among the bridge-to-transplantation group. Conclusion. We conclude that VAD implantation improved end-organ function before heart transplantation in critically ill patients.Öğe Ventricular Assist System Applications in End-stage Heart Failure(Elsevier Science Inc, 2011) Yagdi, T.; Oguz, E.; Ayik, F.; Ertugay, S.; Nalbantgil, S.; Engin, C.; Ozbaran, M.Background. Mechanical circulatory support has an important role in the surgical therapy for heart failure. Patients deteriorating on transplantation waiting lists or those unsuitable for transplantation have been treated with ventricular assist devices. In this report, we have presented application of ventricular assist systems for patients with end-stage heart failure. Methods. Between April 2007 and September 2010, we treated 37 patients with end-stage heart failure with mechanical circulatory support, including 5 children younger than 16 years of age. Three patients were females, and the overall mean age was 40 18 years (range, 1.5-67). In 29 patients we implanted paracorporeal pneumatic ventricular assist devices. Axial flow pumps were chosen to support the left ventricle in 8 patients. Biventricular support was applied in 9 patients because of their poor preoperative clinical conditions and advanced evidence of right ventricular failure. Results. Heart transplantation was performed in 16 patients (43%). One subject, who was managed with a left ventricular assist device implantation and coronary bypass grafting, was weaned from the system because of recovery of ventricular functions. Eleven patients (30%) are still on pump support. Nine patients (24%) died during mechanical circulatory support. The most prevalent cause of mortality was multiorgan failure (n = 5; 13.5%). Cerebrovascular hemorrhage was the cause of death in 2 patients. One patient died due to acute lung injury, and an other due to malignant melanoma. Conclusion. Use of a ventricular assist device as a bridge-to-transplantation or as destination therapy can be performed with acceptable mortality. It may be the most promising option for patients with end-stage heart failure. Development of device technology, advanced monitoring of anticoagulation and anti-aggregation therapy, and greater clinical experience may yield better results.
