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Öğe Chylothorax After Thoracoabdominal Aneurysm Repair: Efficacy of Somatostatin(Elsevier Science Inc, 2011) Oguz, Emrah; Apaydin, Anil Z.; Ayik, Fatih; Balcioglu, Ozlem; Dolapoglu, AhmetChylothorax is a rare but serious complication that presents after thoracoabdominal aortic aneurysm surgery. There are insufficient data to reach a consensus on how to manage it. Some researchers have suggested early reoperation for high output drainage. We present the case of a patient who underwent thoracoabdominal aortic replacement and who subsequently developed postoperative chylothorax. High output (> 1,000 mL per day) chest tube drainage until postoperative day 4 drastically decreased and stopped in a week with the administration of somatostatin and total parenteral nutrition which helped avoid a major re-exploration. Surgery should be reserved as an option only for patients with persistent leaks that do not respond to somatostatin therapy.Öğe Clinical Modelling of RVHF Using Pre-Operative Variables: A Direct and Inverse Feature Extraction Technique(Mdpi, 2022) Uzun Ozsahin, Dilber; Balcioglu, Ozlem; Usman, Abdullahi Garba; Ikechukwu Emegano, Declan; Uzun, Berna; Abba, Sani Isah; Ozsahin, IlkerRight ventricular heart failure (RVHF) mostly occurs due to the failure of the left-side of the heart. RVHF is a serious disease that leads to swelling of the abdomen, ankles, liver, kidneys, and gastrointestinal (GI) tract. A total of 506 heart-failure subjects from the Faculty of Medicine, Cardiovascular Surgery Department, Ege University, Turkey, who suffered from a severe heart failure and are currently receiving support from a ventricular assistance device, were involved in the current study. Therefore, the current study explored the application of both the direct and inverse modelling approaches, based on the correlation analysis feature extraction performance of various pre-operative variables of the subjects, for the prediction of RVHF. The study equally employs both single and hybrid paradigms for the prediction of RVHF using different pre-operative variables. The visualized and quantitative performance of the direct and inverse modelling approach indicates the robust prediction performance of the hybrid paradigms over the single techniques in both the calibration and validation steps. Whereby, the quantitative performance of the hybrid techniques, based on the Nash-Sutcliffe coefficient (NC) metric, depicts its superiority over the single paradigms by up to 58.7%/75.5% and 80.3%/51% for the calibration/validation phases in the direct and inverse modelling approaches, respectively. Moreover, to the best knowledge of the authors, this is the first study to report the implementation of direct and inverse modelling on clinical data. The findings of the current study indicates the possibility of applying these novel hybridised paradigms for the prediction of RVHF using pre-operative variables.Öğe Comparison of Continuous-Flow and Pulsatile-Flow Blood Pumps on Reducing Pulmonary Artery Pressure in Patients With Fixed Pulmonary Hypertension(Wiley, 2013) Ozturk, Pelin; Engin, Aysen Yaprak; Nalbantgil, Sanem; Oguz, Emrah; Ayik, Fatih; Engin, Cagatay; Yagdi, Tahir; Erkul, Sinan; Balcioglu, Ozlem; Ozbaran, MustafaPulmonary hypertension (PH) is considered as a risk factor for morbidity and mortality in patients undergoing heart transplantation. Recently, left ventricular assist device (LVAD) implantation has been increasingly used in reducing pulmonary artery pressure (PAP) in patients with PH unresponsive to medical therapy. Herein, we aimed to compare the efficacy of continuous-flow and pulsatile-flow blood pumps on the improvement of PH in mechanical circulatory support patients. Twenty-seven patients with end-stage heart failure who underwent LVAD implantation surgery were enrolled. Fifteen of them (55.6%) had continuous-flow pump (HeartWare Ventricular Assist System, HeartWare, Inc., Miramar, FL, USA), and 12 of them (44.4%) had pulsatile pump (Berlin Heart EXCOR ventricular assist device, Berlin Heart AG, Berlin, Germany). The efficacy of LVADs on the improvement of PH was compared between continuous-flow and pulsatile pumps by the evaluation of systolic PAP, tricuspid annular plane systolic excursion (TAPSE), right ventricular systolic motion (RVSM), right ventricular ejection fraction (RVEF), and grade of tricuspid insufficiency (TI) for each of the study participants. All of the 15 patients who underwent continuous-flow blood pump implantation surgery (Group 1) were male with a mean age of 46.9 +/- 11.7 years, and in pulsatile-flow blood pump implanted participants (Group 2), the mean age was 40.6 +/- 16.8 years, all of whom were also male (P=0.259). Mean follow-up was 313.7 +/- 241.3 days in Group 1 and 448.7 +/- 120.7 days in Group 2 (P=0.139). In Group 1, mean preoperative and postoperative systolic PAP were measured as 51.7 +/- 12.2mmHg and 22.2 +/- 3.4mmHg, respectively, while those in Group 2 were 54.5 +/- 7.5mmHg and 33.9 +/- 6.4mmHg, respectively. A significantly greater decrease in systolic PAP was noticed in patients with continuous-flow blood pumps (P=0.023); however, no statistically significant difference was found when we considered the change in TAPSE between study groups (P=0.112). A statistical significance in the alteration of RVEF, RVSM, and the grade of TI during study visits was not found between the study groups (P=0.472, P=0.887, and P=0.237, respectively). Although the two studied types of LVADs were found to be effective in reducing PAP in heart transplantation candidates with PH, lesser postoperative systolic PAP values were achieved in patients who underwent continuous-flow pump implantation surgery.Öğe The Effect of Continuous-flow Ventricle Assist Device and Support Time on Pulmonary Artery Pressure in Bridge to Heart Transplant Patients(Elsevier Science Inc, 2013) Balcioglu, Ozlem; Yagdi, Tahir; Engin, Cagatay; Nalbantgil, Sanem; Ertugay, Serkan; Zoghi, Mehdi; Erkul, Sinan; Baysal, Bora; Ozbaran, MustafaÖğe First Successful Experience With The Heartware Assist Device In Child In Turkey(Wiley-Blackwell, 2012) Balcioglu, Ozlem; Erkul, Sinan; Ayik, Fatih; Ulger, Zulal; Karakula, Sultan; Engin, Cagatay; Atay, Yuksel; Yagdi, Tahir; Ozbaran, MustafaÖğe Heartware HVAD Application In Heart Failure Treatment, Ege University Experience(Wiley-Blackwell, 2012) Erkul, Sinan; Balcioglu, Ozlem; Engin, Yaprak; Daylan, Ahmet; Ozturk, Pelin; Nalbantgil, Sanem; Zoghi, Mehdi; Engin, Cagatay; Askar, Fatma; Yagdi, Tahir; Ozbaran, MustafaÖğe Left Ventricular Assist Device Implantation with Tricuspid Ring Annuloplasty(Wiley-Blackwell, 2012) Ertugay, Serkan; Kahraman, Umit; Balcioglu, Ozlem; Nalbantgil, Sanem; Zoghi, Mehdi; Engin, Cagatay; Yagdi, Tahir; Ozbaran, MustafaÖğe New Generation Left Ventricular Assist Device for End Stage Heart Failure Therapy: Ege University Experience(Elsevier Science Inc, 2013) Engin, Yaprak; Yagdi, Tahir; Balcioglu, Ozlem; Engin, Cagatay; Ertugay, Serkan; Nalbantgil, Sanem; Kultayev, Ilyas; Narymbetov, Nurjhan; Zoghi, Mehdi; Ozbaran, MustafaÖğe Risk Factors of Gastrointestinal Bleeding After Continuous Flow Left Ventricular Assist Device(Lippincott Williams & Wilkins, 2018) Balcioglu, Ozlem; Kemal, Hatice S.; Ertugay, Serkan; Ozturk, Pelin; Engin, Yaprak; Nalbantgil, Sanem; Engin, Cagatay; Yagdi, Tahir; Ozbaran, MustafaThis study aimed to compare von Willebrand factor (vWF) levels, ristocetin cofactor levels, platelet counts, aortic valve movements, and right heart failure (RHF) as risk factors of gastrointestinal (GI) bleeding in patients with continuous flow left ventricular assist device (cf-LVAD). In a single centre, 90 patients (mean age 52.0 +/- 10.5 years), of which 59 were male and 31 were female, had cf-LVAD implantation from October 2010 to November 2012. Seventy-six (84.4%) patients had HeartWare (Medtronic, Mounds View, MN) and 14 (15.5%) had Heartmate II (Thoratec, Pleasanton, CA) implanted. vWF level, ristocetin cofactor level, and platelet count were measured before and after implantation to determine the presence of acquired von Willebrand Syndrome; aortic valve movement and postoperative RHF were evaluated to compare the difference in bleeding and nonbleeding patient groups. Fifteen patients (16.6%) suffered GI bleeding after cf-LVAD implantation. A statistically significant decrease was found in vWF and ristocetin cofactor levels from preoperative period to postoperative period in both bleeding and nonbleeding patient groups (p < 0.05). There was no significant difference in bleeding and nonbleeding groups regarding aortic valve movements (p 0.05). Postoperative RHF incidence was significantly high in the bleeding patient group compared with the nonbleeding group (p < 0.05). Therefore, depending on the findings of this study, acquired von Willebrand Syndrome was seen in all cf-LVAD patients, and postoperative RHF was an important risk factor for GI bleeding.Öğe The Role of Artificial Intelligence and Machine Learning in the Prediction of Right Heart Failure after Left Ventricular Assist Device Implantation: A Comprehensive Review(Mdpi, 2024) Balcioglu, Ozlem; Ozgocmen, Cemre; Ozsahin, Dilber Uzun; Yagdi, TahirOne of the most challenging and prevalent side effects of LVAD implantation is that of right heart failure (RHF) that may develop afterwards. The purpose of this study is to review and highlight recent advances in the uses of AI in evaluating RHF after LVAD implantation. The available literature was scanned using certain key words (artificial intelligence, machine learning, left ventricular assist device, prediction of right heart failure after LVAD) was scanned within Pubmed, Web of Science, and Google Scholar databases. Conventional risk scoring systems were also summarized, with their pros and cons being included in the results section of this study in order to provide a useful contrast with AI-based models. There are certain interesting and innovative ML approaches towards RHF prediction among the studies reviewed as well as more straightforward approaches that identified certain important predictive clinical parameters. Despite their accomplishments, the resulting AUC scores were far from ideal for these methods to be considered fully sufficient. The reasons for this include the low number of studies, standardized data availability, and lack of prospective studies. Another topic briefly discussed in this study is that relating to the ethical and legal considerations of using AI-based systems in healthcare. In the end, we believe that it would be beneficial for clinicians to not ignore these developments despite the current research indicating more time is needed for AI-based prediction models to achieve a better performance.Öğe The Use of Total Artificial Heart With Example of Cases for End-Stage Heart Failure Therapy(Elsevier Science Inc, 2013) Ertugay, Serkan; Balcioglu, Ozlem; Engin, Aysen Yaprak; Oguz, Emrah; Engin, Cagatay; Zoghi, Mehdi; Nalbantgil, Sanem; Erkul, Sinan; Yagdi, Tahir; Ozbaran, MustafaÖğe Ventricular Support Systems for End Stage Heart Failure Patients: Which patient, When?(Elsevier Science Inc, 2013) Engin, Yaprak; Engin, Cagatay; Yagdt, Tahir; Ertugay, Serkan; Nalbantgil, Sanem; Zoghi, Mehdi; Balcioglu, Ozlem; Ozturk, Pelin; Ozbaran, Mustafa
