Yazar "Cikirikcioglu, M" seçeneğine göre listele
Listeleniyor 1 - 8 / 8
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Determinants of early mortality and neurological morbidity in aortic operations performed under circulatory arrest(Futura Publ Co, 2000) Yagdi, T; Atay, Y; Cikirikcioglu, M; Boga, M; Posacioglu, H; Ozbaran, M; Alayunt, A; Buket, SObjective: Aneurysms and dissections of the thoracic aorta continue to present a surgical challenge and their incidence is increasing in recent years. The mortality rate of surgical treatment is still higher than those of other cardiovascular operations. Neurological injury is the most feared complication resulting from repair of these lesions. This study aims to determine the factors that influence the neurological outcome and mortality after thoracic aortic operations. Methods: During the period from November 1993 through May 1999, 144 patients were operated on for conditions involving the ascending aorta and/or aortic arch. Ninety-five (66.0%) were operated for aortic dissection and 49 (34.0%) were for aortic aneurysms. Sixty-two patients (43.1%) had replacement of ascending aorta with distal open technique; 82 patients (56.9%) had hemiarch or total arch replacement or repair of the distal arch. Results: Twenty-seven (18.7%) early deaths occurred. New stroke occurred in two patients (1.4%) and temporary neurological dysfunction in nine patients (6.3%). Deep hypothermic circulatory arrest with retrograde cerebral perfusion was used in all patients. On multivariate logistic regression analysis, risk factors for mortality were chronic renal failure, preoperative organ malperfusion, rupture, total circulatory arrest time, 60 minutes, postoperative acute renal failure, postoperative low cardiac output, sepsis, and multiple organ failure. Risk factors for neurological morbidity were preoperative chronic renal failure, preoperative hemodynamic instability, postoperative low cardiac output, and pulmonary complications. Conclusions: Hypothermic circulatory arrest with retrograde cerebral perfusion was not an independent predictor of neurological morbidity on multivariate analysis, even if the arrest period was more than 60 minutes. Lengths of circulatory arrest periods and clinical presentations of the patients are important determinants of mortality.Öğe The effects of modified hemofiltration on inflammatory mediators and cardiac performance in coronary artery bypass grafting(Arnold, Hodder Headline Plc, 2000) Boga, M; Islamoglu, F; Badak, I; Cikirikcioglu, M; Bakalim, T; Yagdi, T; Buket, S; Hamulu, ACardiopulmonary bypass increases the blood levels of various immune mediators, thereby leading to a systemic inflammatory response syndrome, e.g. sepsis, with some hemodynamic alterations, such as vasodilatation, tachycardia, and a decrease in systemic vascular resistance. Perioperative hemofiltration is one of the treatment modalities proposed to prevent this syndrome. Modified hemofiltration has been introduced recently by investigators who recommend that the former standard techniques are ineffective in eliminating the inflammatory mediators. The purpose of this study was to determine the effects of the modified technique on these mediators and on hemodynamic parameters. Forty patients undergoing coronary artery bypass grafting were randomized into equal control and hemofiltered groups. The hemodynamic parameters, as weil as blood samples, were taken before and after hemofiltration to assess blood concentrations of interleukin-6, interleukin-8 and neopterin. The hemodynamic parameters and immune mediator levels did not differ between the two groups during the course of the study, except in the immediate postoperative periods, where cardiac output, cardiac index, and systemic vascular resistance values were significantly greater in hemofiltered group while there were no differences in the immune mediators. The results of our study suggest that the effects of modified hemofiltration on immune mediators are stilt debatable. The improvement found in cardiac performance could be attributed to the prevention of hemodilution and hypervolemia.Öğe The effects of the Harmonic Scalpel on the vasoreactivity and endothelial integrity of the radial artery: A comparison of two different techniques(Mosby, Inc, 2001) Cikirikcioglu, M; Yasa, M; Kerry, Z; Posacioglu, H; Boga, M; Yagdi, T; Topcuoglu, N; Buket, S; Hamulu, AÖğe The histological effect of harmonic scalpel and electrocautery in lung resections - An experimental study in a rat model(Edizioni Minerva Medica, 2004) Cakan, A; Cagirici, U; Cikirikcioglu, M; Posacioglu, H; Veral, AAim In the last decade, ultrasonically activated scalpels (the Harmonic Scalpel, HS) have been developed and used for both open and endoscopic surgical procedures. The present study compares the deepness of lung tissue damage caused by HS and unipolar electrocautery (EC) in rats. Methods. Ten rats were used for the study. Morphological damage on lung parenchyma of the rats was measured with the ocular micrometer in light microscopy. Results. The mean depth of the tissue damage was 0.23+/-0.08 mm in the HS group, and 0.33+/-0.10 mm in the EC group. The difference was statistically significant between the 2 groups (p=0.028). Conclusion. HS induces significantly less tissue damage than EC in rat lungs.Öğe Intramural hydatid cyst of descending aorta complicated by false aneurysm(Scandinavian University Press, 1999) Posacioglu, H; Bakalim, T; Cikirikcioglu, M; Yuce, G; Telli, AHydatid disease is caused by the larval stage of Echinococcus granulosus, and the resultant fluid-filled cysts almost invariably affect the liver. Primary involvement of the aortic wall is very rare. We report a case of hydatid disease presenting as a huge cyst invading the wall of the descending aorta and complicated by a false aneurysm. Diagnostic problems and operative management are reviewed.Öğe Proximal clamping levels in abdominal aortic aneurysm surgery(Texas Heart Inst, 1999) Buket, S; Atay, Y; Islamoglu, F; Yagdi, T; Posacioglu, H; Alat, I; Cikirikcioglu, M; Yuksel, M; Durmaz, IIn the surgical treatment of abdominal aortic aneurysm, the single proximal cross-clamp can be placed at 3 alternative aortic levels. infrarenal, hiatal, and thoracic. We performed this retrospective study to evaluate the advantages and disadvantages of the 3 main aortic clamping locations. Eighty patients presented at our institution with abdominal aortic aneurysms from March 1993 through May 1998. Fifty of these patients had intact aneurysms and underwent elective surgery, and 30 had ruptured aneurysms that necessitated emergency surgery. Proximal aortic clamping was applied at the infrarenal level in 24 patients (22 from the intact aneurysm group, 2 from the ruptured group), at the hiatal level in 34 patients (22 intact, 12 ruptured), and at the thoracic level (descending aorta) via a limited left lateral thoracotomy in 22 patients (6 intact, 16 ruptured). Early mortality rates (within 30 days) were 4% (2 of 50 patients) among patients with in tact aneurysms and 40% (12 of 30 patients) among those with ruptured aneurysms. In the 2 patients from the intact aneurysm group, proximal aortic clamps were applied at the hiatal level. In the ruptured aneurysm group, proximal aortic clamps were placed at the thoracic level in 10 patients, the infrarenal level in 1, and the hiatal level in 1. According to our study, the clinical status of the patient and the degree of operative urgency-as determined by the extent of the aneurysm-generally dictate the proximal clamp location. Patients who present with aneurysmal rupture or hypovolemic shock benefit from thoracic clamping, because it restores the blood pressure and allows time to replace the volume deficit. Infrarenal placement is advantageous in patients with intact aneurysms ii there is sufficient space for the clamp between the renal arteries and the aortic aneurysm. In patients with juxtarenal aneurysms, hiatal clamping enables safe and easy anastomosis to the healthy aorta. Clamping at this level also helps prevent late anastomotic aneurysm formation, which is frequently encountered after inadvertent anastomosis of the graft to a diseased portion of the aorta. Further studies are needed in order to confirm these results.Öğe Single-stage transpericardial repair of acute aortic dissection associated with recoarctation(Mosby, Inc, 2001) Buket, S; Yagdi, T; Cikirikcioglu, M; Alayunt, EAÖğe Upper sternal cleft associated with unusual symptoms(Georg Thieme Verlag Kg, 2000) Sen, S; Posacioglu, H; Cikirikcioglu, M; Guner, HWe report a rare case of upper sternal cleft in a 20-year-old adult with associated unusual symptoms such as dysphagia, restricted lingual movements and a voice problem. The strap muscles causing unusual symptoms were divided from their abnormal insertion site on the lower edge of the cleft. Direct complete closure without compromising the cardiac function was achieved in this patient.
