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Öğe Açık kalp operasyonu sonrası nozokomiyal infeksiyonlar, etkenleri ve antimikrobiyal duyarlılıkları(2000) Yağdı, Tahir; Büke, A.Çağrı; Tünger, Alper; Polat, Süleyha Hilmioğlu; Engin, Çağatay; Bilkay, ÖnolEge Üniversitesi Tıp Fakültesi Göğüs-Kalp-Damar Cerrahisi'nde çeşitli nedenlerle açık kalp operasyonu geçiren olgularda gelişen infeksiyonlar, etkenleri ve antimikrobiyal duyarlılık oranlarının saptanması amaçlanmıştır. Toplam 1072 olgudan 55'inde (%5) nozokomiyal infeksiyon ortaya çıkmıştır. En sık yüzeyel yara yeri infeksiyonuna rastlanmıştır. Kateter ile ilişkili sepsis, pnömoni, üriner sistem infeksiyonu, mediastinit ve endokardit sırasıyla görülen diğer infeksiyonları oluşturmuştur. Bu infeksiyonlardan en sık Staphylococcus aureus izole edilmiştir. Metisilin direnci %92, ko-trimoksazol direnci %21 bulunmuştur. Glikopeptitlere karşı direnç saptanmamıştır, izole edilen diğer etkenlerden Acinetobacter spp. ile Pseudomonas aeruginosa'da karbapenem duyarlılığının yüksek oranlarda olduğu görülmüştür. İnfeksiyon gelişen olgularda mortalite oranı %31 bulunmuştur. Açık kalp operasyonu sonrası gelişen infeksiyonlarda yüksek mortalite hızı da göz önünde bulundurulduğunda kültür ve antimikrobiyal duyarlılık sonuçları alınıncaya kadar ampirik antimikrobiyal sağaltıma en kısa sürede başlanması gerektiği ve sağaltımın S. aureus, Acinetobacter spp. ve P. aeruginosa'yı kapsayacak şekilde oluşmasının yararlı olacağı sonucuna varılmıştır.Öğe Anaesthetic management in a heart transplantation patient with amiodarone associated thyrotoxicosis(2013) Şahutoğlu, Cengiz; Pestılcı, Zeynep; Kocabaş, Seden; Aşkar, Fatma Zekiye; Hepkarşı, Aslı; Engin, Çağatay; Çağıran, Zeynep…Öğe Association between the low percentage of forced vital capacity and increased mortality after left ventricular assist device implantation(2020) Özdil, Ali; Ertugay, Serkan; Engin, Çağatay; Nalbantgil, Sanem; Öztürk, Pelin; Yağdı, Tahir; Özbaran, MustafaBackground:This study aims to investigate the effect of low percentage of forced vital capacity measured in the preoperative period on the 28-day mortality in patients undergoing left ventricular assist device implantation. Methods: A total of 131 patients (111 males, 20 females; median age 54 years; range, 47 to 59 years) who underwent left ventricular assist device implantation with HeartWare™ between December 2010 and January 2016 were retrospectively analyzed. The patients were divided into two groups according to the results of pulmonary function test as a forced vital capacity percentage of ?60% (n=113) and <60% (n=18). Both groups were compared in terms of laboratory and clinical characteristics, and postoperative complications. Risk factors for postoperative 28-day mortality were analyzed.Results:Pre- and intraoperative characteristics were similar in both groups, except for left ventricular end-diastolic diameter. The ventilator-free days up to 28 days was shorter (p=0.046) and the length of intensive care unit stay was longer (p=0.011) in the low percentage of forced vital capacity group. The 28-day mortality rate was also higher (22.2% vs. 9.7%, respectively; p=0.12) in this group. The history of prior cardiac operation (odds ratio: 4.40; 95% confidence interval 1.19-16.20, p=0.026) and tricuspid valve repair at the time of device implantation (odds ratio: 5.30; 95% confidence interval 1.33-21.00, p=0.018) were found to be independent risk factors for mortality. Multivariate analysis showed that a forced vital capacity of <60% was not associated with mortality (odds ratio: 3.96; 95% confidence interval 0.95-16.43, p=0.058). Conclusion:The length of intensive care unit stay and duration of mechanical ventilation may be longer in patients with a low percentage of forced vital capacity. Although the association between 28-day mortality and low percentage of forced vital capacity is not significant, the risk of 28-day mortality is higher in this group. Therefore, the patients should be assessed carefully before the left ventricular assist device operation.Keywords:Complication, heart failure, heart-assist device, mortality, pulmonary function test.Öğe Derin hipotermik sirkulatuar arrestte giriş kriteri olarak juguler bulb venöz oksijen saturasyonu ölçümlerinin klinik önemi(Ege Üniversitesi, 2002) Engin, Çağatay[Abstarct Not Available]Öğe Diagnostic performance of late gadolinium enhancement in the assessment of acute cellular rejection after heart transplantation(2016) Şimşek, Evrim; Nalbantgil, Sanem; Ceylan, Naim; Zoghi, Mehdi; Kemal, Hatice Soner; Engin, Çağatay; Özbaran, MustafaObjective: Allograft rejection is still an important cause of morbidity and mortality after heart transplantation (HTx). Many techniques in cardiac magnetic resonance imaging (CMR) were investigated to diagnose acute cellular rejection (ACR). However, there is not enough information about late gadolinium enhancement (LGE) in the myocardium and ACR.Methods: We prospectively analyzed our consecutive 41 heart transplant recipients who were admitted for routine endomyocardial biopsies. CMR was performed maximum 6 h before the scheduled endomyocardial biopsy. Correlation between LGE in the myocardium and ACR was investigated.Results: Twenty-seven patients showed no rejection, and nine of them had LGE in the myocardium. Fourteen patients had LGE in the left ventricle (LV), and two patients had LGE also in the right ventricle (RV). There was no correlation between LGE and ACR (p=0.879). There was no difference in the left ventricular ejection fraction (LVEF), right ventricular fractional area change (RVFAC), and cardiac ischemic time between the groups (p=0.825, p=0.370, and p=0.419, respectively). LGE in the myocardium could be due to previous rejection episodes; therefore, all patients were retrospectively searched for previous rejection grades and number of episodes. Thirty-eight of the 41 patients had a history of one ACR episode, but none of them had a statistically significant correlation with LGE (for grade 1R, p=0.964 and grade 3R, p=1) There was also no correlation between number of rejection episodes history and LGE.Conclusion: LGE is not suitable to detect ACR in heart transplant patients. LGE and the history of ACR have no correlation.Öğe Distal aort cerrahisinde interkostal arter kliplenmesi ve total rezeksiyon(2007) Apaydın, Anıl Ziya; İslamoğlu, Fatih; Posacıoğlu, Hakan; Çalkavur, İsmet Tanzer; Yağdı, Tahir; Atay, Yüksel; Engin, Çağatay…Öğe Effects of cardiac rehabilitation on functional capacity, psychological symptoms and quality of life in patients with left ventricular assist device(2024) Çınar, Ece; Üzümcügil, Hale; Çapacı, Kazım; Engin, Çağatay; Yağdı, Tahir; Özbaran, Mustafa; Zoghı, MehdiAim: In this prospective randomized trial, we aimed to study the effects of cardiac rehabilitation on functional capacity, depression, and quality of life, in patients undergoing left ventricular assist device (LVAD) implantation for the treatment of heart failure. We also aimed to compare the effectiveness of home and hospital-based exercise programs. Materials and Methods: 42 patients who had received LVAD implants in our university hospital were included in the study. After the subjects were randomized into a hospital exercise group (n=20) and a home exercise group (n=22). They were enrolled in a cardiac rehabilitation program for 8 weeks, which lasted for one hour, three times per week in the hospital and at home respectively. All subjects were assessed at baseline and at the end of 8th week. They were assessed using a cardiopulmonary exercise test (CPET) for peak oxygen consumption (VO2), pulmonary function tests, 6-minute walk test (6MWT) in addition to Short form 36 (SF-36), Minnesota Living with Heart Failure Questionnaire (MLHFQ), State Trait Anxiety Inventory (STAI) and Beck Depression Index for depression (BDI) before and after intervention Results: In our study, we detected a significant improvement in peak VO2, 6MWT values, MLHFQ, STAI state anxiety sub-score in the hospital exercise group (p<0.05). The home exercise group did not improve significantly in any of the parameters except in the pain sub-score of SF-36 (p<0.05). Comparison of the changes seen in the parameters over time, the hospital group showed significantly more improvement than the home exercise group in peak VO2, 6MWT, MLHFQ and trait anxiety sub score of STAI (p<0.05). Age correlated with better gains in FEV1 (r=-0.35, p<0.05) and 6MWT (r=-0.39, p<0.01). Gains in 6MWT correlated with the gains in peak VO2 (r=0.54**, p<0.01). Duration of HF correlated with a poorer response in the FEV1 (r=0.19, p<0.05) and 6MWT (r=-0.25, p<0.01) gains. Conclusion: In this study, we detected a positive effect of supervised hospital exercise program on functional capacity, quality of life and anxiety in patients with implanted LVADs.Öğe Kalp transplantasyonu sonrasındaki neoplastik hastalıklar: Klinik deneyim ve literatürün gözden geçirilmesi(2004) Yağdı, Tahir; Engin, Çağatay; Nalbantgil, Sanem; Nart, Deniz; Hamulu, Ahmet; Durmaz, İsa; Özbaran, MustafaArtmış malignite riski kalp transplantasyonun iyi bilinen bir komplikasyonudur. Bu yazıda post-transplant malignite insidansı ve klinik görünümü değerlendirilmektedir. Şubat 1998 ile Mart 2003 arasında 27 olguya kalp transplantasyonu uygulanmıştır. Operasyon sonrası 2 aydan daha uzun takip uygulanan olgular neoplastik hastalık gelişimi açısından araştırılmışlardır. Transplantasyon sonrasında 2 aydan daha uzun süre takip edilen 22 olgunun üç tanesinde (%13.6) neoplastik hastalık gelişmiştir. Post-transplant lenfoproliferatif hastalık ve Kaposi sarkomu sırasıyla malinyitelerin %67’si (iki olgu) ve %33’ünü (bir olgu) oluşturmaktadır. Transplantasyon sırasındaki ortalama yaş 51’dir. Transplantasyon ile malignite gelişimi arasındaki ortanca süre 14 aydır (2-30 ay). Allogreftin lenfoma tarafından makroskopik tutulumu bir olguda gözlenmiştir. Bu olguda tanı postmortem incelemede konulmuştur. Diğer iki olguda tedavi sonrası takip döneminde tümör rekürrensi gelişmemiştir. Post-transplant neoplastik hastalıkların büyük bölümü uzun takip dönemi sonrasında gözlenmekle birlikte, bazı maligniteler, özellikle lenfoproliferatif hastalık erken postoperatif dönemde ortaya çıkabilmektedir.Öğe Turkish Society of Cardiovascular Surgery (TSCVS) Proposal for use of ECMO in respiratory and circulatory failure in COVID-19 pandemic era(2020) Akar, Ahmet Rüçhan; Ertugay, Serkan; Kervan, Ümit; İnan, M. Bahadır; Sargın, Murat; Engin, Çağatay; Özatik, Mehmet AliThe document is prepared to guide the members of the the Turkish Society of Cardiovascular Surgery (TSCVS) and other extracorporeal membrane oxygenation (ECMO) centers worldwide to share experiences in using ECMO in COVID-19 pandemicÖğe Turkish Society of Cardiovascular Surgery (TSCVS) Proposal for use of ECMO in respiratory and circulatory failure in COVID-19 pandemic era(2020) Sargın, Murat; Özatik, Mehmet Ali; Ertugay, Serkan; Kervan, Ümit; Engin, Çağatay; Akar, Ahmet Rüçhan; İnan, M. BahadırThe document is prepared to guide the members of the TheTurkish Society of Cardiovascular Surgery (TSCVS) andother extracorporeal membrane oxygenation (ECMO) centersworldwide to share experiences in using ECMO in COVID-19pandemic
