Yazar "Kahraman, Umit" seçeneğine göre listele
Listeleniyor 1 - 14 / 14
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Antibody Response to SARS-CoV-2 Vaccination in Heart Failure Patients: Retrospective Single-Center Cohort Study(Mdpi, 2023) Ergi, Defne Güneş; Kahraman, Umit; Akkus, Gözde; Durmaz, Seyfi; Balcıoğlu, Özlem; Engin, Çagatay; Yağmur, BurcuWe sought to investigate the impact of heart failure on anti-spike antibody positivity following SARS-CoV-2 vaccination. Our study included 103 heart failure (HF) patients, including those with and without left ventricular assist devices (LVAD) selected from our institutional transplant waiting list as well as 104 non-heart failure (NHF) patients who underwent open heart surgery at our institution from 2021 to 2022. All the patients received either heterologous or homologous doses of BNT162b2 and CoronaVac. The median age of the HF group was 56.0 (interquartile range (IQR): 48.0-62.5) and the NHF group was 63.0 (IQR: 56.0-70.2) years, and the majority were males in both groups (n = 78; 75.7% and n = 80; 76.9%, respectively). The majority of the patients in both the HF and NHF groups received heterologous vaccinations (n = 43; 41.7% and n = 52; 50.3%, respectively; p = 0.002). There was no difference in the anti-spike antibody positivity between the patients with and without heart failure (p = 0.725). Vaccination with BNT162b2 led to significantly higher antibody levels compared to CoronaVac alone (OR: 11.0; 95% CI: 3.8-31.5). With each passing day after the last vaccine dose, there was a significant decrease in anti-spike antibody positivity, with an OR of 0.9 (95% CI: 0.9-0.9). Furthermore, hyperlipidemia was associated with increased antibody positivity (p = 0.004).Öğe Dumbbell-Shaped Abdominal Aortic Aneurysm Causing Duodenal Obstruction(Texas Heart Inst, 2022) Ergi, Defne Gunes; Apaydin, Anil Ziya; Kahraman, Umit; Ertugay, Serkan[No Abstract Available]Öğe Effects of Continuous-Flow Left Ventricular Assist Device Therapy on Peripheral Vascular Function(Lippincott Williams & Wilkins, 2022) Kaya, Ersin; Kocabas, Umut; Simsek, Evrim; Nalbantgil, Sanem; Kahraman, Umit; Engin, Cagatay; Yagdi, TahirThe peripheral vascular effects of continuous-flow left ventricular assist device (CF-LVAD) implantation are still unclear. The aim of the current study was to determine peripheral vascular function before and after implantation of CF-LVAD in patients with end-stage heart failure (HF), and to compare this data to age- and sex-matched chronic heart failure with reduced ejection fraction (HFrEF) patients. Forty-three consecutive end-stage HF patients (New York Heart Association [NYHA] class III/IV; three women and 40 men; mean age 53 +/- 11 years) who planned to receive CF-LVAD implantation comprised the LVAD patient population, and their clinical characteristics, preoperative and third postoperative month peripheral vascular function assessment data including flow-mediated dilation (FMD) and pulsatility index (PI) assessed by ultrasound Doppler in brachial artery were compared to age- and sex-matched chronic, stable HFrEF patients (NYHA class II; five women and 30 men; mean age 51 +/- 10 years). After CF-LVAD implantation, median FMD decreased from 5.4 to 3.7% (p < 0.001), and median PI decreased from 6.9 to 1.4 (p < 0.001). In patients with end-stage HF before CF-LVAD implantation, FMD and PI were significantly lower compared to the chronic HFrEF patients (FMD: 5.4% +/- 0.9% vs. 7.6% +/- 1.1%; p < 0.001, respectively) and (PI: 6.9 +/- 1.3 vs. 7.4 +/- 1.2; p = 0.023, respectively). The current study revealed impaired peripheral vascular function in the end-stage HF patients compared to stable HFrEF patients, and documented the deterioration of peripheral vascular function after CF-LVAD implantation. These results suggest that impaired peripheral vascular function in the CF-LVAD patients compared to preoperative assessment is a consequence of the nonpulsatile blood flow due to the continuous-flow mechanical support.Öğe Endovascular treatment of a ruptured aortic pseudoaneurysm and its complications in an 8-year-old child with Ehlers-Danlos syndrome type VI(Oxford Univ Press, 2023) Kahraman, Umit; Akhundova, Mahsati; Cinar, Celal; Ertugay, SerkanThe procollagen-lysine, 2-oxoglutarate 5-dioxygenase 1 (PLOD1) gene may affect arterial integrity through enzymatic roles and the modulation of vascular smooth muscle cells. We present a complicated vascular case of an 8-year-old male child with Ehlers-Danlos syndrome type VI. The patient was diagnosed with a ruptured pseudoaneurysm of the infrarenal abdominal aorta. Endovascular treatment was performed using a covered self-expandable endograft. However, complications arose at the vascular access sites during the procedure, highlighting arterial fragility. PLOD1 mutations can be associated with false abdominal aortic aneurysms or arterial fragility. Open repair poses a high risk for patients with Ehlers-Danlos syndrome. Although the long-term results are unknown, endovascular stent grafts may be a suitable option for emergency clinical scenarios such as ruptured abdominal aortic pseudoaneurysms. Ehlers-Danlos syndrome is a connective tissue disorder characterized by joint hypermobility, skin elasticity, disability, abnormal scarring, and vascular complications.Öğe Exercise capacity following ventricular assist device implantation via thoracotomy with outflow cannula anastomosis to the descending aorta(Wiley, 2021) Gallastegi, Ander Dorken; Kahraman, Umit; Yagmur, Burcu; Cinar, Ece; Nalbantgil, Sanem; Engin, Cagatay; Yagdi, TahirLeft ventricular assist device (LVAD) implantation via left lateral thoracotomy with outflow cannula anastomosis to the descending aorta is an alternative technique that avoids anterior mediastinal planes and requires a single incision. This study compares changes in exercise capacity following LVAD implantation with outflow cannula anastomosis to the descending aorta versus ascending aorta. Adult patients who received a continuous flow centrifugal LVAD implantation and completed both pre- and postimplantation cardiopulmonary exercise tests (CPETs) and or 6-minute walk tests (6MWT) were included. Change in CPET parameters (maximum oxygen intake: vO(2)max, oxygen uptake efficiency ratio: OUES, ventilatory efficiency ratio: vE/vCO(2)Slope) and 6MWT distance were compared between ascending and descending aorta anastomosis groups. Ascending and descending aorta anastomosis cohorts included 59 and 14 patients, respectively. Pre- and postimplantation CPETs were performed 63 +/- 12 days before and 216 +/- 17 days following implantation. The improvement in CPET parameters (vO(2)max, OUES, vE/vCO(2)Slope) or 6MWT distance was not significantly different between the ascending and descending aorta anastomosis groups. This study found no significant difference in the improvement of CPET parameters or 6MWT distance between LVAD implantation via thoracotomy with outflow cannula anastomosis to descending aorta and standard implantation via sternotomy with outflow cannula anastomosis to ascending aorta.Öğe Haemophagocytic lymphohistiocytosis in a patient with left ventricular assist device(Oxford Univ Press Inc, 2021) Ergi, Defne Guenes; Gallastegi, Ander Dorken; Arslan, Eren; Kahraman, UmitLeft ventricular assist devices provide circulatory support to heart failure patients while awaiting a suitable donor heart. However, with their increased duration of therapy, complications are seen frequently. Although coagulation disorders (bleeding and thrombosis) are the most common complications, infection is also a major complication associated with significant morbidity. We report a case of a 53-year-old male with a left ventricular assist device who presented with driveline infection. He subsequently developed pancytopenia and was diagnosed with haemophagocytosis. Immediate treatment with intravenous immunoglobulin and methylprednisolone was started. His blood cell count returned to normal levels and the patient became eligible for heart transplantation again. Our case represents the rare occurrence of haemophagocytosis in a patient, which, if unnoticed, could lead to fatal consequences.Öğe Impact of Residual Mitral Regurgitation on Right Ventricular Systolic Function After Left Ventricular Assist Device Implantation(Wiley, 2017) Ertugay, Serkan; Kemal, Hatice S.; Kahraman, Umit; Engin, Catagay; Nalbantgil, Sanem; Yagdi, Tahir; Ozbaran, MustafaSignificant mitral regurgitation (MR) is thought to decrease after left ventricular assist device (LVAD) implantation, and therefore repair of mitral valve is not indicated in current practice. However, residual moderate and severe MR leads to pulmonary artery pressure increase, thereby resulting in right ventricular (RV) dysfunction during follow-up. We examined the impact of residual MR on systolic function of the right ventricle by echocardiography after LVAD implantation. This study included 90 patients (mean age: 51.7 +/- 10.9 years, 14.4% female) who underwent LVAD implantation (HeartMate II=21, HeartWare569) in a single center between December 2010 and June 2014. Echocardiograms obtained at 3-6 months and over after implantation were analyzed retrospectively. RV systolic function was graded as normal, mild, moderate, and severely depressed. MR (>= moderate) was observed in 43 and 44% of patients at early and late period, respectively. Systolic function of the RV was severely depressed in 16 and 9% of all patients. Initial analysis (mean duration of support 174.3 +/- 42.5 days) showed a statistically significant correlation between less MR and improved systolic function of RV (P=0.01). Secondary echocardiographic analysis (following a mean duration of support of 435.1 +/- 203 days) was also statistically significant for MR degree and RV systolic dysfunction (P= 0.008). Residual MR after LVAD implantation may cause deterioration of RV systolic function and cause right-sided heart failure symptoms. Repair of severe MR, in selected patients such as those with severe pulmonary hypertension and depressed RV, may be considered to improve the patient's clinical course during pump support.Öğe Late outflow graft stenosis of left ventricular assist device and endovascular treatment(Springer Japan Kk, 2023) Karaca, Sedat; Erdinli, Dilek; Kahraman, Umit; Cinar, Celal; Engin, Cagatay; Yagdi, Tahir; Ozbaran, MustafaLeft ventricular assist device (LVAD) systems are preferred as a bridging to transplantation or as a destination therapy in the treatment of end-stage heart failure. LVAD-related complications are seen in different clinical variations with the widespread use of LVADs. Some of these complications are seen as related to outflow graft, such as graft stenosis, graft kinking and graft thrombosis. Outflow graft complications have a direct impact on LVAD flow rate and acutely impair the clinical condition of patients. Treatment modalities include surgical approach, endovascular approach, and medical approach. In this case report, we aim to share a 57-year-old male patient, who had outflow graft stenosis near the anastomosis line between ascending aorta and the left ventricular assist device outflow graft, and the endovascular treatment.Öğe 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 Long-Term Outcomes in Ventricular Assist Device Outflow Cannula Anastomosis to the Descending Aorta(Elsevier Science Inc, 2022) Gallastegi, Ander Dorken; Hoscoskun, Elif B.; Kahraman, Umit; Yagmur, Burcu; Nalbantgil, Sanem; Engin, Cagatay; Yagdi, TahirBACKGROUND Left ventricular assist device (LVAD) implantation via thoracotomy with outflow cannula anastomosis to the descending aorta is an alternative implantation technique that uses a single incision and avoids anterior mediastinal planes. We evaluated long-term survival and hospital readmissions after LVAD implantation via thoracotomy with outflow cannula anastomosis to the descending aorta. METHODS Adult patients implanted with a continuous flow centrifugal LVAD at an academic center were retrospec-tively analyzed. Patients were assigned to 1 of 2 cohorts based on the anastomosis site of the LVAD outflow cannula: ascending aorta cohort (Asc-Ao) and descending aorta cohort (Desc-Ao). Primary and secondary outcomes were sur-vival and hospital readmissions during device support. Readmission analysis included patients with double dagger 30-day survival after discharge. Multivariable analysis and propensity score matching were performed. RESULTS Survival analysis included 330 patients (Asc-Ao: 272, Desc-Ao: 58). Readmission analysis included 277 patients (Asc-Ao: 231, Desc-Ao: 46) and a total of 1028 readmissions during 654 patient-years of follow-up were analyzed. There was no significant difference in in-hospital, 6-month, 1-year, 3-year, and 5-year mortality between the two cohorts. Readmission-free survival, 30-day readmission, number of admissions per year and hospital length of stay per year were not significantly different between the 2 cohorts after adjustment for patient characteristics. CONCLUSIONS This study found no difference in long-term survival or hospital readmissions between LVAD implan-tation via thoracotomy with outflow cannula anastomosis to the descending aorta and standard implantation. (Ann Thorac Surg 2022;114:1377-85) (c) 2022 by The Society of Thoracic SurgeonsÖğe Open Repair of a Complicated Late Endoleak Induced by Another Endoleak(Texas Heart Inst, 2022) Apaydin, Anil Ziya; Ertugay, Serkan; Kahraman, Umit; Tuncer, Osman NuriA 66-year-old man had an enlarging aortic aneurysm sac after an endovascular aortic replacement procedure that had been performed at another institution 4 years previously; it was without any endoleak but was complicated by the occlusion of the left limb, requiring cross-femoral bypass. Current computed tomography revealed dilatation of the proximal neck and the right common iliac artery. A type Ib endoleak was found from the distal end of the right limb of the endograft, possibly secondary to the dilatation of the artery around it; it then pressurized and caused the dilatation of the juxtarenal aorta around the proximal landing zone and induced a concomitant type Ia endoleak. The patient was operated on owing to the risk of rupture. Pelvic ischemia was a concern during decision-making. The patient underwent removal of the endograft and replacement of a bifurcated aortoiliac and femoral graft with good outcome. Midline laparotomy and a supraceliac clamping approach enable the removal of endografts with suprarenal fixation and revascularization of internal iliac arteries. Open repair offers a definitive solution for complicated endoleaks when endovascular options could be risky and ineffective.Öğe Outcomes of patients with left ventricular assist device infected with SARS-CoV-2(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2022) Kahraman, Umit; Ergi, Defne Gunes; Yagmur, Burcu; Engin, Cagatay; Yagdi, Tahir; Nalbantgil, Sanem; Ozbaran, MustafaBackground: The aim of this study was to describe clinical characteristics, course, and outcomes of the novel coronavirus disease 2019 (COVID-19) in heart failure patients with left ventricular assist device. Methods: Between November 2020 and August 2021, a total of 20 patients (18 males, 2 females; mean age: 57.0+10.0 years; range, 30 to 71 years) with left ventricular assist device and who were diagnosed by the COVID-19 polymerase chain reaction testing were included. For each patient, disease-related factors were evaluated including presence of hospitalization, home quarantine, presence of lung damage, antiviral medication strategy, symptomatology and complications following COVID-19. Results: Seven patients 35% patients died in our cohort following the COVID-19. All these patients experienced variety of complications following COVID-19 including subarachnoid hemorrhage and right heart failure. Three patients were already hospitalized due to COVID-19 and decompensated progressively, resulting in death on Days 14, 4, and 7 after the initial diagnosis. Conclusion: COVID-19 seems to be an important cause of mortality in patients with LVAD who have borderline cardiopulmonary function. Great care should be taken to avoid interruption in routine follow-ups with these patients, since they present a more sensitive population.Öğe Prognostic Value of Cardiopulmonary Exercise Test Parameters in Ventricular Assist Device Therapy(Lippincott Williams & Wilkins, 2022) Dorken Gallastegi, Ander; Ergi, Gunes D.; Kahraman, Umit; Yagmur, Burcu; Cinar, Ece; Karapolat, Hale; Nalbantgil, SanemCardiopulmonary exercise test (CPET) parameters are established prognosticators in heart failure. However, the prognostic value of preimplantation and postimplantation CPET parameters in left ventricular assist device (LVAD) therapy is unclear and it is evaluated in this study. Adult patients who were implanted with an LVAD and underwent CPET during the preimplantation or postimplantation period were retrospectively analyzed. Five CPET parameters were calculated: vO(2) max, oxygen uptake efficiency slope (OUES), VE/vCO(2) Slope, VE/vCO(2) min, and VE/vCO(2) max. The relationship between CPET parameters and postimplantation outcomes was evaluated with multivariable analysis. Pre and postimplantation CPET cohorts included 191 and 122 patients, respectively. Among preimplantation CPET parameters: vO(2) max and OUES were associated with 1, 3, and 5 year mortality, VE/vCO(2) min was associated with 3 and 5 year mortality, whereas VE/vCO(2) Slope was associated with 5 year mortality. From postimplantation CPET parameters: vO(2) max was an independent predictor of 3 and 5 year mortality, whereas VE/vCO(2) max was an independent predictor of 3 year mortality following LVAD implantation. Preimplantation CPET parameters have a prognostic value for long-term survival following LVAD implantation, whereas their association with early postimplantation outcomes appears to be weaker. Postimplantation vO(2) max and VE/vCO(2) max values are associated with survival on device support and may provide a second chance for prognostication in patients without preimplantation CPET data.Öğe Risk factors for neurological complications and clinical outcomes in patients with left ventricular assist devices(Mre Press, 2021) Kodik, Meltem Songur; Yildiz, Ali Kemal; Uz, Ilhan; Yalcinli, Sercan; Kahraman, Umit; Bolat, Elif; Altunci, Yusuf AliObjectives: Patients with left ventricular assist devices (LVADs) frequently experience cerebrovascular complications. We investigated the complications, including intracranial hemorrhage (ICH) and ischemic stroke (IS), in patients with LVADs. Methods: A historical cohort study was performed at an emergency clinic including patients who underwent LVAD placement between February 16, 2015, and April 1, 2020. of the 295 patients with LVADs, 71 (24.1%) were admitted to the emergency service between the study dates because of IS and ICH. Electronic medical files were reviewed, and patients were categorized as ICH or IS. Results: of the included patients, 245 (83.0%) were male. The most common postoperative complications were pump thrombosis (26.8%, n = 79), blood culture positivity (19.3%, n = 57), and surgical bleeding (5.8%, n = 17). The most frequent LVAD indication was ischemic dilated cardiomyopathy (71.5%, n = 211). The mean age was 49.6 +/- 16.7 and 51.3 +/- 14.8 years for patients with and without neurological complications, respectively (P = 0.415). Neurological complications were seen in 65 (31.3%) patients with and in 6 (6.9%) patients without coronary ischemia (P < 0.001). Neurological complications were found in 39 (30.5%) patients with an implantable cardioverter defibrillator (ICD) and in 32 (19.2%) patients without an ICD (P = 0.024). Neurological complications were found in 19 (61.3%) patients with and in 52 (19.7%) patients without a history of stroke (P < 0.001). Logistic regression analysis revealed that age and Glasgow coma scale (GCS) were the only significant variables independently affecting mortality status. While a younger age was a protective factor, a one-unit increase in the GCS was associated with a 4.1-fold (95% CI: 1.308-13.071) increase in mortality. Conclusions: Coronary ischemia, ICD, cerebrovascular disease, and smoking significantly affected the presence of complications. Moreover, patients with combined IS and ICH had a lower chance of recovering. Interventional procedures should be performed as early as possible, especially in elderly patients with a low GCS.