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Öğe Axillary Artery Injury Following Inferior Dislocation of the Glenohumeral Joint(Derman Medical Publ, 2013) Korkmaz, Mehmet Fatih; Disli, Olcay Murat; Karakaplan, Mustafa; Akca, Baris; Erdem, Mehmet NuriIn this paper, we described a case of axillary artery injury following a primary traumatic inferior shoulder dislocation. It is aimed at raising the index of awareness for identifying this limb threatening injury based on its pathognomonic triad of findings during clinical examination, and to consolidate current thinking on its subsequent management and outcome. To our knowledge, this is the only report in the English literature describing vascular injury in primary traumatic inferior shoulder dislocation in a young man.Öğe Coronary Bypass Surgery in Patients with Pulmonary Hypertension: Assessment of Early and Long Term Results(Medical Tribune Inc, 2015) Akca, Baris; Erdil, Nevzat; Disli, Olcay Murat; Donmez, Koksal; Erdil, Feray; Colak, Mehmet Cengiz; Battaloglu, BektasPurpose: We aimed to evaluate the effects of preoperative pulmonary hypertension (PH) on early and long term results in patients undergoing coronary bypass surgery and the effects of coronary bypass surgery on PH. Methods: Among 2325 patients who underwent elective isolated coronary artery bypass surgery between March 2003 and March 2012, 287 patients with high preoperative pulmonary arterial pressure (PAP) >= 30 mmHg were examined. Patients' data were obtained by retrospective examination of our clinic's database. 69 patients who had complete parameters included in the study. Results: There was no increase in the New York Heart Association (NYHA) functional classification 84% of cases. Preoperative and postoperative values of the mean ejection fraction and mean PAP of patients was respectively 45.28 +/- 9.67 (25-65), 46.03 +/- 12.4 (20-65) (p = 0.447), 36.67 +/- 6.81 (30-60) mmHg, 37.81 +/- 10.07 (20-70) mmHg (p = 0.378). The late mortality of cases was 5.79%. In our study, during 33.9 +/- 17 (9-100) months follow up period, life expectancy was calculated as 94.7 months. Conclusion: Preoperative evaluation of these patients for appropriate medical treatment at peroperative and postoperative period, coronary bypass can be performed with low morbidity and mortality rates. In the late period after surgical revascularization PH showed no significant change and had no adverse effect on quality of life.Öğe Due of a Ascending-to-Descending Aortic Bypass for Complex Coarctation of the Aorta(Derman Medical Publ, 2013) Battaloglu, Bektas; Disli, Olcay M.; Akca, Baris; Karakurt, Cemsit; Erdil, NevzatA variety of approaches and surgical techniques have been proposed for the management of complex form of aortic coarctation. When there is an additional cardiovascular disorder that requires surgical correction it is preferable to correct both lesions through the same incision simultaneously. In this paper, we describe the technique of ascending-to-descending aorta bypass grafting performed through the median sternotomy and simultaneous additional cardiovascular disorders repair in a case who had complex aortic Coarctation.Öğe The effects of pulmonary hypertension on early outcomes in patients undergoing coronary artery bypass surgery(Tubitak Scientific & Technological Research Council Turkey, 2016) Akca, Baris; Donmez, Koksal; Disli, Olcay Murat; Akgul Erdil, Feray; Colak, Mehmet Cengiz; Aydemir, Ilhan Koray; Battaloglu, BektasBackground/aim: To investigate the effects of pulmonary hypertension on early clinical variables in patients undergoing coronary artery bypass grafting surgery. Materials and methods: The preoperative echocardiographic data of patients who underwent isolated coronary artery bypass surgery were evaluated retrospectively. A total of 1244 patients were included in the study. The patients were divided into two groups: one group consisted of patients with systolic pulmonary artery pressure (SPAP) values equal to or greater than 30 mmHg (Group 1, n = 184), while the other group consisted of patients with SPAP values below 30 mmHg (Group 2, n = 1060). Results: Early mortality was similar in both groups (0% in Group 1 and 1.2% in Group 2; P > 0.05). Comparison of postoperative data indicated that Group 1 had a higher need for inotropic agent treatment, a longer average duration of ventilation, and a longer average duration of stay in the intensive care unit (P < 0.05). For the other variables, no significant differences were identified between patients with and without pulmonary hypertension (P > 0.05). Conclusion: Mild pulmonary hypertension (mean SPAP = 37.7 +/- 8.4 mmHg) was not associated with a significant difference in the mortality of patients undergoing coronary artery bypass grafting. For patients undergoing this type of coronary bypass surgery, lower morbidity and mortality rates can be achieved through comprehensive preoperative examinations and effective perioperative medical procedures.Öğe Is preoperative anemia a risk factor of new-onset atrial fibrillation in patients underwent isolated coronary artery bypass surgery?(2019) Akca, BarisAim: The impact of preoperative anemia in coronary artery bypass surgery (CABG) remains controversial and mostly associated with worse outcomes. Also, relationship between anemia and new on-set Atrial Fibrillation (NOAF) is still uncertain in patients who underwent CABG. This study aimed to investigate the anemia whether a risk factor of NOAF in patients who underwent isolated CABG.Material and Methods: Between March 2007 - December 2017 data of patients who underwent isolated CABG were retrospectively examined and 2027 patients included in study. Anemia was defined as hemoglobin level 13 g/dl for men and 12 g/dl for women. Patients were grouped as non-AF (n=1772) and AF (n=255) according to development of NOAF after CABG or not. Multivariate logistic regression analysis was performed to determine AF risk factors.Results:Overall anemia incidence of this study was 25.8% (n= 522). Also, anemia was observed in 17.4% of males and 52.2% of females. The incidence of anemia was similar in both groups; AF group 29% (n=74), non-AF group 25.3% (n=448) (p = 0.202). The mean hemoglobin and mean hematocrit level of AF and non-AF groups were similar (p=0.749, p=0.954 respectively) and 13.88 ± 1.77 g/dl, 13.84±1.63 g/dl and 41.13±5.48 %, 41.15±4.97 % respectively. Multivariate logistic regression analysis revealed that the parameters of mean hemoglobin, mean hematocrit and preoperative anemia were not NOAF risk factors after CABG. The parameters of carotid artery disease (OR=1.996), low LVEF (OR=1.429), BUN (OR=1.019), Euroscore (OR=1.151), need of inotrop (OR=2.270), mean perfusion time (OR=1.008), mean crosclamp time (OR=1.007) and mean ventilation time (OR=1.030) were independent risk factors of NOAF after CABG. Postoperative early mortality of groups were similar (p=0.299).Conclusion: Preoperative anemia was not a risk factor of NOAF in post-CABG patients. In addition, the mortality-enhancing effect of preoperative anemia was not detected in AF patients.Öğe Is There Any Difference in Risk Factors between Male and Female Patients in New-Onset Atrial Fibrillation after Coronary Artery Bypass Grafting?(Georg Thieme Verlag Kg, 2018) Akca, Baris; Erdil, Nevzat; Colak, Mehmet Cengiz; Disli, Olcay Murat; Battaloglu, Bektas; Colak, CemilBackground We aimed to investigate the risk factors of post-coronary artery bypass grafting (CABG) atrial fibrillation (AF) in male and female patients without any history of AF, to identify the sex-specific risk factors, and to examine the effect of sex-specific risk factors on the overall population. Methods This retrospective study was conducted using the hospital database with 4,758 patients who underwent CABG surgery. Among them, 2,836 patients with complete data participated in this study. The female patients were divided into two groups as patients who developed new-onset AF after CABG and those who did not. The relationship between the patients' variables and risk factors of post-CABG AF was examined. Results The overall incidence of post CABG AF was 12.9% (386/2,836). Sex-specific incidence of AF was similar: 3.2% (91/690) and 12.9% (277/2146) in female and male patients, respectively (p = 0.849). Multiple analysis revealed the independent risk factors for male and female patients, respectively: mean age (odds ratio [OR] = 1.057, OR = 1,076), age over 65 years (OR = 2.156, OR = 2.736), the European System For Cardiac Operative Risk Evaluation Scores (EuroSCORE) (OR = 1.13, OR = 1.218), COPD (OR = 1.589, OR = 1.789), BUN level (OR = 1.026, OR = 1.019), mean cardiopulmonary bypass (CPB) time (OR = 1.007, OR = 1.010), prolonged CPB time (OR = 1.604, OR = 2.309), mean cross-clamp time (OR = 1.009, OR = 1.017), need of inotropic support (OR = 2.249, OR = 2.731), and mean mechanical ventilation time (VT) (OR = 1.026, OR = 1.027). Low left ventricular ejection fraction (LVEF) (OR = 1.419), left ventricular (LV) aneurysm repair (OR = 1.533), carotid artery disease (OR = 1.750), prolonged VT (OR = 1.729), and use of intra-aortic balloon pump (IABP) (OR = 2.436) were found to be the risk factors only for male AF patients. Unstable angina (OR = 1.969), right coronary artery (RCA) disease (OR = 2), prolonged cross-clamp time (OR = 2.152), and the number of grafts per operation (OR = 1.298) were found to be the risk factors only for female AF patients. Conclusion This study suggests that predictors of AF in the overall population may be due to isolated patient groups. Multiple regression analysis and artificial intelligence modelling should be performed on large-scale, isolated groups to make strong AF prediction.Öğe Is there any difference in risk factors between male and female patients in new-onset atrialfibrillation after coronary artery bypass grafting?(Georg thıeme verlag kg, rudıgerstr 14, d-70469 stuttgart, germany, 2018) Akca, Baris; Erdil, Nevzat; Colak, Mehmet Cengiz; Disli, Olcay Murat; Battaloglu, Bektas; Colak, CemilBackground We aimed to investigate the risk factors of post-coronary artery bypass grafting (CABG) atrial fibrillation (AF) in male and female patients without any history of AF, to identify the sex-specific risk factors, and to examine the effect of sex-specific risk factors on the overall population. Methods This retrospective study was conducted using the hospital database with 4,758 patients who underwent CABG surgery. Among them, 2,836 patients with complete data participated in this study. The female patients were divided into two groups as patients who developed new-onset AF after CABG and those who did not. The relationship between the patients' variables and risk factors of post-CABG AF was examined. Results The overall incidence of post CABG AF was 12.9% (386/2,836). Sex-specific incidence of AF was similar: 3.2% (91/690) and 12.9% (277/2146) in female and male patients, respectively (p = 0.849). Multiple analysis revealed the independent risk factors for male and female patients, respectively: mean age (odds ratio [OR] = 1.057, OR = 1,076), age over 65 years (OR = 2.156, OR = 2.736), the European System For Cardiac Operative Risk Evaluation Scores (EuroSCORE) (OR = 1.13, OR = 1.218), COPD (OR = 1.589, OR = 1.789), BUN level (OR = 1.026, OR = 1.019), mean cardiopulmonary bypass (CPB) time (OR = 1.007, OR = 1.010), prolonged CPB time (OR = 1.604, OR = 2.309), mean cross-clamp time (OR = 1.009, OR = 1.017), need of inotropic support (OR = 2.249, OR = 2.731), and mean mechanical ventilation time (VT) (OR = 1.026, OR = 1.027). Low left ventricular ejection fraction (LVEF) (OR = 1.419), left ventricular (LV) aneurysm repair (OR = 1.533), carotid artery disease (OR = 1.750), prolonged VT (OR = 1.729), and use of intra-aortic balloon pump (IABP) (OR = 2.436) were found to be the risk factors only for male AF patients. Unstable angina (OR = 1.969), right coronary artery (RCA) disease (OR = 2), prolonged cross-clamp time (OR = 2.152), and the number of grafts per operation (OR = 1.298) were found to be the risk factors only for female AF patients. Conclusion This study suggests that predictors of AF in the overall population may be due to isolated patient groups. Multiple regression analysis and artificial intelligence modelling should be performed on large-scale, isolated groups to make strong AF prediction.Öğe Large Thrombus Formation from Right Atrial Incision Site after Closure of Atrial Septal Defect(Korean Soc Cardiology, 2013) Disli, Olcay Murat; Erdil, Nevzat; Akca, Baris; Otlu, Yilmaz Omur; Battaloglu, BektasAtrial septal defect (ASD) is the common congenital anomaly which requires surgical interventions. Right atrial thrombus formations after primary suture repairs of the ASD and evidences of thromboembolic complications are extremely rare. Specifically, the cases of thromboembolic complications have high mortality and morbidity risks. Two cases of giant intra-atrial thrombus formation detected in the late stage after primary repairs of ASDs are being discussed.Öğe Management of war-related vascular injuries: A civilian surgeon experience in the treatment of war casualties at a secondary care hospital(Carol Davila Univ Medicine & Pharmacy Publ, 2019) Akca, BarisBackground: This study presents the management of patients with war-related injuries and early results of vascular injuries treated at a secondary care hospital neighboring to civil war. Methods: Between December 2013-December 2014 ninety-six war-related injury patients evaluated by a single vascular surgeon and participating disciplines according to components of injury in polytrauma patients. Thirty-six patients who underwent vascular surgery were retrospectively registered to the study. Demographics, treatment and early results of patients reviewed. Results: Mean age was 26.69 +/- 11.80 (7-66) years and 91.66% (33/36) were males. Injuries were caused by shrapnel wound due to bombing 61.11% (22/36), stab wound 8.33% (3/36), gunshot wound 30.55 % (11/36). The number of patients with polytrauma was 29, seven patients had isolated vascular injury. Among 42 arterial and 31 venous injuries primary suture repair, autologous vein graft interposition and prosthetic graft interposition performed to 20.54% (15), 28.76% (21), 19.17% (14) respectively. Amputation and all-cause mortality were %8.3 (3/36), 13.8% (5/36) respectively. Conclusions: Vascular injury with concomitant trauma is the main issue of war-related injuries. Surgeons should be cautious about patients who were initially deemed not to need surgery for vascular injury and then were found to need it. Repetitive physical examination is very important in case of any suspicion, especially in limited conditions for diagnostic tools like CT angiography. A rapid, careful multidisciplinary evaluation of experienced surgeons for the diagnosis and the treatment priorities in war-related injury patients may lead to increase life and limb salvage rates with a better quality of life.Öğe Prediction of Postcoronary Artery Bypass Grafting Atrial Fibrillation: POAFRiskScore Tool(Georg Thieme Verlag Kg, 2023) Arslan, Ahmet Kadir; Erdil, Nevzat; Guldogan, Emek; Colak, Cemil; Akca, Baris; Colak, M. CengizBackground Atrial fibrillation (AF), a condition that might occur after a heart bypass procedure, has caused differing estimates of its occurrence and risk. The current study analyses the possible risk factors of post-coronary artery bypass grafting (post-CABG) AF (postoperative AF [POAF]) and presents a software for preoperative POAF risk prediction. Methods This retrospective research was performed on 1,667 patients who underwent CABG surgery using the hospital database. The associations between the variables of the patients and AF risk factors after CABG were examined using multivariable logistic regression (LR) after preprocessing the relevant data. The tool was designed to predict POAF risk using Shiny, an R package, to develop a web-based software. Results The overall proportion of post-CABG AF was 12.2%. According to the results of univariate tests, in terms of age ( p < 0.001), blood urea nitrogen ( p = 0.005), platelet ( p < 0.001), triglyceride ( p = 0.0026), presence of chronic obstructive pulmonary disease (COPD; p = 0.01), and presence of preoperative carotid artery stenosis (PCAS; p < 0.001), there were statistically significant differences between the POAF and non-POAF groups. Multivariable LR analysis disclosed the independent risk factors associated with POAF: PCAS (odds ratio [OR] = 2.360; p = 0.028), COPD (OR = 2.243; p = 0.015), body mass index (OR = 1.090; p = 0.006), age (OR = 1.054, p < 0.001), and platelet (OR = 0.994, p < 0.001). Conclusion The experimental findings from the current research demonstrate that the suggested tool ( POAFRiskScore v.1.0 ) can help clinicians predict POAF risk development in the preoperative period after validated on large sample(s) that can represent the related population(s). Simultaneously, since the updated versions of the proposed tool will be released periodically based on the increases in data dimensions with continuously added new samples and related factors, more robust predictions may be obtained in the subsequent stages of the current study in statistical and clinical terms.Öğe Right axilloaxillary cannulation for surgical management of a giant ascending aortic aneurysm(Wiley, 2018) Battaloglu, Bektas; Akca, Baris; Erdil, Nevzat; Colak, Cengiz[Abstract Not Available]Öğe The Surgical Repair of a Hyperimmunoglobulin E Syndrome Associated Ascending Aortic Aneurysm(Elsevier Science Inc, 2017) Battaloglu, Bektas; Colak, Cengiz; Disli, Olcay M.; Akca, Baris; Erdil, Nevzat; Karakurt, CemsitHyperimmunoglobulin E syndrome (HIES) is an immunodeficiency disorder that manifests itself by affecting more than one system. Arterial aneurysms are among the significant complications associated with HIES. Surgical procedures for patients with such aneurysms are uncommon. In this study, we aim to present the case and surgical repair of a male child who was previously diagnosed with HIES and presented with rapidly expanding ascending aortic aneurysm. (C) 2017 by The Society of Thoracic SurgeonsÖğe Unexpected Contralateral Femoral Artery Atheromatous Plaque Embolism After TAVI(Derman Medical Publ, 2017) Akca, Baris; Erdil, Nevzat; Hidayet, Siho; Colak, Mehmet Cengiz; Battaloglu, BektasVascular complications associated with transfemoral transcatheter aortic valve implantation are frequent and unfortunate consequences of arterial sheath insertion. The current report presents a case of atheromatous plaque embolization to the left common femoral artery when the right femoral artery is cannulated by surgical cutdown following transcatheter aortic valve implantation. If the transfemoral access route is used, bilateral lower extremity pulses should be monitored closely and, in the case of an acute ischemia, the necessity of emergency operation should be noted.
