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Öğe Anomalous LAD and CX artery arising separately from the proximal right coronary artery - A case report of single coronary artery with coronary artery disease(Blackwell Publishing, 2006) Kosar, F; Ermis, N; Erdil, N; Battaloglu, BCoronary artery anomaly has been reported at a rate of 0.6% to 1.3% in routine angiographic series. Moreover, single coronary artery is one of the rarest anomalies among coronary anomalies. Eventhough patients with coronary anomalies are usually asymptomatic, they may also be associated with myocardial ischemia, ventricular fibrillation, syncope, congestive heart failure, and sudden death. In this article, we report a case of single coronary artery anomaly with the left anterior descending (LAD) and left circumflex (LCx) coronary artery arising separately from the proximal right coronary artery. Since the presented case was associated with ischemic heart disease, coronary artery bypass grafting was carried out. He is currently well.Öğe Arterial myocardial revascularization using bilateral radial artery - 17 years after right pneumonectomy(Texas Heart Inst, 2004) Erdil, N; Nisanoglu, V; Toprak, HI; Erdil, FA; Kuzucu, A; Battaloglu, BWe report the case of a 51-year-old man who underwent arterial myocardial revascularization with the use of bilateral radial arteries, 17 years after undergoing a right pneumonectomy. We used a fast-track anesthesia protocol for the procedure. There was no perioperative complication, and postoperative recovery was uneventful. The patient was discharged from the hospital 5 days after the operation.Öğe A case of left atrial myxoma associated with atrial septal defect(Wiley, 2005) Kosar, F; Erdil, N; Gullu, H; Sahin, I; Nisanoglu, V; Battaloglu, BCardiac myxoma is the most frequent primary tumor of the heart. However, it is rarely associated with congenital cardiac anomalies such as atrial septal defect in the literature. We present a 72-year-old woman referred to the emergency department with loss of consciousness and finally diagnosed as a pedinculated mobile left atrial myxoma and concomitant occurrence of an ostiurn secundum type atrial septal defect. The mass was successfully excised, and atrial septal defect was safely repaired by primary suture, The patient is currently well after surgery. Atrial myxoma should be considered in the differential diagnosis when patients present with neurological consequences of systemic embolization.Öğe Complete left-sided absence of the pericardium in association with buptured type A aortic dissection complicated by severe left hemothorax(Texas Heart Inst, 2005) Nisanoglu, V; Erdil, N; Battaloglu, BWe report an unusual clinical presentation of an acute type A aortic dissection as a left hemothorax in a patient with a congenital pericardial defect. Although the pericardial defect was diagnosed preoperatively, we could not exclude the possibility of a ruptured descending aorta until we discovered the site of the rupture during operation. The presence of a pericardial defect would at first appear to be a fatal disadvantage in such a situation as this, due to massive bleeding into the pleural space; but we believe that in our patient spontaneous drainage of blood into the pleural cavity prevented severe cardiac tamponade. The only reason for his deteriorating hemodynamic status was hypovolemia, which was corrected with volume replacement.Öğe Does cardiopulmonary bypass alter plasma level of tumor markers? CA 125 and carcinoembryonic antigen(Georg Thieme Verlag Kg, 2002) Battaloglu, B; Kaya, E; Erdil, N; Nisanoglu, V; Kosar, F; Ozgur, B; Yildirim, BBackground: In addition to malignant diseases, acute and chronic inflammations may elevate plasma levels of tumor markers CA 125 and carcinoembryonic antigen (CEA). Cardiopulmonary bypass (CPB) causes a generalized inflammatory response. In this study, we have investigated the effect of CPB on plasma levels of CA 125 and CEA. Methods: We measured plasma levels of CA 125 and CEA in patients undergoing coronary artery bypass grafting (CABG) with CPB (Group 1, n = 21), and in patients who underwent off-pump CABG, that is, without CPB (Group 2, n = 16). Blood samples were collected preoperatively, and on postoperative days 1, 6, and 12. Results: Within both groups, CEA plasma levels were not significantly influenced in any samples. Comparing with preoperative values, CA 125 values elevated significantly on postoperative days 6 and 12 within both groups. It was observed that the elevation of CA 125 plasma levels in these samples were significantly higher in Group 1. Conclusions: The results indicate that CPB elevated plasma level of CA 125. However, clinical importance of this finding needed further evaluation.Öğe Early postoperative candida colonization in alimentary canal in patients undergoing open heart surgery(Edizioni Minerva Medica, 2005) Alat, I; Kuzucu, Ç; Akpinar, MB; Egri, M; Battaloglu, B; Cihan, HBAim To examine the frequency and factors predisposing to candidiasis in the digestive tract in the early postoperative period after open heart surgery. Methods. One hundred patients undergoing open heart surgery were enrolled in this study. Patients were divided into 2 groups in regard to Candida spp. colonization. Group A means increased Candida spp. colonization after open heart surgery (31/100). Group B indicates unchanged Candida spp. colonization after open heart surgery (69/100). Samples were obtained from both oral and anal inucosa in 3 different periods of operation: 1) preoperatively (stage 1), 2) at the end of the first hour in the intensive care unit (stage 2), 3) 24 hours after operation (stage 3). Findings were compared with both preoperative and intraoperative parameters. For fungal isolation Sabourauds dextrose agar and blood agar were used. Results. In Group A (31), there was a significant relationship between the samples in stage 1 and 2 (p=0.031), and also a significance between stage 1 and 3 (p=0.048). Comparison between Candida positive and negative groups (Group A and B) did not reflect any statistical significance (P>0.05). Conclusion. Candida colonization in the alimentary canal in the early postoperative period after open heart surgery is due to individual preoperative features. However, early postoperative Candida colonization in the digestive tract is not a risk factor for sepsis unless the patient has an additional risk factor leading to prolongation of length of stay in the intensive care unit.Öğe Effect of posterior pericardiotomy on early and late pericardial effusion after valve replacement(Blackwell Publishing, 2005) Erdil, N; Nisanoglu, V; Kosar, F; Erdil, FA; Cihan, HB; Battaloglu, BObjective: Pericardial effusion (PE) after cardiac surgery is frequent. It is more frequently seen after valve replacement or other types of heart surgery. Oral anticoagulants and antiplatelet agents may induce effusion development after open heart surgery. Our objective was to determine the efficiency of posterior pericardiotomy (PP) after cardiac valve operation for reducing the incidence of early and late PE and tamponade. Methods: This prospective randomized study was carried out in 100 consecutive patients undergoing mechanical valve replacement between August 2001 and May 2003 in our institution. Patients were divided into two groups; each group consisted of 50 patients. Longitudinal incision was made parallel and posterior to the left phrenic nerve, extending from the left inferior pulmonary vein to the diaphragm in Group 1. Posterior pericardiotomy was not done in Group 2. Results: Early PE was detected in four patients (8%) and in 19 patients (38%) in Group 1 and Group 2, respectively (p < 0.001). No late PE effusion was developed in Group 1 despite nine (18%) late PE developing in Group 2 (p < 0.003). The rate of delayed pericardial tamponade was lower in Group 1, but this difference was not statistically significant (0% vs 10%; p < 0.056). Conclusion: These findings suggest that PP is an easy, feasible, and beneficial technique for reducing both the occurrence of early and late PE or pericardial tamponade in patients undergoing valve replacement.Öğe Effects of coronary revascularization and concomitant aneurysmectomy on QT interval duration and dispersion(Churchill Livingstone Inc Medical Publishers, 2006) Kosar, F; Nisanoglu, V; Aksoy, Y; Colak, C; Erdil, N; Battaloglu, BA reduction in QT dispersion (QTd) has been previously shown in patients receiving thrombolytics and undergoing coronary artery bypass grafting (CABG). The purpose of the present study was to investigate changes occurring in corrected QT intervals or QT dispersion after CABG and concomitant aneurysmectomy in the same session. The study population included 43 patients with coronary artery disease with left ventricular aneurysm (LVA). The control group included 32 patients with coronary artery disease without LVA. The study patients underwent CABG and aneurysmectomy in the same surgical session. Corrected maximum and minimum QT interval duration (QTcmax and QTcmm) and corrected QT dispersion (QTcd) were measured in the study patients before and after surgery. QTcmax and QTcd in the patients with LVA were significantly higher than in the patients without LVA (P < .001 and P < .001, respectively). QTcmax and QTcd in the patients with LVA were significantly shortened after surgery (P < .001 and P < .001, respectively). This study showed that QTcmax and QTcd values are significantly reduced after CABG and concomitant aneurysmectomy. We have suggested that coronary revascularization and left ventricular reconstruction in the same session have beneficial effects on QT interval duration and dispersion. (c) 2006 Elsevier Inc All rights reserved.Öğe Increased thrombolysis in myocardial infarction frame counts in patients with isolated coronary artery ectasia(Springer, 2004) Senen, K; Yetkin, E; Turhan, H; Atak, R; Sivri, N; Battaloglu, B; Tandogan, IThe Thrombolysis in myocardial infarction (TIMI) frame count is a simple clinical tool for assessing quantitative indexes of coronary blood flow. This measurement has been significantly correlated with flow velocity measured with a flow-wire by several investigators during baseline conditions or hyperemia. In this study we aimed to evaluate the coronary flow in patients with isolated coronary artery ectasia by means of the TIMI frame count and to compare the results with those of patients with angiographically normal coronary arteries. The study population consisted of 37 patients with coronary artery ectasia only in the right coronary artery (RCA). The control group consisted of 31 patients with angiographically proven normal coronary arteries. Coronary artery ectasia was defined as nonobstructive lesions of the coronary arteries with a luminal dilatation 1.5-fold or more of the adjacent normal coronary segments. The TIMI frame count was determined for each major coronary artery in each patient according to the methods first described by Gibson et al. The TIMI frame count of RCA in the study group was significantly higher than in that of the control group (51+/-17 vs 25+/-8, P<0.0001). The TIMI frame counts of the study group for the left anterior descending and left circumflex coronary artery were also significantly higher than those of the control group (corrected TIMI frame count for LAD=42+/-11 vs 24+/-7, P<0.001; TIMI frame count for LCx=44+/-15 vs 25+/-9, P<0.001). In patients with coronary artery ectasia, the TIMI frame count of the RCA was higher than that of the left anterior descending and left circumflex coronary artery (51+/-17 vs 42+/-11 and 44+/-15, respectively, P<0.05). We have shown increased TIMI frame counts in patients with isolated coronary artery ectasia and suggest that the pathophysiological mechanism of coronary artery ectasia is not a focal disease. TIMI frame counts can be regarded as an index of the severity of impaired coronary flow in patients with coronary artery ectasia.Öğe Left main coronary artery compression by dilated pulmonary trunk in a patient with atrial septal defect(Acta Cardiologica, 2003) Gullu, H; Kosar, F; Battaloglu, BA 52-year-old man, presenting with exertional chest pain was investigated to explain his chest pain. Echocardiographic examination revealed he had the ostium secundum type of atrial septal defect, dilated right heart chambers, dilated pulmonary artery, and pulmonary artery systolic pressure of 65 mm Hg calculated from tricuspid regurgitation, but his chest pain could not be explained with these findings. Therefore, cardiac catheterization and coronary angiograph were performed Coronary angiography revealed severe stenosis of the left main coronary artery and otherwise normal vessels. Angiographic images made us think that there might be an external compressing structure on the left main coronary artery. For further evaluation, contrast-enhanced magnetic resonance images of the heart were taken. These images showed that the markedly dilated pulmonary artery was compressing the left main coronary artery.
