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Öğe Aberrant Right Subclavian Artery and Axillary Artery Cannulation in Type A Aortic Dissection Repair(Elsevier Science Inc, 2013) Battaloglu, Bektas; Secici, Serkan; Colak, Cengiz; Disli, Olcay M.; Erdil, Nevzat; Kutlu, RamazanCurrently, right axillary artery cannulation and unilateral antegrade cerebral perfusion through the same cannula are preferred choices for acute type A aortic dissection repair. However, the existence of an aberrant right subclavian artery can jeopardize cerebral perfusion through the right axillary artery cannula. In this study, we intended to explain the repair of acute type A aortic dissection using right axillary artery cannulation in a patient with aberrant right subclavian artery. (C) 2013 by The Society of Thoracic SurgeonsÖğe Anomalous Origin of the Left Coronary Artery from the Right Coronary Sinus(Medical Tribune Inc, 2012) Colak, Mehmet Cengiz; Erdil, Nevzat; Disli, Olcay; Kahraman, Ercan; Battaloglu, BektasAnomalous origin of the left coronary artery (LCA) from the right coronary artery sinus is a rare congenital coronary anomaly. We report a case of a 48-year-old symptomatic man who was admitted to our clinic with a history of hypertension, type 2 diabetes mellitus, myocardial infarction and hypercholesterolemia. Coronary angiography was performed revealing anomalous left coronary artery from the right coronary artery sinus. In addition, stenosis of RCA and well developed stenotic diagonal artery were detected with coronary angiography. We performed coronary by-pass with left internal mammarian artery to diagonal artery and vena saphena to right coronary artery (RCA). Both coronary angiography and intraoperative view should be evaluated well in patients with anomalous of the coronary artery.Öğe Axillary Artery Perfusion in Acute Type A Aortic Dissection Repair(Wiley, 2008) Battaloglu, Bektas; Erdil, Nevzat; Nisanoglu, VedatBackground: We evaluated our experience with axillary artery perfusion technique in acute type A aortic dissection repair. Methods: Between September 2000 and July 2006, 41 consecutive patients with acute type A aortic dissection underwent surgical repair. In 35 of 41 patients (85.4%), arterial perfusion was performed through right axillary artery and in the remaining six patients (14.6%), arterial perfusion site was femoral artery. Indication for femoral artery perfusion was cardiac arrest and ongoing cardiopulmonary resuscitation in one and pulslessness of right upper limb in five patients. Mean age was 54.9 +/- 15.3 (16 to 90 years) and 28 were male. Unilateral antegrade cerebral perfusion (perfusate temperature 22 to 25 degrees C) through axillary artery was performed in all axillary artery perfused patients and in three patients who had femoral artery perfusion. Results: Five patients died postoperatively (hospital mortality 12.2%). All of them had evidence of single or multiple organ malperfusion preoperatively. We did not experience any new transient or permanent neurologic deficit after the procedure in the unilateral antegrade cerebral perfusion patients. Complications related to axillary artery cannulation were observed in two patients (5.3%). One patient with femoral artery cannulation experienced femoral arterial thrombosis, postoperatively. Conclusions: Right axillary artery cannulation for repair of acute type A aortic dissection is a simple and safe procedure. In the case of pulslessness of right upper limb, femoral artery is still the choice of cannulation site. doi: 10.1111/j.1540-8191.2008.00754.x (J Card Surg 2008;23:693-696)Öğe Coronary aneurysm accompanied by a coronary artery fistula and atrial septal defect(Springer India, 2012) Akturk, Erdal; Battaloglu, Bektas; Yagmur, Julide; Eyupkoca, FerhatA 56-year-old female patient was admitted to our clinic with complaint of dyspnea on exertion with progressive worsening of the functional class in last months. Electrocardiography showed Atrial Fibrillation (AF) and Transthoracic Echocardiography (TTE) showed normal Left Ventricular (LV) systolic function with grade 3 tricuspide and grade 2 mitral insufficiency. Pulmonary arterial pressure was 45 mmHg and Right Atrium (RA) and right ventricle were dilated. Selective coronary angiography was performed. There was no obvious lesion on coronary arteries and their branches, except that the Right Coronary Artery (RCA) was dilated and tortuous and had an aneurysm. Multidetector computed tomography showed significantly dilated and tortuous RCA which significantly broadened distally and opened into the RA. Under cardiopulmonary bypass, right atriotomy was performed and an Atrial Septal Defect (ASD) revealed. This defect was closed and repaired primarily. Fistula ostium was seen from coronary sinus. Primary repair from coronary sinus window was performed. Severe regurgitation of tricuspid valve was observed and De Vega anuloplasty was performed.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 Early Outcomes of Radial Artery Use in All-Arterial Grafting of the Coronary Arteries in Patients 65 Years and Older(Texas Heart Inst, 2010) Erdil, Nevzat; Nisanoglu, Vedat; Eroglu, Tamer; Fansa, Iyad; Cihan, Hasan Berat; Battaloglu, BektasWe retrospectively evaluated early clinical results of coronary revascularization using none but arterial grafts in patients aged 65 years and older. The cases of 449 consecutive patients who had undergone isolated myocardial revascularization were divided into 2 groups: the arterial conduit group (n=107) received a left internal mammary artery (LIMA) graft and 1 or both radial arteries (RAs), while the mixed-conduit group (n=342) received a LIMA graft and 1 or more saphenous vein grafts (SVGs), with or without an RA. There was no significant difference between the groups' rates of mortality The arterial conduit group had a significantly shorter overall postoperative hospital stay than did the mixed-conduit group (mean, 6.6 +/- 0.9 vs 7.2 +/- 5 days; P=0.04). Linear regression analysis revealed that the presence of hypertension (beta=0.13; 95% confidence interval [CI], 0.054-0.759; P=0.02) and high EuroSCORE (beta=0.24; 95% CI, 0.053-0.283; P=0.004) were the major predicting factors for long hospital stay Graft-harvest-site infection was statistically more frequent in the mixed-conduit group than in the arterial conduit group (6.4% vs 0, respectively; P=0.007). Angiography was performed postoperatively (mean, 24.9 +/- 16.3 mo; range, 17-65 mo) in 21 patients. In these patients, all LIMA grafts were patent, as were 86.9% of the SVGs and 90.9% of the RA grafts. Myocardial revascularization using all arterial grafts (at least 50% RAs) in patients aged 65 years and older is safe and reliable, produces short-term results equal to those of saphenous vein grafting, and can reduce graft-harvest-site infections. (Tex Heart Inst J 2010; 37(3):301-6)Öğe Early results of surgery for acute type A aortic dissection without using neurocerebral monitoring(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2010) Erdil, Nevzat; Gedik, Ender; Erdil, Feray; Nisanoglu, Vedat; Battaloglu, Bektas; Ersoy, OzcanBackground: This study aimed to determine if the routine use of unilateral antegrade cerebral perfusion during repair of acute type A aortic dissection can eliminate the need for intraoperative neurophysiologic monitoring. Methods: Between September 2000 and December 2009, 66 consecutive patients with acute type A aortic dissection underwent surgical repair in our clinic. In 57 patients (86.4%), arterial perfusion was provided through a right axillary artery cannula and in the remaining nine patients (13.6%) the arterial perfusion site was the femoral artery. Results: Postoperative hospital mortality was 13.6% (n=9). Postoperative hemorrhage or tamponade requiring resternotomy occurred in seven patients (10.6%). Nine patients (13.6%) required postoperative inotropic support. Postoperative atrial fibrillation was observed in six patients. Mean intensive care unit stay and hospital stay were 5.1 +/- 4.4 days (range, 2 to 26 days) and 10.8 +/- 8.9 days (range, 7 to 60 days), respectively. Mean extubation time was 15.4 +/- 13.9 hours (range, 7 to 74 hours). One of the surviving patients experienced new transient neurological deficits in the postoperative period. Conclusion: Unilateral antegrade selective cerebral perfusion techniques may provide reliable brain protection and reduce cerebral complication rates without the use of routine cerebral monitoring devices, even for longer periods of circulatory arrest during surgery of acute type A aortic dissection.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 Effects of rivaroxaban on myocardial ischemia-reperfusion injury in rats(2022) Kahraman, Ercan; Akça, Barış; Çolak, Mehmet Cengiz; Disli, Olcay Murat; Parlakpınar, Hakan; Battaloglu, Bektas; Erdil, NevzatMyocardial infarction and further ischemia-reperfusion injury is a life-threatening conditions in humans. In this study, the effects of rivaroxaban, an anticoagulant agent, were aimed to be studied in a myocardial ischemia-reperfusion (I/R) injury model in rats. Male Wistar-albino rats were allocated into three groups; Rivaroxaban (n=15), control (n=15) and sham (n=10). Myocardial ischemia (30 minutes) and then reperfusion (120 minutes) were surgically performed in the rivaroxaban given (3mg/kg/ day by gavage for 10 days before surgical procedures) and the control groups. Electrocardiography changes, blood pressure and heart rate were recorded before ischemia, and during the periods of ischemia and the reperfusion. Hemodynamic and blood parameters were recorded. Necrotic tissue in the myocardium was determined by the triphenyl tetrazolium chloride dye method. The extent of myocardial necrosis and risk area was calculated using a computer-assisted image program. In the rivaroxaban administered group, the size of necrotic area in the myocardium decreased significantly, however, mean heart rate and mean arterial blood pressure did not change. K+ and CK levels in serum, which are indicative of tissue necrosis, were significantly lower in the rivaroxaban group compared to the control group (p<0.05). Rivaroxaban use, compared to the control group, effectively reduced the extent of myocardial injury as assessed by less necrotic myocardial tissue in rats. This protective effect of rivaroxaban may be attributed to its less thrombus formation in the coronary arteries during ischemia and less acidosis during tissue damage.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 Left ventricular aneurysmal repair within 30 days after acute myocardial infarction - Early and mid-term outcomes(Texas Heart Inst, 2007) Battaloglu, Bektas; Erdil, Nevzat; Nisanoglu, VedatFor safe resection, left ventricular aneurysmal repair after acute myocardial infarction is usually delayed. However delaying surgery may not be possible or prudent in some patients who are clinically unstable after acute myocardial infarction. We retrospectively reviewed the early and mid-term outcomes of left ventricular aneurysmal repair in patients who had experienced acute myocardial infarction <30 days before the repair. From September 2007 through May 2006, 127 consecutive post-infarction patients underwent concurrent anteroapical left ventricular aneurysmal repair and coronary artery bypass grafting. In Group I (38 clinically unstable patients), the surgery was performed <30 days after myocardial intarction. In Group II, 89 patients underwent the surgery >= 30 days after infarction. The mean follow-up period was 26.16 +/- 16.41 months. One Group I patient (2.6%) died in the hospital due to graft-versus-host reaction. Three Group II patients (3.4%) died- 2 of low cardiac output and I of multiple-organ failure. Hospital mortality rates were not statistically significant between groups (P=0.582). All patients required similar perioperative inotropic support, intra-aortic balloon pump support, and re-exploration for bleeding or cardiac tamponade. The actuarial survival rates were 94.7% (Group I) and 94.4 % (Group II). Postoperative New York Heart Association functional class improved similarly In both groups. We infer that left ventricular aneurysmal repair with coronary revascularization <30 days after a recent myocardial infarction is a feasible procedure, with acceptable morbidity and mortality rates. Our mid-term results were comparable with those for patients who underwent this surgery >= 30 days after acute myocardial infarction.Öğe Management of infective endocarditis and long-term outcomes of patients who underwent surgery: The fifteen-year experience of a tertiary care center(2020) Akca, Barış; Erdil, Nevzat; Çolak, Mehmet Cengiz; Dişli, Olcay Murat; Battaloglu, BektasAbstract: Infective endocarditis (IE) is still associated with severe complications and poor prognosis. The surgery of IE has various technical difficulties due to severe infection, inflammation of heart tissue, and systemic effects, so controversies continue about the optimal timing of operation. This study presents the treatment approaches, early and late-term outcomes of IE patients, who underwent surgery.This retrospective descriptive study is conducted with 46 patients (31males) operated between 2002-2018. The demographics and preoperative, intraoperative and postoperative data of patients were analyzed from the clinical database and patient records. Emergency surgery was performed to 15 (32.26%) patients.Numbers of patients with mitral valve, aortic valve, and prosthetic valve endocarditis were 14, 25, 7 respectively. Aortic valve replacement (AVR), mitral valve replacement (MVR), MVR + AVR and mitral valve repair were performed in 24, 12, 8 and 2 patients, respectively. Additionally, peri-cardial patch repair (periannular abscess or damage (n=12), aorta-right atrial fistulae (n=3)), debulking of associated tricuspid valve vegetation (n=2), tricuspid De Vega annuloplasty (n=3), Bentall operation (n=1) and aortic root enlargement (n=5) were performed. The mean follow-up period and mortality rates were 24.86 ± 38.98 months, 13.04% respectively. The mean survival and reoperation-free time were 179.02 ± 13.78 and 203 ± 10.09 months, respectively. Patients can be managed appropriately with early diagnosis, aggressive medical and surgical treatment via a multidisciplinary approach with customized management according to guidelines in terms of individual characteristics. In cases of worsening hemodynamic status, uncontrolled infection, large and mobile vegetations surgery should be performed as soon as possibleÖğe Nebivolol in preventing atrial fibrillation following coronary surgery in patients over 60 years of age(Soc Brasil Cirurgia Cardiovasc, 2014) Erdil, Nevzat; Kaynak, Murat; Donmez, Koksal; Disli, Olcay Murat; Battaloglu, BektasObjective: Postoperative atrial fibrillation is a common complication after cardiac surgery, with an incidence as high as 20-50%. Increased age is associated with a significant increase in postoperative atrial fibrillation risk. This common complication is associated with higher morbidity and mortality rates. The aim of this study was to assess the efficacy of nebivolol in preventing atrial fibrillation following coronary artery bypass surgery in patients over 60 years of age. Methods: In this prospective randomized study, 200 patients who were candidates for elective coronary artery bypass surgery were divided into two groups. The first group was administered with nebivolol and the second group was administered with metoprolol. Treatment was initiated four days prior to surgery, and patients were monitored for atrial fibrillation until discharge. Forty-one patients recieved 50 mg metoprolol succinate daily, which was initiated minimum 4 days before surgery. Results: Demographic data were similar in both groups. The incidence of postoperative atrial fibrillation in both groups was similar, with no significant difference being identified [n=20 (20%); n=18 (18%), P=0.718; respectively]. There were not any mortality at both groups during study. Inotropic agent requirement at ICU was similar for both groups [n=12 (12%), n=18 (18%), P=0.32]. Conclusion: We compared the effectiveness of nebivolol and metoprolol in decreasing the incidence of postoperative atrial fibrillation, and determined that nebivolol was as effective as metoprolol in preventing postoperative atrial fibrillation at patients. Nebivolol may be the drug of choice due to its effects, especially after elective coronary artery bypass surgery.Öğe Perioperative Management of a Levoatrial Cardinal Vein in the Absence of the Brachiocephalic Vein(Texas Heart Inst, 2013) Disli, Olcay Murat; Battaloglu, Bektas; Erdil, Nevzat; Karakurt, Cemsit; Elkiran, OzlemLevoatrial cardinal vein is a rare congenital anomaly of the systemic veins. It is commonly associated with left-sided obstructive conditions such as aortic atresia, mitral atresia, and cor triatriatum. We report the case of a 14-year-old boy who was undergoing surgery for correction of a secundum atrial septal defect. Intraoperatively, we discovered that he had a levoatrial cardinal vein and no brachiocephalic vein. However, collateral vessels provided adequate flow to the right atrium, and the patient's left-sided venous pressure was not excessive, so we ligated the levoatrial cardinal vein and directly repaired the septal defect. Postoperatively, the left venous drainage was satisfactory and the patient was asymptomatic. In addition to our patient's case, we discuss the embryology, diagnosis, and treatment of levoatrial cardinal vein. (Tex Heart Inst J 2013;40(2):201-3)Öğe Plasma Iron, Copper, Zinc Levels in Patients Experiencing Delirium Following Coronary Artery Bypass Grafting(Universitatsverlag Ulm Gmbh, 2008) Cumurcu, Birgul Elbozan; Karlidag, Rifat; Unal, Suheyla; Sezer, Ozlem Hesna; Battaloglu, Bektas; Mendil, Durali; But, KadirAim: To investigate the role of plasma iron (Fe), copper (Cu), and zinc (Zn) levels on delirium in patients following coronary artery bypass grafting (CABG). Methods: Twelve of the 50 patients included in the study showed signs of delirium during postoperative follow-up. We diagnosed delirium using DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) criteria. Delirium Rating Scale (DRS) was used to estimate delirium severity. In both groups pre-and postoperative plasma Fe, Cu, and Zn levels were analyzed with atomic absorption spectrometry (FAAS) method and compared statistically. Results: There was no significant difference between the groups for preoperative plasma Fe and Zn levels, while the Cu level was statistically significantly lower in the delirium group (p<0.05). The postoperative plasma Fe and Zn levels were statistically significantly higher in the delirium group (p=0.0001). The Cu level was statistically significantly higher in the delirium and non-delirium group (p=0.0001, p<0.05, respectively). The comparison of postoperative plasma Fe, Cu and Zn levels between the two groups showed a statistically significantly higher level in the delirium group compared to the non-delirium group (p=0.0001). The postoperative plasma Cu/Zn levels were statistically significantly higher in the delirium group (p<0.05). Conclusion: It may be suggested that the increased postoperative plasma levels of these trace elements may play a role in delirium seen after CABG.Öğe Predictors of Postoperative Atrial Fibrillation after On-Pump Coronary Artery Bypass Grafting: Is Duration of Mechanical Ventilation Time a Risk Factor?(Medical Tribune Inc, 2014) Erdil, Nevzat; Gedik, Ender; Donmez, Koksal; Erdil, Feray; Aldemir, Mustafa; Battaloglu, Bektas; Yologlu, SaimPurpose: This study aimed to establish the role of risk factors in the etiology of postoperative atrial fibrillation (AF) after coronary artery bypass grafting (CABG). Methods: Between September 2001 and March 2008, 1040 patients underwent isolated CABG at our clinic. Nine hundred and eleven of these patients did not have any AF (Non-AF Group) and the other one hundred and twenty-nine had AF (AF Group). A retrospective study was performed for patient, disease and treatment related factors and multivariate analysis was used to identify independent clinical predictors of postoperative AF. Results: Postoperative AF was identified in 129 (12.4%) of the patients, and those were significantly older and had significantly higher additive EuroSCORE score as compared with patients without AF. During the postoperative course, patients with postoperative AF also had significantly higher and prolonged (6 hours) mechanical ventilation time, longer and prolonged intensive care unit stay and longer hospital stay. Logistic regression analysis revealed that postoperative AF development ratio was 1.690 times higher when the ventilation time was over 6 hours (OR 1.690, 95% CI 1.092-2.615, p = 0.018); 1.240 times higher in the presence of elevated additive EuroS CORE score (OR 1.240, 95% CI 1.109-1.385, p = 0.0001); 1.052 times higher in the presence of advanced age (OR 1.052, 95% CI 1.031-1.0741, P = 0.0001). Conclusion: Analysis of our data reveals that, patient's age, additive EuroSCORE score, and prolonged ventilation are predictors of postoperative AF. Identification of risk factors might lead to better prevention of this problem and its potential consequences. However, to support our investigation and obtain more reliable evidence, prospective randomized controlled trials are needed.Öğe Pseudoaneurysm of High Origin Ulnar Artery After Penetrating Trauma(Sage Publications Inc, 2010) Erdil, Nevzat; Colak, Cengiz; Donmez, Koksal; Cihan, Hasan; Battaloglu, BektasHigh origin ulnar artery from the brachial artery is rare and lies superficially in the forearm. Its reported frequency ranges from 0.17% to 2%. Pseudoaneurysms of peripheral arteries are very rare, and mostly these are the result of penetrating injuries. Here, we report a case pseudoaneurysm of high origin ulnar artery from the brachial artery and its surgical approach method.
