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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 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 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 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.