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    Effect of preoperative vitamin D levels on the development of atrial fibrillation after cardiac bypass surgery
    (2020) Tuncay, Aydin; Bozguney, Muhammat; Ozmen, Rifat; Elcik, Deniz; Tekin, Ali Ihsan
    Aim: Atrial fibrillation is a common complication after coronary bypass surgery. There are various studies aimed at predicting the development of postoperative atrial fibrillation (POAF). Low vitamin D status has been associated with an increased risk of cardiovascular disease. Atrial fibrillation (AF) is the most common cardiac arrhythmia. We purpose to evaluate the effect of serum 25(OH) vitamin D level on the development of POAF after cardiac bypass surgery (CABG). Material and Methods: Our study is a retrospective chart review which all patients who underwent isolated, elective, on-pump CABG operation between January 2017 and January 2018. POAF was defined as the development of atrial fibrillation after the completion of cardiac surgery, which required intervention.The whole study population divided into two groups: group I, patients who developed POAF and group II, patients who did not.Ejection fraction and left atrium diameter of participants were recorded. 25(OH)D and parathormone values, as well as other demographic and clinical characteristics, were collected. Results: A total of 78 patients were available for analyses. While 61 patients did not develop POAF, 17 patients developed. The rate of POAF was 22%. The median ages of the patients with and without POAF were significantly different (61(54-72) vs. 69(65-77) years, p=0.012). The left atrial diameter was larger in patients with POAF (p=0.025). Preoperative ejection fractions were not different between the groups. Total bypass time and cross-clamp time were not significantly different. Although the mean value of preoperative 25(OH)D level was slightly higher in patients who did not develop POAF compared to that of patients with POAF, the difference was not statistically different between the groups. Conclusion: Preoperative 25(OH)D levels were not different between the patients with and without POAF.
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    Flow-Mediated Vasodilatation which is diagnostic method of endothelial dysfunctions change in atrial septal defect patients before and after closure of the ASD
    (2020) Elcik, Deniz; Karadavut, Serhat; Dogan, Ali; Kelesoglu, Saban; Cetinkaya, Zeki; Tuncay, Aydin
    Aim: Atrial septal defect secondary pulmonary hypertension causes disruption of the endothelial structure, resulting in an increase in vasoconstrictor mediators and a decrease in vasodilator mediators. These changes on the endothelial system alter the flow in the pulmonary vein and the systemic vein bed. This also has an effect on flow mediated vasodilatation. Our purpose in this study is to evaluate the endothelial dysfunction after atrial septal defect closure via flow mediated vasodilatation. Material and Methods: Total 51 patients with pre and one mount after post treatment secundum-type atrial septal defect and 40 healthy volunteers were prospectively enrolled. Atrial septal defect was treated with transcathater closure procedure. Flow mediated vasodilatation was measured to evaluate endothelial function prior to and one month after the defect was closured.Results: Flow-mediated vasodilatation values were significantly higher in an atrial septal defect′s patient than in the healthy volunteer (11.2 ± 1.01 m/s vs. 12.7 ± 1.18 m/s, P 0.001). Flow-mediated vasodilatation values were significantly reduced at the follow-up one month after the procedure compared to baseline. Moreover, there was a significant negative correlation between pulmonary arterial pressure values and flow-mediated vasodilatation (r=-0.347; p=0.013) in the pretreatment group.Conclusion: Flow-mediated vasodilatation values were significantly lower in the right cardiac chambers, and the systolic pulmonary arterial pressure was improved. This result has shown us that atrial septal defect closure may benefit from endothelial dysfunction.