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    Arterial myocardial revascularization using bilateral radial artery 17years after right pneumonectomy
    (Texas Heart Instıtute Journal, 2004) Erdil, Nevzat; Nisanoğlu, Vedat; Toprak, Hüseyin İlksen; Erdil, Feray Akgül; Kuzucu, Akın; Battaloğlu, Bektaş
    fter coronary artery bypass grafting (CABG), patients with a previous pneumonectomy are predisposed to a substantial risk of cardiopulmonary complications. The best surgical strategy for performing CABG on After patient with a single lung is unclear from the literature;1 few such cases have been reported.1-4 To our knowledge, this is the 1st report of arterial myocardial revascularization with use of bilateral radial arteries and fast-track anesthesia in a patient with a previous pneumonectomy
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    Early results of surgery for acute type A aortic dissection withoutusing neurocerebral monitoring
    (Turk Gogus Kalp Damar Cerrahısı Dergısı-Turkısh Journal Of Thoracıc Andcardıovascular Surgery, 2010) Erdil, Nevzat; Gedik, Ender; Erdil, Feray Akgül; Nisanoğlu, Vedat; Battaloğlu, Bektaş; Ersoy, Özcan
    Background: 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.
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    Effect of posterior pericardiotomy on early and late pericardial effusion after valve replacement
    (Journal of Cardiac Surgery, 2005) Nisanoğlu, Vedat; Erdil, Nevzat; Battaloğlu, Bektaş; Koşar, Feridun; Erdil, Feray Akgül; Cihan, H. Berat
    Pericardial effusion (PE) after cardiac surgery is frequent. It is more frequently seenafter valve replacement or other types of heart surgery. Oral anticoagulants and antiplatelet agents mayinduce effusion development after open heart surgery. Our objective was to determine the efficiency ofposterior pericardiotomy (PP) after cardiac valve operation for reducing the incidence of early and late PEand tamponade.Methods: This prospective randomized study was carried out in 100 consecutive patientsundergoing mechanical valve replacement between August 2001 and May 2003 in our institution. Patientswere divided into two groups; each group consisted of 50 patients. Longitudinal incision was made paralleland posterior to the left phrenic nerve, extending from the left inferior pulmonary vein to the diaphragm inGroup 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 wasdeveloped in Group 1 despite nine (18%) late PE developing in Group 2 (p < 0.003). The rate of delayedpericardial 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 forreducing both the occurrence of early and late PE or pericardial tamponade in patients undergoing valvereplacement.
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    The effects of N acetylcysteine on pulmonary functions in patients undergoing on pump coronary artery surgery a double blind placebo controlled study
    (Eur rev med pharmacol sci, 2016) Erdil, Nevzat; Eroğlu, Tamer; Akça, Barış; Dişli, Olcay Murat; Yetkin, Özkan; Çolak, Mehmet Cengiz; Erdil, Feray Akgül; Battaloğlu, Bektaş
    Abstract. – OBJECTIVE: To investigate the effects of N-acetylcysteine (NAC) on pulmonary function tests and arterial blood gases in patients undergoing on-pump coronary artery surgery. PATIENTS AND METHODS: The effect of NAC was assessed within the scope of a prospective, single center, double-blind, placebo-controlled, parallel group study. Eighty-two patients undergoing coronary artery bypass grafting were randomized into two groups to receive either placebo (group 1, n = 40) or NAC (group 2, n=42). Both the NAC group and the placebo-receiving control group also included a COPD subgroup consisting of patients with an FEV1/FVC ratio of < 0.7 and an FEV1 value of 50- 80%. Pulmonary function tests were performed preoperatively and on postoperative day 60. RESULTS: Both groups were similar with respect to age, gender, preoperative risk factors, ejection fraction (EF), mean cross-clamp time, ventilation time, intensive care unit (ICU) stay, atrial fibrillation (AF) and hospital stay (p > 0.05). Postoperative FVC and FEV1 values in group 1 and the postoperative FEV1, FEV1/FVC and FEF 25-75 values in group 2 were lower in comparison to their preoperative values. However, in both group 1 and 2, the decreases observed in these parameters were not statistically significant (p > 0.05). In the COPD subgroup of group 1, a postoperative decrease was observed in the FEV1 and FEF25-75 values, with the FEV1 decreasing by 4.55%, and the FEF25-75 decreasing by 4.2% (p < 0.05). In the COPD subgroup of group 2, no significant decrease was observed in the pulmonary function test values (p > 0.05).
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    The effects of pulmonary hypertension on early outcomes in patients undergoing coronary artery bypass surgery
    (Turk J Med Sc, 2016) Akça, Barış; Dönmez, Köksal; Dişli, Olcay Murat; Erdil, Feray Akgül; Çolak, Mehmet Cengiz; Battaloğlu, Bektaş; Erdil, Nevzat
    Background/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.
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    he effects of pulmonary hypertension on early outcomes in patients undergoing coronary artery bypass surgery
    (Turkish Journal of Medical Sciences, 2016) Akça, Barış; Dönmez, Köksal; Dişli, Olcay Murat; Erdil, Feray Akgül; Çolak, Mehmet Cengiz; Aydemir, İlhan Koray; Battaloğlu, Bektaş; Erdil, Nevzat
    Öz (İngilizce): Background/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.
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    İntravenöz kanülasyon ağrısına buzun etkisi
    (Fırat Tıp Dergisi, 2009) Öztürk, Erdoğan; Erdil, Feray Akgül; Begeç, Zekine; Yücel, Aytaç; Şanlı, Mukadder; Ersoy, Mehmet Özcan
    Öz: Amaç: İntravenöz kanülasyon (İK) anestezistlerin günlük pratiğinde en çok uyguladıkları girişimdir. İK hastalar için rahatsız edici olduğu kadar ağrı verici bir işlemdir, ağrının önlenmesi hastalar için konfor sağlar. Gereç ve Yöntemler: Etik kurul onayı alındıktan sonra çalışmaya ASA I olan 45 olgu alındı. Antekübital bölgede enfeksiyon, geçirilmiş operasyon, skar, psöriyazis, aktif dermatit ile periferik sinir hastalığı bulunan ayrıca kanülasyonun zor olacağı düşünülen olgular çalışma dışı bırakıldı. Olguların bir ekstremitesine buz uygulayarak (Grup B) diğerine klasik (Grup K) yöntemle intravenöz kanülasyon yapıldı. Olguların girişim öncesi ve sonrası arteriyel kan basınçları ve kalp atım hızları kaydedildi, girişim sonrası visuel analog skala (VAS), hasta memnuniyet skoru (HMS) ve yöntem tercihi soruldu. Bulgular: Çalışmaya 45 olgu dahil edildi. Olguların ortalama yaşı 33,84±14,48 vücut ağırlığı 70,31±10,57 kg'dı. Grup B'de VAS (3,62±1,13) ve HMS (2,53±0,72) Grup K'ya göre anlamlı düşüktü ve çalışmaya dahil edilen olguların 35'i (%77) sonraki kanülasyon işlemlerinde buzlu yöntemi tercih edeceklerini ifade ettiler. Sonuç: Buz yönteminin ucuz, kolay temin edilebilir ve uygulanabilir olması nedeniyle intravenöz kanülasyon ağrısının önlenmesinde mevcut yöntemlere bir alternatif olacağını düşünmekteyiz.
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    Koroner arter cerrahisinde tek kros klemp tekniğinin erken dönem sonuçlara etkisi
    (Turkiye Klinikleri Cardiovascular Sciences, 2006) Nisanoğlu, Vedat; Erdil, Nevzat; Özgür, Bülent; Erdil, Feray Akgül; But, A. Kadir; Çolak, Mehmet Cengiz; Cihan, H. Berat; Battaloğlu, Bektaş
    Amaç: Koroner arter bypass cerrahisinde distal ve proksimal anastomozlar tek aortik klemp ile yapmak, nörolojik ve kardiyak hasarı azaltabilir. Bu çalışmada, tek ve çift klemp tekniklerinin erken postoperatif sonuçlar üzerine etkilerini inceledik. Gereç ve Yöntemler: Yaklaşık 3 yıllık bir dönemde, 774 izole koroner arter cerrahisi işlemi gerçekleştirildi. Grup 1'de, aortik tek klemp kullanılarak cerrahi revaskülarizasyon yapılan 391 hasta bulunurken, Grup 2'de çift aortik klemp tekniği kullanılan 383 hasta vardı. Bu iki grup postoperatif erken dönem sonuçlar bakımından karşılaştırıldı. Bulgular: Aortik kros klemp süresi, tek klemp tekniği uygulanan grupta istatistiksel olarak anlamlı bir şekilde uzun idi (p= 0.0001). Kardiyopulmoner bypass süreleri bakımından gruplar arasında anlamlı farklılık yoktu (p= 0.546). Erken mortalite oranı her iki grupta benzer idi (Grup 1 %2.1; Grup 2 %1.8, p= 0.642). Postoperatif nörolojik ve kardiyak olay açısından iki grup arasında istatistiksel fark tespit edilmedi. Sonuç: Postoperatif komplikasyonlar açısından, tek ve çift klemp teknikleri karşılaştırıldığında istatistiksel olarak anlamlı farklılık bulunmadığı sonucuna vardık.
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    Manyetik Rezonans Görüntüleme Ünitesindeki Pediyatrik Olgularda Anestezi Deneyimlerimiz
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2008) Öztürk, Erdoğan; Yücel, Aytaç; Begeç, Zekine; Erdil, Feray Akgül; Demir, Kadir; Ersoy, M. Özcan
    Günümüzde, teknolojik ve farmakolojik gelişmeler sayesinde, hastalara tanı ve tedavi amacıyla ameliyathane dışı ortamlarda invaziv ve invaziv olmayan girişimler artarak uygulanmaya başlanmıştır. Bu girişimlerde başarı oranının artırılması ve hasta güvenliğinin sağlanması için anestezistlere görev düşmektedir. Bu çalışmada Ekim 2002-Aralık 2006 tarihleri arasında manyetik rezonans görüntüleme ünitesinde kliniğimizce pediyatrik olgulara uygulanan anestezi tekniklerini ve ortaya çıkan komplikasyonları sunmayı amaçladık. Çalışmaya 1458 pediyatrik olgu dahil edildi. Bu olgulardan üçünde kardiyak arrest sonucu eksitus, 168 olguda ise minör komplikasyonlar ile karşılaşıldı bunlar; bradikardi, (45) desatürasyon (98) ve uzamış sedasyon (22) şeklindeydi. Anestezistler ameliyathane dışı ortamlarda görev yaparken komplikasyonlardan kaçınılması için normalden daha dikkatli olmak zorundadır. Ayrıca anestezi verilecek ameliyathane dışı ortamlarda hasta ve personel güvenliğini sağlamak için gereken fiziki ve teknik altyapının düzenlenmesinde anestezistlerin aktif görev almaları gerektiği kanısındayız.