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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 A case of vasospastic angina resulting from coronary emboli in a patient with prosthetic valves(Int Heart Journal Assoc, 2004) Kosar, F; Gullu, H; Sahin, I; Acikgoz, N; Topal, E; Erdil, NIn addition to coronary atherosclerotic disease, coronary thromboembolisin can also lead to acute coronary syndromes. However, coronary thromboembolism due to prosthetic heart valves is very rare and not very well-known. It has Only a few cases have been reported. In this paper, we present a rare case with vasospastic angina pectoris secondary to coronary thromboembolism in a patient with prosthetic heart valves.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 Coronary-coronary bypass - Using vein graft on a beating heart in a patient with porcelain aorta(Texas Heart Inst, 2002) Erdil, N; Ates, S; Demirkilic, U; Tatar, H; Sag, CThere is increased risk of systemic embolism during cardiopulmonary bypass in patients with a severely atherosclerotic ascending aorta. We report a coronary-coronary bypass in a 74-year-old man with a porcelain aorta. He underwent a proximal right coronary-distal right coronary artery bypass with a saphenous vein graft, combined with a pedicled arterial graft (left internal mammary artery) to the left anterior descending artery, in the presence of a beating heart without cardiopulmonary bypass. The patient survived without evidence of perioperative myocardial infarction or cerebrovascular accident. One year later follow-up angiography showed graft patency with good distal runoff Coronary-coronary bypass on a beating heart without cardiopulmonary bypass can be performed safely in a patient with porcelain aorta.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 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 Experience of the small size (25 mm) sorin bicarbon bileaflet prosthetic valve in patients with small mitral annuli(Blackwell Futura Publishing, Inc, 2003) Erdil, N; Cetin, L; Demirkilic, U; Tatar, H; Uzun, MBackground. Currently, there is a tendency to use large-size prosthetic valves in mitral position in order to achieve better hemodynamic performance. We aimed to evaluate hemodynamic performance of 25 mm prosthetic valves in mitral position. Methods: Between August 1998 and May 2000, a total of 40 patients, 34 women and 6 men (mean age 42 12 years), underwent mitral valve replacement with 25 mm bileaflet mechanical valve. Preoperative functional capacity was New York Heart Association classes III and IV in 31 patients. Major indication for surgery was severe mitral stenosis in all patients. Results: Total hospital mortality was 5% (two patients). Mean follow-up period was 14.7 +/- 4.9 months (2 to 23 months). No thromboembolic event, paravalvular leak, mechanical failure, endocarditis were observed during the follow-up period. Postoperatively 92.5% of the patients were in the functional capacity of New York Heart Association class I. Postoperative echocardiographic observations have given an average pulmonary artery pressure of 29 +/- 2 mmHg, effective orifice area as 2.95 +/- 0.1 cm(2), and mean prosthetic gradient as 6.5 +/- 2.7 mmHg. Conclusion: In short- and mid-term, small-size (25 mm) Sorin mechanical mitral valves had excellent hemodynamic performance in patients with severe mitral stenosis, moderate or serious pulmonary hypertension, and small mitral annuli, whose body surface area was smaller than 1.6 m(2).Öğe Frequency of left atrial myxoma with concomitant coronary artery disease(Springer, 2003) Erdil, N; Ates, S; Cetin, L; Demirkilic, U; Sener, E; Tatar, HPurpose. Simultaneous coronary artery bypass grafting with a resection of left atrial myxoma has been rarely reported. The ages and the symptoms of patients who have left atrial myxomas and coronary artery disease are similar. In this report, we present our cases of left atrial myxoma with concomitant coronary artery disease who were all treated surgically. Methods. Between September 1998 and January 2001, 11 patients were surgically treated after being diagnosed to have left atrial myxoma. Routine coronary angiography was performed on all patients preoperatively. In four patients concomitant coronary artery disease was identified. At surgery we performed coronary artery bypass grafting after a resection of left atrial myxoma in three patients. Results. All patients were weaned from cardiopulmonary bypass without any difficulty. The postoperative course was uneventful. The follow-up period was 17 +/- 10 months (range 3-32 months). All patients were symptom-free and no recurrence of myxoma was detected. Conclusion. Based on our experience, cardiovascular surgeons should be aware of the concomitance of these diseases. It is therefore recommended that coronary angiography should be performed on all patients who present with left atrial myxomas.Öğe Midterm experience with the Sorin Bicarbon heart valve prosthesis for rheumatic disease(Edizioni Minerva Medica, 2003) Erdil, N; Cetin, L; Ates, S; Demirkilic, U; Sener, E; Tatar, H; Cakir, BBackground In this study, we present a single center experience with Bicarbon bileaftet valve in 307 patients with rheumatic heart disease. Methods. Between August 1998 and September 2000, 307 patients underwent heart valve replacement using the Bicarbon bileaflet valve (Sorin Biomedica, Saluggia, Italy) with an average age of 47.19+/-13.21 years (range 14 to 80 years), consisting of 147 males and 160 females at Alkan Hospital, Cardiovascular Surgery Department. Aortic valve replacement (AVR) was performed in 77 patients, mitral valve replacement (MVR) in 156 patients and double valve replacement (DVR) in 74 patients. Results. The early mortality rate was 3.3% (10/307) and there was no late mortality. The actuarial survival rate, including hospital mortality, was 96.74+/-1.01% for the whole group, 96.5+/-1.5% for the MVR group, 97.4+/-1.8% for the AVR group and 97.3+/-1.9% for the DVR group at 35 months. One patient had obstructive valve thrombosis with MVR. The 35 months actuarial freedom from valve thrombosis was 99.58+/-0.4% for the whole group. Four patients were reoperated and the 35 months actuarial freedom from reoperation was 98.53+/-0.7% for the whole group, 98.65+/-0.9% for the MVR group, 96.73+/-02% for the DVR group and 100% for the AVR group. No instances of perivalvular leak, hemolysis, endocarditis or embolism were observed during the entire follow-up period. Mean follow-up duration was 16.5+/-7.9 months (ranged 4 to 35 months). Conclusions. We have presented our mid-term results with the Sorin Bicarbon bileaflet valve in patients with rheumatic heart disease, which provided good clinical performance combined with meticulous patient care and advanced surgical techniques.Öğe Pericardial hydatid cyst mimicking acute coronary syndrome(Texas Heart Inst, 2005) Kosar, F; Aksoy, Y; Sahin, I; Erdil, NCardiac hydatid cysts are found mostly within myocardium. Only a few cases of pericardial location have been reported. Patients with hydatid cysts are usually asymptomatic. A 46-year-old man with clinical and electrocardiographic features mimicking acute myocardial ischemia was hospitalized for further evaluation. Detailed imaging and laboratory investigation revealed a pericardial hydatid cyst. The patient underwent operation for curative excision. After surgery the patient's symptoms resolved and his clinical status improved. We think that pericardial hydatid cyst should be considered in the differential diagnosis of patients with angina-like pain-especially in geographic areas where hydatid cysts are endemic.
