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Öğe Anesthetic management of a patients with acute type A aortic dissection immediately after caesarean section(2012) Yücel A.; Gedik E.; Özgül Ü.; Erdo?an Kayhan G.; Koç E.; Erdil N.; Ersoy M.O.Acute aortic dissection is a disease which characterized by arterial wall separation, intimal dissection and hematoma. It has been seen half of dissections in women less than 40 yr of age occur during pregnancy, more commonly in the third trimester and postpartum period. Aortic dissection is a potentially risk factor for mother and baby during pregnancy. Ehlers-Danlos and Marfan's syndrome and number of pregnancy are associated with occurring of the aortic dissection. In this report, we discuss the management of anesthesia a patient with Marfanoid appearance who developed type A dissection of the aorta occurred 4 hours after elective Caeserean section.Öğe Arterial Myocardial Revascularization Using Bilateral Radial Artery: 17 Years after Right Pneumonectomy(2004) Erdil N.; Nisanoglu V.; Toprak H.I.; Erdil F.A.; Kuzucu A.; Battaloglu B.We 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 Assessment of patient characteristics in cancer-associated venous thrombosis in Türkiye (CAT-TR study)(Turkish National Vascular and Endovascular Surgery Society, 2023) Unal O.; Akay H.T.; Doganci S.; Bozkurt A.K.; Erdil N.; Sirlak M.; Uguz E.Aim: In cancer patients, the overall risk of venous thromboembolism (VTE) is increased 7-fold, and in cases of certain malignancies, this risk increases to 28-fold. The main objectives of this study are to describe patterns of use of anticoagulants for the treatment of cancer-related VTE in Türkiye and to assess patient characteristics. Material and Methods: This was a multicenter, retrospective, descriptive study utilizing data from 17 centers across Türkiye. We included 2936 patients with a diagnosis of any cancer and a diagnosis of proximal lower-limb deep vein thrombosis (DVT) and/or pulmonary embolism (PE) between January 1, 2016, and December 31, 2019. These patients were only included if the cancer diagnosis was made at least 6 months before the diagnosis of VTE or within 30 days following the diagnosis of VTE. Patients were followed from the day after the index date until the earliest date among the dates of death, the end of the study, or the end of the 6-month treatment period. Results: The study included 2796 patients with VTE between 2016 and 2019. While 41.4% of the participants were female, 58.6% were male, and 66.1% of the patients had DVT while 45.2% had PE. Furthermore, 52.7% had a history of smoking and only three patients had known hereditary thrombophilia. Lung cancer was the most common type of cancer, diagnosed in 872 patients (29.3%), followed by colon cancer diagnosed in 255 patients (8.6%) and breast cancer diagnosed in 202 patients (6.8%). Among these patients, 70.3% were in an advanced stage of the disease. Chemotherapy was administered to 469 (65.7%) patients at the time of disease onset. Among the patients with VTE, 99.5% were treated, and low-molecular-weight heparin was used in 97.5% of these cases while 3% of the patients were treated with direct oral anticoagulants. Bleeding was observed in 1.6% of the patients who participated in this study, and 39.1% of the bleeding events whose type was specified were categorized as major bleeding. Bleeding was most intense in the gastrointestinal tract (56.7%). Recurrence was observed in 1.5% of the patients and improvement was observed in 42.1%. In the first 6 months after diagnosis, 14.3% of the patients died. Causes of mortality could not be obtained from the patients’ records. Conclusion: VTE is common in patients with active cancer and associated with high recurrence and mortality rates. Efforts are needed to prevent VTE, diagnose it in time, and reduce the recurrence rates, especially in the first year after VTE diagnosis. © 2023, Turkish National Vascular and Endovascular Surgery Society. All rights reserved.Öğe Cardiopulmonary bypass before general anesthesia in prosthetic valve thrombosis(2002) Erdil N.; Çetin L.; Nisanoglu V.; Şener E.; Demirkiliç U.Valve obstruction is a lifethreatening complication of mechanical valve prostheses. Emergency operation is mandatory for patients who subsequently develop cardiogenic shock and severe pulmonary edema. In this severely compromised hemodynamic condition, cardiac arrest develops in most of the patients before surgery and just after general anesthesia induction. In one such case, we performed femorofemoral cardiopulmonary bypass with local anesthesia before general anesthesia induction and successfully replaced the thrombosed prosthetic valve, thus avoiding a catastrophic outcome.Öğe Complete left-sided absence of the pericardium in association with ruptured type A aortic dissection complicated by severe left hemothorax(2005) Nisanoglu V.; Erdil N.; Battaloglu B.We 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. © 2005 by the Texas Heart® Institute.Öğe Coronary-coronary bypass: Using vein graft on a beating heart in a patient with porcelain aorta(2002) Erdil N.; Ates S.; Demirkilic U.; Tatar H.; Sag C.There 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 run-off Coronary-coronary bypass on a beating heart without cardiopulmonary bypass can be performed safely in a patient with porcelain aorta.Öğe Early outcomes of radial artery use in all-arterial grafting: Of the coronary arteries in patients 65 years and older(Texas Heart Institute, 2010) Erdil N.; Nisanoglu V.; Eroglu T.; Fansa L.; Cihan H.B.; Battaloglu B.We 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 (?=0.13; 95% confidence interval [CI], 0.054-0.759; P=0.02) and high EuroSCORE (?=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, 11-65 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. © 2010 by the Texas Heart® Institute, Houston.Öğe Giant left atrial thrombus formation in patient with a previous coronary artery bypass grafting.(2013) Erdil N.; Disli O.M.; Yagmur J.; Secici S.; Donmez K.; Akca B.; Battaloglu B.Free-floating left atrial ball thrombus is a rare condition. We report a giant left atrial ball thrombus which was removed under surgery uneventfully, in a 48-year-old male patient with the presence of sinus rhythm and no valvular disease with previous off-pump coronary artery bypass surgery.Öğe An intelligent system for the classification of postoperative pleural effusion between 4 and 30 days using medical knowledge discovery(Scientific Publishers of India, 2017) Guldogan E.; Arslan A.K.; Colak M.C.; Colak C.; Erdil N.Objective: Pleural Effusion (PE) is a considerable and a common health problem. The classification of this condition is of great importance in terms of clinical decision making. The purpose of the study is to design an intelligent system for the classification of postoperative pleural effusion between 4 and 30 days after surgery by medical knowledge discovery (MKD) methods. Materials and methods: This study included 2309 individuals diagnosed with coronary artery disease for elective coronary artery bypass grafting (CABG) operation. The results of chest x-ray were used to diagnose PE. The subjects were allocated to two groups: PE group (n=81) and non-PE group (n=2228), consecutively. In the preprocessing step, outlier analysis, data transformation and feature selection processes were performed. In the data mining step, Naïve Bayes, Bayesian network and Random Forest algorithms were utilized. Accuracy and area under receiver operating characteristics (ROC) curve (AUC) were calculated as evaluation metrics. Results: In the preprocessing step, 85 outlier observations were removed from the study. The rest of the data consisted of 2224 subjects: 2149 of these individuals were in non-PE group, and the 75 were in PE group. Random Forest yielded the best classification performance with 97.45% of accuracy and 0.990 of AUC for 0.7 of the optimal split ratio by Grid search algorithm. Conclusion: The achieved results pointed out that the best classification performance was obtained from the RF ensemble model. Therefore, the suggested intelligent system can be used as a clinical decision making tool. © 2017, Scientific Publishers of India. All rights reserved.Öğe An intercoronary communication between the circumflex and the left anterior descending coronary artery with coronary artery disease: A difference from collateral coronary vessels [1](2004) Kosar F.; Erdil N.; Topal E.; Nisanoglu V.[No abstract available]Öğe Left ventricular aneurysmal repair within 30 days after acute myocardial infarction: Early and mid-term outcomes(2007) Battaloglu B.; Erdil N.; Nisanoglu V.For 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 2001 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 infarction. 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 1 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 reexploration 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. © 2007 by the Texas Heart® Institute.Öğe Partial dehiscence of mechanical aortic valve due to infective endocarditis(Asia Publishing Exchange Pte Ltd, 2003) Battaloglu B.; Erdil N.; Nisanoglu V.; Kosar F.[No abstract available]Öğe Plasminogen activator inhibitor -1 levels in patients with primary varicose vein(2012) Erguzel N.; Yetkin E.; Erdem G.; Erdil N.; Yetkin G.; Heper G.; Celik T.Aim. Plasmin is involved in extracellular matrix remodeling by activating some matrix metallo-proteinases and degrading extracellular matrix; therefore component of fibrinolytic system such as tissue plasminogen activator and plasminogen activators inhibitors (PAI-1) might have a role in the pathogenesis of vascular remodeling. In our study we aimed to investigate the levels of PAI-1 levels in patients with primary varicose veins (VV) and in their age and gender matched control group. Methods. Forty-one consecutive patients with peripheral varicose veins and 37 healthy age and gender-matched control subjects were included in the study from the outpatient cardiology and cardiovascular surgery clinic. Study population consisted of 41 consecutive patients who met the inclusion criteria and diagnosed as having class II primary VV according to CEAP classification. Routine biochemical and hematological analysis were performed in all patients and control subjects. Results. Plasma levels of PAI-1 were found to be lower in patients than those in control subjects (5.19±2.2 ng/mL vs. 6.47±2.6 ng/mL, P=0.025). Logistic regression analysis revealed that only the plasma levels of PAI-1 were found to be independently but inversely associated with the presence of primary VVs (Odds ratio: 0.80 CI: 0.64-0.99, P=0.04). Conclusion. We have shown that PAI-1 levels are significantly decreased in patients with pVVs and it has an independent association with the presence of pWs. However, its exact relation and role via matrix metlalloproteinases on the pathogenesis of the disease remains to be elucidated in further studies.Öğe Prevalence and incidence of deep venous thrombosis and pulmonary embolism in 2 regions in Turkey (A sub-analysis of CAT-TR study)(Turkish National Vascular and Endovascular Surgery Society, 2023) Akay H.T.; Unal O.; Doganci S.; Bozkurt A.K.; Erdil N.; Sirlak M.; Uguz E.Aim: Venous thromboembolism (VTE) is a relatively common public health problem. In addition to increasing mortality due to complications, it also causes an increase in the cost of the country's economy and loss of labor due to the morbidity it creates. Considering that the recurrence of VTE is a common condition, the importance of this disease for the society increases even more. Although we have come a long way in treatment and follow-up, we see that VTE and its related complications maintain their place as a significant risk factor in the society at increasing rates. Material and Methods: This is an additional analysis of a multicentral, retrospective descriptive study, CAT-TR (Assessment of Patient Characteristic in Cancer Associated Venous Thrombosis in Turkey). The aim of the CAT-TR study was to evaluate patient characteristic and treatment patterns of cancer-induced VTE in Turkey. This article aims to evaluate the incidence and prevalence of cancer-induced VTE in two regions of Turkey between January 01, 2016 and December 31, 2019. Results: In our study, the 4-year prevalence of Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE) in Central Anatolia and Marmara was 86.43, 103.56 and 105.68, 98.04 per 100.000 people, respectively. The cumulative incidence of cancer-related VTE in the Central Anatolian and Marmara populations is 17.22 and 6.71 per 100.000 people, respectively. Conclusion: The values we found in the prevalence and incidence study of VTE will be very valuable in terms of being a reference for us in the treatment and prevention of the disease. We believe that this study will shed light on new studies for diseases that may cause VTE in larger populations and strategies to be followed in prevention. © Author(s).Öğe A rear complication of chronic hypertension in childhood: Aortic dissection: A case report(2010) Karakurt C.; Koçak G.; Erdil N.; Battalo?lu B.; Nisano?lu V.; Tabel Y.; Si?irci A.Aortic dissection is a life-threatining condition and is commonly seen elderly patients with connective tissue disorders, hypertension, and atherosclerosis. Hypertension is a main risk factor of development aortic aneursym and aortic dissection in adult patients. Aortic dissection is rare in infants and children younger than 16 years old, and is not always associated with Marfan's syndrome or other connective tissue di sorder. We descri be a 16-years-old boy, applied our emergency department due to strongly chest pain, with ruptured aortic dissection related to chronic renal hypertension and successfully treated with surgical approach. Chronic hypertensive patients in childhood should be monitoring with echocardiography regularly for aortic root dilatation and dissection. Copyright © 2010 by Tür kiye Klinikleri.
