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  • Küçük Resim
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    Nebivolol in preventing atrial fibrillation following coronary surgery in patients over 60 years of age
    (Revısta Brasıleıra De Cırurgıa Cardıovascular, 2014) Erdil, Nevzat; Kaynak, Murat; Dönmez, Köksal; Dişli, Olcay Murat; Battaloğlu, Bektaş
    Objective: 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.
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    On pump coronary artery bypass surgery in high risk patients aged over65 years euroscore 6 or more ımpact on early outcomes
    (Journal Of Internatıonal Medıcal Research, 2009) Erdil, Nevzat; Nisanoğlu, Vedat; Kaynak, Murat; Fansa, Iyad
    The results of on-pump coronary artery bypass graft (CABG) surgery in 166 highrisk elderly patients (EuroSCORE 6 or more; over age 65 years [mean 71.8 years]) were compared with 176 low-risk elderly patients (EuroSCORE below 6; over age 65 years [mean 68.8 years]). There was no significant difference in hospital mortality or number of grafts between the two groups. Rates of inotropic agent use, intra-aortic balloon pump insertion and atrial fibrillation, and the duration of intensive care unit and hospital stay were significantly higher in high-risk than low-risk patients. There were no significant differences in the incidence of major complications between the two groups. The results suggest that, in selected patients, on-pump CABG can be safely performed in high-risk patients over 65 years old with no effect on mortality.
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    Successful posterıor mıtral leaflet reconstructıon wıth autologousperıcardıum ın a chıld wıth endocardıtıs
    (Internatıonal Journal Of Cardıology, 2011) Dişli, Olcay Murat; Kaynak, Murat; Seçici, Serkan; Erdil, Nevzat; Battaloğlu, Bektaş
    We describe successful treatment, including valve repair for mitral endocarditis. A 9 year-old boy presented with weakness and high fever. Despite 2 weeks of antibiotics at the local hospital infectious signs persisted. To determine the cause of the fever, he was admitted to our hospital. Transesophageal echocardiography (TEE) revealed severe mitral regurgitation; posterior leaflet was perforated and very large mobile vegetation was spread on the posterior wall of the left atrium. Abscess formation was visible beyond the posterior leaflet. Staphylococcus aureus was isolated from blood cultures. Intra-operatively, the patient underwent abscess debridement followed by reconstruction of the mitral annulus with fresh autologous pericardial patch. Mitral repair was achieved by quadrangular resection of the posterior mitral valve leaflet, retention of the primary and secondary chordae. Body of the posterior valve leaflet was reconstructed using fresh autologous pericardium. The constructed posterior valve was implanted on the edge of the sutured annular patch. Antibiotic therapy was continued for 6 weeks after surgery, and infections did not reoccur. The postoperative course was uneventfull and follow-up echocardiography showed minimally regurgitation of the mitral valve.