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Öğe Air within the aneurysm sac following endovascular management of abdominal aortic aneurysm in a patient with acute pancreatitis(Turkish Soc Radiology, 2009) Kutlu, Ramazan; Nisanoglu, VedatA 44-year-old man with an abdominal aortic aneurysm presented with acute pancreatitis with abundant peripancreatic fluid and was successfully treated with endovascular stent graft. Early post-procedural radiological examinations showed air inside the aneurysm sac. Due to the possible infection from pancreatitis, antibiotic treatment was initiated, and he was closely monitored. Serial radiological examinations showed gradual decrease and eventual resolution of air at the end of one month. Follow-up computed tomography 10 months post-implantation revealed no problems. presence of air inside the aneurysm sac could be a sign of graft infection. Although the air usually resolves spontaneously, close surveillance is necessary for cases with higher risk of infection.Öğe Axillary Artery Perfusion in Acute Type A Aortic Dissection Repair(Wiley, 2008) Battaloglu, Bektas; Erdil, Nevzat; Nisanoglu, VedatBackground: We evaluated our experience with axillary artery perfusion technique in acute type A aortic dissection repair. Methods: Between September 2000 and July 2006, 41 consecutive patients with acute type A aortic dissection underwent surgical repair. In 35 of 41 patients (85.4%), arterial perfusion was performed through right axillary artery and in the remaining six patients (14.6%), arterial perfusion site was femoral artery. Indication for femoral artery perfusion was cardiac arrest and ongoing cardiopulmonary resuscitation in one and pulslessness of right upper limb in five patients. Mean age was 54.9 +/- 15.3 (16 to 90 years) and 28 were male. Unilateral antegrade cerebral perfusion (perfusate temperature 22 to 25 degrees C) through axillary artery was performed in all axillary artery perfused patients and in three patients who had femoral artery perfusion. Results: Five patients died postoperatively (hospital mortality 12.2%). All of them had evidence of single or multiple organ malperfusion preoperatively. We did not experience any new transient or permanent neurologic deficit after the procedure in the unilateral antegrade cerebral perfusion patients. Complications related to axillary artery cannulation were observed in two patients (5.3%). One patient with femoral artery cannulation experienced femoral arterial thrombosis, postoperatively. Conclusions: Right axillary artery cannulation for repair of acute type A aortic dissection is a simple and safe procedure. In the case of pulslessness of right upper limb, femoral artery is still the choice of cannulation site. doi: 10.1111/j.1540-8191.2008.00754.x (J Card Surg 2008;23:693-696)Öğe COLON PERFORATION FOLLOWING CORONARYARTERY BYPASS GRAFTING(Istanbul Univ, Faculty Medicine, Publishing Office, 2006) Isik, Burak; Nisanoglu, Vedat; Yilmaz, Mehmet; Sogutlu, GokhanAlthough incidence of gastrointestinal complications following cardiac surgery is low, concomitant mortality is high. Intestinal ischemia is the most life-threatining one among these complications. In this paper, two cases of colon perforation, one of which with a mortal course, following coronary artery bypass grafting are presented. Delay with a concern of a negative laparotomy increases high mortality rate of ischemic intestinal complications rather than an early and curative procedure in a patient with a recent cardiac surgical procedure.Öğe Early Outcomes of Radial Artery Use in All-Arterial Grafting of the Coronary Arteries in Patients 65 Years and Older(Texas Heart Inst, 2010) Erdil, Nevzat; Nisanoglu, Vedat; Eroglu, Tamer; Fansa, Iyad; Cihan, Hasan Berat; Battaloglu, BektasWe 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 (beta=0.13; 95% confidence interval [CI], 0.054-0.759; P=0.02) and high EuroSCORE (beta=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, 17-65 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. (Tex Heart Inst J 2010; 37(3):301-6)Öğe Early results of surgery for acute type A aortic dissection without using neurocerebral monitoring(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2010) Erdil, Nevzat; Gedik, Ender; Erdil, Feray; Nisanoglu, Vedat; Battaloglu, Bektas; Ersoy, OzcanBackground: 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.Öğe HEPATIC ARTERY THROMBOSIS IN 153 CONSECUTIVE LIVER TRANSPLANT RECIPIENTS PERFORMED IN YEAR 2008: A NEW SURGICAL TECHNIQUE.(John Wiley & Sons Inc, 2009) Kirimlioglu, Vedat; Yilmaz, Sezai; Nisanoglu, Vedat; Ara, Cengiz; Aydin, Cemalettin; Ozgor, Dincer; Kirimlioglu, Hale[Abstract Not Available]Öğe Left ventricular aneurysmal repair within 30 days after acute myocardial infarction - Early and mid-term outcomes(Texas Heart Inst, 2007) Battaloglu, Bektas; Erdil, Nevzat; Nisanoglu, VedatFor 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 2007 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 intarction. 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 I 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 re-exploration 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.Öğe True popliteal aneurysm presenting with acute limb ischemia and deep venous thrombosis: Report of a case(Int Scientific Literature, Inc, 2008) Erdil, Nevzat; Nisanoglu, Vedat; Eroglu, Tamer; Fansa, Iyad; Cihan, Hasan Berat; Battaloglu, BektasBackground: True popliteal aneurysm complicated with distal arterial embolization and popliteal vein thrombosis is rare. Case Report: We report a case of a 26-year-old male with popliteal artery aneurysm who presented with two major complication related to the aneurysm; distal arterial embolization and popliteal vein thrombosis. He was treated successfully by vein graft interposition and anticoagulation therapy. Conclusions: This case suggests popliteal aneurysm may cause concurrent limb-threatening complications such as acute leg ischemia and deep venous thrombosis.
