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Cengiz Köksal

Publications and source records attributed to Cengiz Köksal.

8 recordsLinked to original sources
PubMed2004

Simultaneous off-pump coronary revascularization with pulmonary resection or vascular surgery.

Patients who require coronary artery bypass grafting and who also have vascular disease or lung malignancy constitute a high-risk group, and their management remains controversial. Combining off-pump coronary surgery (OPCAB) with peripheral artery revascularization or lung resection is an attractive proposition, as it avoids the risks associated with cardiopulmonary bypass. This paper presents the results of 26 such combined procedures consisting of simultaneous OPCAB and peripheral revascularization or lung resection, between April 2001 and March 2003. Twenty underwent concomitant carotid endarterectomy and OPCAB, four underwent aortobifemoral bypass and OPCAB, and two underwent pneumonectomy and OPCAB. There was no in-hospital mortality. Prolonged ventilatory support was necessary in one patient who had a lung resection. The median postoperative length of stay in the Intensive Care Unit was 1.3 days (range 1 to 6) and the median length of hospital stay was 5.7 days (range 4 to 16 days). Off-pump coronary surgery clearly has a place for patients with peripheral vascular disease or pulmonary malignancy who additionally require myocardial revascularization.

Aged↗
PubMed2002

Thoracofemoral bypass for treatment of juxtarenal aortic occlusion.

Descending thoracic aorta-to-femoral artery bypass grafting is considered a good alternative procedure for revascularization in cases of aortic graft failure, graft infection, and other intraabdominal pathologies not amenable to standard aortofemoral revascularization. Its use as the primary mode of treatment in selected cases is still under investigation. From January 1998 to June 2001, 5 patients underwent descending thoracic aorta-to-femoral artery bypass grafting as primary treatment for juxtarenal aortic occlusion. There was no operative mortality nor major morbidity; a groin incision infection occurred in one case. The mean hospital stay was 8.2 days and intensive care unit stay was 2.6 days. Graft failure was not encountered in the short-term follow-up. In spite of the small number of patients, it was concluded that thoracic aortofemoral bypass offers excellent inflow and reliable patency and may be considered for primary revascularization in cases of juxtarenal aortic occlusion.

Aged↗
PubMed2002

Vascular echinococcosis.

Three patients with arterial echinococcosis presented with chronic or acute arterial occlusion. One case diagnosed as Leriche's syndrome was found at surgery to have aortic occlusion caused by hydatid cysts; arterial reconstruction was performed by aortoiliac interposition of a woven Dacron vascular graft. In the other 2 cases presenting with acute femoral or brachial artery occlusion, embolectomy revealed hydatid cysts as the cause of occlusion.

Adult↗
PubMed2002

Comparison of enoximone, amrinone, or levosimendan enriched St. Thomas' hospital cardioplegic solutions used for myocardial preservation in isolated guinea pig hearts.

Myocardial contractile function after cardioplegic arrest is often depressed and an ideal cardioplegic solution has not been developed yet. The aim of this study was to assess the efficacy of phosphodiesterase III inhibitors, amrinone and enoximone, and levosimendan, a novel Ca2+ sensitizing agent, on recovery of hearts after normothermic cardioplegic arrest when added to the St. Thomas' hospital cardioplegic solution. In the control group, isolated guinea pig hearts were perfused in Langendorff apparatus and arrested with standard St. Thomas' solution. In other groups, amrinone (10(-5) mol.L-1), levosimendan (10(-5) mol.L-1), or enoximone (10(-4) mol.L-1) were added to the cardioplegic solution. In all hearts, intraventricular pressure, +dp/dtmax, -dp/dtmax, area under pressure-time curve, heart rate, coronary flow, lactate dehydrogenase and creatine kinase enzyme leakage, and oxygen consumption were measured. In the enoximone group, contractility force and +dp/dtmax, were found to be significantly high in the reperfusion and inotropic periods in comparison with other groups (p < 0.05). -dp/dtmax and area under contractility-time curve values were significantly high in inotropic period in enoximone group (p < 0.05). No statistically significant difference was noted in other groups. Cardioplegic solution enrichment with enoximone augmented mechanic functions in reperfusion period. No positive effect of amrinone or levosimendan was observed in this study.

Amrinone↗
PubMed2002

Combined off-pump coronary revascularization and lung resection.

Concomittant severe coronary artery disease and lung malignancies occur rarely. Combined conventional coronary artery bypass grafting (CABG) with the use of cardiopulmonary bypass (CPB) with lung resection posses several perioperative and postoperative problems related to extracorporeal circulation and heparinization. The avoidance of CPB may be advantageous by decreasing blood loss, pulmonary complications and hospital stay. Further, exposure to the immunosuppressive and inflammatory effects of CPB may have deleterious impact on tumor growth and dissemination. Off-pump CABG makes the combined procedure safer as it abolishes the complications of CPB. We report two patients with the diagnosis of severe coronary artery disease and lung malignancies, underwent off-pump CABG and lung resections in the same surgical setting.

Aged↗
PubMedDate not supplied

Surgical treatment of Buerger's disease.

We aimed to evaluate the characteristics of 198 new patients with Buerger's disease treated surgically in the last decade. We also compared these results with our former series reported in 1993. The records of patients with Buerger's disease who were enrolled in an ongoing investigational protocol between 1991 and 2001 were reviewed. Sympathectomy was carried out in 161 patients and revascularization in 19 patients. The cumulative secondary patency rate was 57.9% for bypass grafts at a mean follow-up of 5.4 years. Clinical outcome following sympathectomy was considered improved in 52.3% of patients, stable in 27.8%, and worse in 19.8%. Seven major and 36 minor amputations were performed, with a limb salvage rate of 95.6%. The aggressiveness of the disease has increased compared with previous series, parallel to the expansion of cigarette consumption. Bypass surgery should be considered for patients with severe ischemia who have target vessels. Sympathectomy still has a role to improve distal flow.

Adolescent↗