Biomedical subjects

Levent Yazicioğlu

Publications and source records attributed to Levent Yazicioğlu.

3 recordsLinked to original sources

PubMed2003

Conduction disturbances in coronary artery bypass surgery.

BACKGROUND: Conduction disturbances are very common after coronary artery bypass grafting (18-45%). Long cross-clamp time, method of cardioplegia, depth of hypothermia, and patient age are some of the risk factors. We planned this study to ascertain the effect of crystalloid or tepid blood cardioplegia (CP) on conduction disturbances. METHODS: One hundred patients were randomly divided into two groups. The first group received tepid blood CP and the second received cold crystalloid CP. St. Thomas II CP was used as CCP and the same CP was mixed with blood with a ratio of 4:1 in the tepid CP group. In both groups as an initial bolus, a 10 to 15 ml/kg CP was infused with a pressure of 75 mmHg. Additionally, 400 ml of CP were given every 20 min during the cross clamping period in addition to infusion of 50-100 ml of CP after each distal anastomosis. Blood samples for CK, CK-MB, LDH and Troponin T measurements were obtained at induction, before bypass, after cross clamping, before de-clamping, after de-clamping and after bypass. Postoperative ECGs were analyzed by a cardiologist. RESULTS: There were no deaths in both groups but the mean hospitalization was 8.4 +/- 1.7 days in group I, and 14.4 +/- 3.1 days in group II (P=0.004). Although there were significant rises in CK, CK-MB, LDH and Troponin T levels in both groups after CPB or de-clamping, the difference in increment between the two groups was not significant. Twelve patients in group II (24%) developed new fascicular blocks, four of these caused hemodynamic instability and needed inotropic treatment but only one was discharged with LAHB. Four patients in group I (8%) also developed new conduction disturbances within the first hour, but all completely resolved. Incidence of conduction disturbances was significantly increased in the crystalloid CP group (P=0.019). CONCLUSION: There were no significant differences in cardiac enzyme measurements between cold crystalloid and tepid blood CP, but crystalloid CP caused more fascicular blocks. We conclude that myocardial protection was equal in both cardioplegia methods whereas conduction disturbances have been assumed to be caused by cold injury to the conduction tissues.

Cardioplegic Solutions↗

PubMed2003

Surgery for cardiac hydatid disease: an Anatolian experience.

OBJECTIVE: The purpose of this study was to describe the clinical/pathological features and the outcome of the surgical treatment of cardiac hydatid disease in our unit and other hospitals of Anatolia over a fifteen-years period. METHODS: Between 1984 and 2001, fifty cases of surgically treated cardiac hydatid disease were identified by systematic literature search from Anatolia. Twelve patients were operated at the Department of Cardiovascular Surgery, Ankara University within the same period. Overall thirty-nine patients were female (mean age 29.8+/-14 years). Sixty-three percent of patients were complaining of dyspnea at the time of referral to the hospital and 22% presented with signs of acute coronary syndrome. RESULTS: The most common cardiac location was the left ventricle (46.7%) followed by the interventricular septum, the right ventricle and atria. The most common procedure was controlled puncture and aspiration of the cyst content, its excision and closure of the resulting cavity, which were performed under cardiopulmonary bypass. Overall Anatolian operative mortality was 4.8% (3 patients). No late deaths but recurrence in one patient have occurred. CONCLUSION: In view of the lack of efficient alternative treatment options, we recommend surgical intervention even in asymptomatic patients in order to prevent the occurrence of lethal complications.

Adolescent↗

PubMed2002

Off-pump coronary artery bypass surgery in the left ventricular dysfunction.

OBJECTIVE: The purpose of this study is to report our experience in off-pump coronary artery surgery in patients who have left ventricular dysfunction. METHODS: Off-pump coronary artery surgery was performed to 48 patients who were chosen randomly among 265 patients having two or more coronary artery disease and whose ejection fraction (EF) was less than 30%. In these patients fractioned shortening (FS) was evaluated by echocardiography, EF with multiple gated acquisition (MUGA) and ischaemic regions with myocardial perfusion scintigraphy both pre- and postoperatively. Coronary artery angiography was done to all patients at the end of the 1st year and patients were evaluated according to New York Heart Association (NYHA) classification. RESULTS: There were three deaths. The clinical situations of 41 of 45 patients (91.1%) improved after the operation. These four patients who didn't improve in NYHA status were the ones in whom complete revascularization couldn't be done. The FS and EF values were significantly increased at the 1st month, and 1st year. The constant perfusion defects and irreversible damaged areas changed into dynamic myocardial tissue in the 1st year scintigraphies. DISCUSSION: Off-pump CABG can be done with an acceptable mortality and clinic results in patients who have ventricular dysfunction.

Adult↗