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Biomedical subjects

Nezihi Kucukarslan

Publications and source records attributed to Nezihi Kucukarslan.

8 recordsLinked to original sources

Muscle sparing thoracotomy in pediatric age: a comparative study with standard posterolateral thoracotomy.

Alternative approaches to the standard posterolateral incision for thoracotomy have been developed to minimize its postoperative pain and wound related side effects. Muscle-sparing (MS) thoracotomy has been a well-known substitution to the standard posterolateral thoracotomy for this purpose; however it has not been studied in the pediatric age group in detail. We studied retrospectively the patients with thoracotomy for non-cardiac, thoracic surgical procedures. Group 1 included the patients with standard posterolateral thoracotomy for the surgery. The patients with MS thoracotomy composed group 2. The related data were collected retrospectively. The early postoperative morbidities (time requiring for regaining shoulder girdle movement, extubation, intensive care unit stay, and hospital stay) and late musculoskeletal anomalies (scoliosis, elevation of the shoulder, winged scapula, asymmetry of the nipples) were compared between groups. A total of 90 patients were included in the study. Group 1 constituted 50 patients with an average age of 4.24 +/- 2.91 years. Group 2 included 40 patients with an average age of 4.20 +/- 2.92 years. Comparison of the demographics and the baseline characteristics of the patients were not different between groups. In comparison of operative characteristics, there was lesser morbidity in group 2 as re-exploration for bleeding, wound infection, wound healing and fewer intensive care unit and hospital stay days. Late follow-up revealed a significant increase in musculoskeletal deformities in group 1. We conclude that muscle-sparing incision should be preferred to the standard posterolateral thoracotomy in pediatric age.

Child↗

Aortic elastic properties in young pregnant women.

This study aimed to investigate the aortic elastic properties of young pregnant women by comparing them with those of age-matched healthy females. The study group consisted of 21 pregnant women at a mean age of 26 +/- 1 years; 22 healthy women at a mean age of 25 +/- 1 years constituted the control group. Doppler-color echocardiographic variables and serum estradiol (E2) levels were measured from both groups. The blood samples were obtained from the control group in the first week after menstrual bleeding. Diastolic and systolic blood pressure (DBP and SBP, respectively) were measured with a sphygmomanometer. Systolic and diastolic aortic diameters (AOS and AOD, respectively) were measured 3 cm proximal to the aortic valves. Aortic elastic properties were assessed according to the following formulas: 1, Aortic strain = (AOS - AOD)/AOD; 2, Aortic distensibility = 2 x (AOS - AOD)/(PP x AOD); 3, Aortic diameter change = AOS - AOD; 4, Aortic stiffness index = ln(SBP/DBP)/(AOS - AOD)/AOD. The results were expressed as mean +/- standard deviation and compared by t-test between groups. P < 0.05 was considered as statistically significant. All women in the study group were in their first pregnancy and second trimester. The height and weight were 160 +/- 5 vs 164 +/- 6 cm and 60 +/- 9 vs 54 +/- 3 kg in the study vs control groups, respectively (P < 0.05). The AOD was 26 +/- 3 vs 26 +/- 4 mm and AOS 29 +/- 3 vs 28 +/- 4 mm. Pulse pressure was 43 +/- 3 vs 45 +/- 8 mmHg in the study vs control groups, respectively (P > 0.05). The serum E2 level was significantly higher in pregnant women (21 300 +/- 2 300 pg/ml). Derived aortic elastic properties in pregnant women were also increased significantly (P < 0.0005). The indexes of aortic elastic properties are altered and aortic stiffness is decreased among young pregnant women. This may be due to the adaptation mechanisms including high estradiol levels detected in pregnancy.

Adult↗

Comorbidity of constrictive pericarditis and hemophilia A.

OBJECTIVE: To report a case of comorbidity of constrictive pericarditis and hemophilia A. CLINICAL PRESENTATION AND INTERVENTION: A 21-year-old male with hemophilia A was referred to our clinic and was examined with the subsequent evaluation of shortness of breath, leg edema and ascites. Clinical and laboratory examinations were performed. The results were consistent with constrictive pericarditis (CP), and the symptoms were completely relieved following institution of medical therapy. CONCLUSION: Because hemophilia A and pericarditis may be coincidentally present clinical conditions, avoidance of surgical procedures in hemophilic patients is preferable unless the resolution of the symptoms of pericarditis cannot be effected by medical therapy.

Adult↗

Noncompaction of ventricular myocardium involving both ventricles.

AIM: We aimed to present a case with ventricular myocardial noncompaction involving both ventricles. METHODS AND RESULTS: Noncompaction of ventricle is a rare and unclassified congenital cardiac malformation is due to an arrest in intrauterine endomyocardial morphogenesis. We presented a ventricular myocardial noncompaction case involving both left and right ventricles. The physical examination of this case is consistent with mitral regurgitation and the echocardiographic findings are consistent with noncompaction of ventricular myocardium involving both ventricles with left ventricular systolic failure. CONCLUSION: Transthoracic echocardiography is a useful clinical tool for diagnosing noncompaction of both the right and left ventricular myocardium. The LVNC definition can also be utilized for RVNC, which this diagnosis has never been reported in a Turkish patient.

Adult↗

Transcutaneous axillary artery cannulation.

The axillary artery may be an alternative cannulation site for patients with diffused atherosclerosis, aortic dissection, and aneurysm. There are different techniques for axillary artery cannulation that can be performed easily with a transcutaneous approach. Small incision necessity, less dissection, and good wound healing are other advantages of this technique.

Anticoagulants↗

A simple atraumatic clamp technique without a stabilizer in off-pump CABG: how to do it.

A method of stabilization of the heart and the coronary artery during the construction of the distal anastomosis in coronary artery procedures without cardiopulmonary bypass is described. The technique exposes and immobilizes the coronary artery, allowing a precise anastomosis on the beating heart. In addition, it is simple, safe, and inexpensive.

Constriction↗

Is it necessary to use a drain after harvesting radial artery? A randomized prospective study.

BACKGROUND: Radial artery (RA) is a second choice after internal thoracic artery in coronary artery bypass operations. There are some complications in forearm after harvesting RA. We have prospectively compared the necessity of inserting drain in the forearm cavity after RA harvesting to prevent such complications. METHODS: Eighty consecutive patients (younger than 65 years old, left ventricle ejection fraction >40%) undergoing coronary artery bypass operations were prospectively enrolled into study. Patients were divided into two groups by using, Table of Random Digit, for randomization. In group I patients (n = 40), we inserted drain during the forearm closing and in group II patients (n = 40), we did not use any drain. Patients in both groups evaluated for wound site complications such as hematoma, errythema, vascular complications, motor deficit, paresthesia, hand edema, and infection. RESULTS: We found two hand edemas, one hematoma, five paresthesias, one infection, and three ecchymosis in Group I patients and one hematoma, four paresthesias, one infection, and four ecchymosis in Group II patients. There was no statistically significant difference between the groups in complications. CONCLUSION: Placing of a drain into the forearm has not significant advantages but the cost and the complaints of patients could be reduced by not using the drain.

Coronary Artery Bypass↗

Tricuspid insufficiency does not increase early after permanent implantation of pacemaker leads.

BACKGROUND: Interference between pacemaker (PM) lead and tricuspid apparatus may cause tricuspid regurgitation (TR). However, data regarding TR in patients with implanted PM are controversial. Our aim is to find out the degree of TR in a group of patients before and following PM implantation in a prospective manner. METHODS: The study group consisted of the patients referred for implantation of permanent PM or implantable cardioverter defibrillator (ICD). All patients underwent two-dimensional and Doppler echocardiographic evaluation before and after device implantation. The severity of TR was qualitatively classified into four groups as normal or trivial, mild, moderate, or severe. All studies were reviewed for accuracy by a second independent interpreter. RESULTS: Sixty-one patients (mean age 53 +/- 8 years, 44 male) referred for PM (n = 55) or ICD (n = 6) implantation consisted of the study population. Echocardiographic degree of TR was mild in 21 (70%), moderate in 7 (23%) and severe in 2 (7%) patients before PM implantation. Following device implantation, mild TR was noted in 23 (76%), moderate in 10 (33%), and severe in 2 (6%) cases. After the procedure, the TR severity was increased from normal/trivial to mild in 5 (16%) cases and from mild to moderate in 3 (10%). There was no worsening of the severity of TR in patients with moderate regurgitation following device implantation. The severity of TR did not change at a mean follow-up of 6 +/- 3 months. CONCLUSIONS: New or worsening TR is relatively rare after PM implantation. It is not associated with an acute worsening or clinical deterioration. But echocardiographic follow-up is recommended to monitor other complications in chronic phase.

Cardiomyopathy, Dilated↗