PubMed Health⌕ Search

Biomedical subjects

Suat Büket

Publications and source records attributed to Suat Büket.

6 recordsLinked to original sources

Perioperative determinants of mortality and morbidity in distal arch and proximal descending aortic aneurysm surgery.

BACKGROUND: The purpose of this article is to describe our experience on distal arch and proximal descending aortic aneurysm repair, and to evaluate retrospectively the determinants of mortality and morbidity. MATERIAL/METHODS: Between 1994 and 2002, 30 patients (mean age 53.4 years) underwent repair of distal arch or proximal descending aortic aneurysm approached through left thoracotomy with deep hypothermic circulatory arrest. Femoro-femoral bypass was used in all patients except for four, in whom the left subclavian artery was cannulated. Retrograde cerebral perfusion was performed in 16 patients. The mean circulatory arrest time was 30.7 min. RESULTS: Overall hospital mortality was 13.3%. Excessive blood (p=0.008) and plasma (p=0.009) transfusions, and coronary artery disease (p=0.012) were correlated with mortality. The overall rate of postoperative complications was 30%. Renal failure and respiratory failure were the most frequent complications (16.7%), while the rates of stroke and transient neurological dysfunction were 6.7% and 3.3%, respectively. Age >70 years, bypass time >140 min, distal ischemia time >55 min, and excessive blood or plasma transfusions were determinants of postoperative complications. CONCLUSIONS: Deep hypothermic circulatory arrest with left thoracotomy is a valid procedure with acceptable mortality rates in the management of aneurysms of distal arch and proximal descending aorta. Prolonged bypass and distal ischemia times and excessive blood transfusions are associated with increased postoperative morbidity.

Adult↗

Adverse effects of cell saver in patients undergoing ruptured abdominal aortic aneurysm repair.

A retrospective analysis of 56 patients undergoing ruptured abdominal aortic aneurysm (AAA) repair was performed to find out if cell saver had any impact on postoperative morbidity and mortality. All patients but one were male. The mean age was 68 +/- 8 years (35-85 years). Cell saver was used in 40 patients (CS group) and was not used in 16 patients (NCS group). We compared the incidences of respiratory, renal, and gastrointestinal complications; reoperation; transfusion requirement; length of hospital stay; and mortality between the groups. This study demonstrated that intraoperative cell saver usage significantly increased the incidence of respiratory complications and the need for blood and fresh frozen plasma transfusion, and prolonged the hospital stay in patients with ruptured AAA, but did not have any impact on mortality. Postoperative complications were more prominent in patients who received >3000 mL cell saver blood.

Adult↗

Superior mesenteric artery aneurysm.

A 38-year old woman with mid-epigastric pain, diarrhea, and weight loss, underwent resection of a superior mesenteric artery aneurysm and primary repair of the artery. Pathological examination showed degenerative atherosclerotic changes, marked medial and intimal thickening, and vegetations. Microbiological studies demonstrated Streptococcus viridans as the infecting organism of this mycotic aneurysm. The patient made a good recovery and remained well after 3 years.

Adult↗

[Surgical treatment of aortic coarctation in adults: mid-term results and effects on the systolic blood pressure].

OBJECTIVE: To evaluate the outcome and the systolic blood pressure changes after surgical treatment of aortic coarctation in adults. METHODS: Between February 1995 and January 2001, 12 adult patients with a mean age of 29+/-10 years, underwent repair of aortic coarctation in our clinic. The diagnostic and operative data of these patients were retrospectively analyzed. Follow-up was complete in all hospital survivors. RESULTS: The mean systolic blood pressure of 8 hypertensive patients decreased from 155+/-7 mmHg to 115+/-9 mmHg after surgical intervention. One patient with a dilated cardiomyopathy died one day after the operation due to an intractable ventricular fibrillation (mortality 8.3%). Four patients had been operated for coexisting cardiovascular pathologies during a mean follow-up period of 32+/-26 months. CONCLUSION: Surgical treatment of aortic coarctation in adults can be safely performed with an acceptable mortality and morbidity, both resulting from coexisting cardiovascular disorders in our patient group. The systolic blood pressure may decrease significantly after the operation.

Adolescent↗

Experience with cerebral perfusion in total aortic arch replacement.

BACKGROUND: The interruption of cerebral circulation is a major problem in the surgical repair of the aortic arch. This study was undertaken to identify the perioperative risk factors for mortality and neurological morbidity, and the outcome after total aortic arch replacement. MATERIAL/METHODS: Between June 1995 and March 2002, 23 patients (13 males) underwent total aortic arch replacement. The mean age was 61.7I9.4 years (range 35-77). All patients underwent total arch replacement with a period of hypothermic circulatory arrest (HCA). Selective cerebral perfusion was utilized as an adjunct to HCA (retrograde in 19 patients and antegrade in 4 patients). The elephant trunk technique was used in 18 patients, while proximal and middle portion of the descending aorta was also replaced in 5 patients. The patient information in our database was retrospectively reviewed. The risk factors affecting mortality and morbidity were analyzed by univariate analysis. RESULTS: The in-hospital mortality rate was 17.4%. None of the survivors developed major stroke. Temporary neurological dysfunction (TND) was seen in 5 patients. Univariate analysis revealed that excessive blood transfusion was the only factor correlated with hospital death among 18 perioperative variables (p<0.006). HCA lasting > 55 minutes and a history of hypertension were associated with the development of TND (p<0.032 and p<0.02, respectively). CONCLUSIONS: Total arch replacement can be performed with acceptable mortality and neurological morbidity. Midterm survival is excellent in hospital survivors. The duration of HCA is not associated with in-hospital mortality when selective cerebral perfusion (either antegrade or retrograde) is used as an adjunct.

Adult↗