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Biomedical subjects

Suat Nail Omeroğlu

Publications and source records attributed to Suat Nail Omeroğlu.

13 recordsLinked to original sources
PubMed2004

Evolution of repaired and non-repaired tricuspid regurgitation in rheumatic mitral valve surgery without severe pulmonary hypertension.

The aim of this study was to evaluate the usefulness of repairing significant tricuspid regurgitation (> or = grade 2) without severe pulmonary hypertension (< or = 50 mm Hg). Between 1993 and June 2001, 88 consecutive patients were operated on for rheumatic mitral valve disease associated with significant tricuspid regurgitation and without severe pulmonary hypertension. The severity of the tricuspid valve disease was assessed by echocardiography. Sixty-three patients had severe (> or = grade 3) tricuspid regurgitation (Group I), and 25 patients had moderate (grade 2) tricuspid regurgitation (Group II). There was no hospital mortality. six patients died during follow-up. The overall actuarial survival rate for 8 years was 92.1% +/- 3.1%. Cox proportional hazard regression analysis showed that age ( p = 0.006) and pulmonary complication ( p = 0.01) were associated with increased late mortality. Freedom from death was similar in both groups at 8 years (93.1% +/- 3.3% versus 88% +/- 8%, p = 0.7). Severe postoperative tricuspid regurgitation (> or = grade 3), caused by the failure of tricuspid repair or leaving the valve untouched, impaired long-term survival after surgery, and actuarial survival was 96.1% +/- 2.7% and 83% +/- 7.8% at 7 years ( p = 0.048), respectively. Severe tricuspid regurgitation, functional or organic, should be corrected at the time of mitral valve surgery, whereas untouched functional moderate tricuspid regurgitation improves after mitral valve surgery.

Adult↗
PubMed2004

Does radial artery harvesting cause any changes in the forehand circulation during the postoperative period? An angiographic study.

OBJECTIVE: The aim of this study was to evaluate angiographic changes in the ulnar and interosseous arteries, and the collateral circulation of forehand after harvesting radial artery. METHODS: Forty patients were studied between June 1998 and June 2001. Study group consisted of 30 patients who received radial artery as a conduit for coronary artery bypass operation, and control group consisted of 10 patients who did not undergo any cardiac or vascular operation before. Preoperative risk factors were similar between the two groups. All patients underwent angiographic evaluation to detect coronary artery and left forehand arterial circulation. RESULTS: Angiographic evaluation was performed 25.5 +/- 2.0 months after the initial operation in the study group. Mean diameter of ulnar artery was 2.9 +/- 0.59 mm (range 2.1 - 4.8) in the study group and 3.2 +/- 0.8 mm (range 1.5 t- 4.7) in the control group (p >0.05). Mean diameter of interosseous artery was significantly higher in the study group than in control one: 2.06 +/- 0.57 mm (range 1.2 t- 4.2) versus 1.46 +/- 0.79 mm (range 0.8 t- 3.6); (p = 0.003). CONCLUSION: Although angiography was performed in a limited number of patients, interosseous artery rather than ulnar artery enlarged to compensate blood supply of forehand 25 months after harvesting the radial artery for coronary artery bypass grafting.

Adult↗
PubMed2003

Rupture of abdominal aortic aneurysms in Behçet's disease.

Behget's disease is a systemic disease of unknown etiology with a chronic relapsing course,characterized by oral aphtous, genital ulcers, ocular lesions, and occasionally vasculitis. Major asymptomatic vascular complications should always be considered in patients with Behget'sdisease. We present the surgical treatment of two male Behget's patients of 41 and 30 years of age with ruptured infrarenal abdominal aortic aneurysms. The urgent repairs of ruptured abdominal aortic aneurysms were performed successfully in both patients. Because Behget's disease is usually seen at young ages, vascular assessment should also be done routinely for early diagnosis and therapy, which can be life-saving.

Adult↗
PubMed2002

Five-year experience in aortic root replacement with the flanged composite graft.

BACKGROUND: Replacement of the aortic root with a composite graft containing a prosthetic mechanic valve is the preferred surgical procedure for tailoring the aortic root. The aim of this study is to determine the 5-year experience with the composite root replacement using our new modification of the Bentall technique. METHODS: Between January 1996 and June 2001, 96 patients underwent aortic root replacement using a flanged composite graft. Eighty patients (83.3%) were male, and 16 patients (16.7%) were female with a mean age of 48.7 +/- 14.4 years. Indications for operation were a true or false aneurysm (65.6%), severe calcified aortic valve stenosis (4.2%) or severe aortic insufficiency (2.1%) with dilated ascending aorta, acute dissection (2.1%), or combination of indications (26%). Thirty-one patients (32.3%) received a concomitant cardiac procedure. Mean aortic cross-clamp time was 89.5 +/- 28.6 minutes, and mean cardiopulmonary bypass time was 146.2 +/- 45.6 minutes. Total follow-up was 253.9 patient-years. RESULTS: Operative mortality was 8.3% (8 patients). The causes of hospital mortality were severe bleeding (3 patients), low cardiac output syndrome (2), acute respiratory distress syndrome (2) and cerebrovascular event (1). No patient died of flange-related complications. Univariate predictors of early mortality were low cardiac output syndrome (p < 0.001), neurologic complication (p = 0.03), and renal complication (p = 0.03). Multivariate analysis demonstrated only low cardiac output syndrome to be significant (p = 0.001) predictor for early mortality. There were five (5.7%) late deaths. Actuarial survival was 82.65% +/- 4.8% at 5 years (1.95% patient-year). Cox proportional hazards regression analysis demonstrated only low cardiac output syndrome to be significant (p = 0.032) predictor for late mortality. Actuarial freedom from prosthetic- and technique-related mortality was 100% at 5 years. CONCLUSIONS: The flanged composite graft offers excellent long-term results, with very low prevalence of prosthetic-related complications. The new created sinuses and the flange are especially helpful to continue physiologic function of the aortic root.

Adult↗
PubMed2002

Coronary bypass surgery in patient with malaria.

A 65-year-old man with unstable angina pectoris developed malaria prior to coronary artery bypass grafting. After 3 weeks on antimalarial therapy, left internal mammary artery-to-left anterior descending artery anastomosis was performed on the beating heart to avoid the effects of cardiopulmonary bypass. There was no complication in the early postoperative period.

Aged↗
PubMedDate not supplied

A simple method to prevent internal thoracic artery tension: a single pericardio-thoracic suture technique.

Tension on the internal mammary artery is a major risk for anastomosis in patients with severe emphysematous lungs. For this reason, it can be necessary to harvest the internal thoracic artery to its origin, to skeletonize it, or as a last resort to use it as a free graft. Sometimes, these maneuvers cannot be enough to solve the problem. A simple suture technique to hang up the pericardium to the chest wall is described that eliminates herniation of emphysematous lungs across mediastinum and reduces tension on the left internal mammary artery.

Anastomosis, Surgical↗
PubMedDate not supplied

Long-term outcome after total correction of tetralogy of Fallot in adolescent and adult age.

Although most patients with tetralogy of Fallot (TOF) undergo radical repair during infancy and childhood, patients remaining undiagnosed and untreated until adulthood can still be treated. These patients have either a previous palliative or natural collateral circulation to the lung or a mild form of right ventricular outflow tract (RVOT) obstruction. The aim of this study is to analyze the perioperative and long-term results of radical corrective procedures in patients who reached adult ages. Two hundred and seven patients with TOF underwent complete correction between 1985-and 2002, 64 (30.9%) of whom were aged 14 years or more. The mean age at corrective repair for this group was 20.6 +/- 7.5 years (range 14 to 49 years). Only two patients had previous modified Blalock-Taussig shunts. In 44 patients (68.7%) besides infundibular resection, a transannular gluteraldehyde-treated pericardial patch was used to reconstruct right ventricular outflow tract (RVOT). Only infundibular patching was used in 15 patients (23.4%) and infundibular muscular resection with primary closure of right ventricle was performed in five patients (7.8%). Hospital mortality was 3.1% with two patients. Four patients (6.2%) underwent reoperation because of recurrent ventricular septal defect (VSD) with/without residual obstruction or pulmonary regurgitation. All survivors were in NYHA class I (42) or II (17). Late mortality was recorded in two patients and 16-year actuarial survival was 89.2%+/- 4.9%. The significant negative predictors of late survival determined by univariate analysis were reoperation <0.018) and associated cardiac anomalies <0.011). Multivariate analysis showed that there was no negative predictor of late-term mortality. Corrective procedures in adult patients with TOF can be performed successfully compared to patients who underwent operation during infancy and childhood.

Adolescent↗
PubMedDate not supplied

Does mediastinitis affect the graft patency?

As inflammation began to be recognized as a major contributor to the pathogenesis of atherosclerosis, we evaluated the patients that developed mediastinitis, a long-standing inflammatory process, after coronary artery bypass grafting. There are many studies that have focused on the graft patency. But, till now, no study has been done to detect the effects of mediastinitis to graft patency. So, we aimed to detect the effect of mediastinitis on the graft patency in patients who have undergone coronary artery bypass surgery. Sixteen of 45 patients who have been operated upon for coronary artery bypass surgery and developed mediastinitis, which was treated with open drainage and mediastinal irrigation with late wound closure, were included in the study. The mean age of the patients was 55 +/- 11 (range 35-69) and nine of the patients were male. The graft patency was evaluated with control coronary angiographies after a mean period of 30.42 +/- 43.17 months (range 1-132). The left internal thoracic artery was patent in all patients (100%). Right internal thoracic artery patency rate was 50% (1/2). One individual bypassed radial artery was patent, whereas the sequential bypassed graft was occluded. The patency ratio of radial artery anastomosis was 33% (1/3). Twelve of the 17 saphenous vein grafts were patent (70.58%). The total number of patent distal anastomosis was 30/38 (78.94%). When compared with the graft patency of patients without infection, it was found that mediastinitis does not affect the graft patency rates adversely.

Adult↗
PubMedDate not supplied

LDH levels and left atrial ultrastructural chances in patients with mitral paraprosthetic regurgitation.

BACKGROUND AND AIM: The aim of this study was to assess the effect of paraprosthetic regurgitation of mitral mechanical valves to myocardial tissue and lactate dehydrogenase (LDH) level. METHODS: We compared 19 patients (study group) who had mitral mechanical valve with severe mitral paravalvular regurgitation with 20 patients (control group) who had native valve with severe rheumatic mitral regurgitation. None of the patients had clinical hemolytic anemia. On transesophageal echocardiographic examination, semiquantative evaluation and spatial distribution of regurgitant jets were noted in both of the groups. Five LDH isoenzymes were studied in two groups. Myocardial tissue specimens were taken from the left atrial wall during reoperation. Grids randomly taken were studied under the transmission electron microscope. RESULTS: Total serum LDH levels of the study group (578 +/- 12 IU/L) were higher than the control group (495 +/- 6.2 IU/L) (p < 0.001). We found LDH1/LDH2 more than 1 in all patients; the ratio was not statistically different in the control group. Electron microscopy revealed the same degree of injury in both groups. Haptoglobin levels were decreased and reticulocyte counts were increased in patients with paraprosthetic valve regurgitation. CONCLUSIONS: Electron microscopic findings support that myocardial injury contributes to increase of total LDH level and high LDH1/LDH2 ratio. But statistically significant elevation in total LDH level in study group and the stable state of LDH1/LDH2 ratio between two groups showed that hemolysis caused by paraprosthetic regurgitation is the most important factor for the increase of total LDH level, so that high LDH level can be used as a reliable parameter for the diagnosis of intravascular hemolysis in paraprosthetic regurgitation.

Adult↗