Biomedical subjects

Turhan Yavuz

Publications and source records attributed to Turhan Yavuz.

15 recordsLinked to original sources

PubMed2006

Quality of life in the elderly after coronary bypass surgery.

In addition to the clinical outcome, a patient's perspective and satisfaction with their health status have become important indicators. One of the most common measures to assess the quality of life is Short Form (SF)-36. The objective of the present study was to measure the functional status of elderly patients who had undergone coronary bypass surgery and to evaluate the impact of that surgery on their quality of life. The study involved 120 nonsmoking patients who underwent coronary bypass surgery between January 1, 2001 and January 1, 2003 at the Sevket Demirel Heart Center. Assessments were made using physical, clinical, and laboratory findings. We used the Turkish version of the Short Form (SF)-36 preoperatively and 18 months after surgery. The paired t test, two-tailed correlation, and variant analysis were used for statistical analysis. Of the 120 patients, 108 could be followed during the study period. Significant physical and mental improvements were seen in all areas, especially in the items of vitality and mental health. Females seemed to benefit from surgery more than males. Cardiac surgery substantially improved the quality of life of our patients. The findings allowed us to determine the patient's perspective of his or her outcome. With this knowledge, health care workers can provide information to the patient regarding functional limitations after cardiac surgery.

Activities of Daily Living↗

PubMed2006

A fatal case of Behcet's disease with rare complications.

Behcet's disease BD may involve in any large or small artery, vein. We present a case of BD with multiple venous thromboses, cardiac and pulmonary involvements, and renal failure. A 22-year-old man admitted with progressive dyspnea and edema on his face and neck. He had the history of recurrent oral and genital ulcers, and pustular skin lesions for 4 years. Doppler ultrasonography revealed right internal jugular vein thrombosis. Transthoracic echocardiography showed a pericardial effusion, decreased left ventricular ejection fraction. While his symptoms were regressing moderately with a pulse cyclophosphamide, prednisolone, and low molecular weight heparin treatment, new thromboses occurred in vena cava inferior, and bilateral renal veins after the third and 7th dosages of pulse cyclophosphamide. Creatinine levels increased progressively, which required hemodialysis. However, he died after the second session of hemodialysis. Patients with BD should be followed up for new developing thrombosis even during an immunosuppressive treatment.

Adult↗

PubMed2005

Vascular wall damage in rats induced by organophosphorus insecticide methidathion.

We have examined the effect of subchronic methidathion (MD) administration on vascular wall damage. The experimental groups were: control group and rats treated with 5 mg/kg MD. The MD group was given MD by gavage for 5 days a week for 4 weeks at a dose level of 5 mg/kg per day by using corn oil as the vehicle. The levels of malondialdehyde (MDA) were determined in the vascular tissue. Histopathological examination was examined in the thoracic aortic tissue. The levels of MDA were increased in the MD group compared with the control group (P < 0.01). In the MD group, subchronic MD administration led to the irregulation, prominent breaks and fragmentation of the elastic fibers were located in the media of aortic wall. In conclusion, it is likely that subchronic MD administration caused vascular wall damage and, in addition, lipid peroxidation may be one of the molecular mechanisms involved in MD-induced vascular toxicity.

Animals↗

PubMed2005

Beneficial effect of the addition of nitroglycerin to the cardioplegic solution on lipid peroxidation during coronary artery bypass surgery.

The effects of the addition of a nitric oxide (NO) donor to the cardioplegic solution on reperfusion injury and lipid peroxidation (LPO) in coronary artery bypass grafting (CABG) are not known. Therefore, this work was conducted to determine the possible effects of nitroglycerin on LPO and reperfusion injury as a result of CABG. A prospective double-blind, placebo-controlled study was conducted in 30 consecutive patients with coronary artery disease who underwent CABG with cardiopulmonary bypass. The patients were randomly assigned to receive 3 microg/kg of nitroglycerin added to the cardioplegic solution (NTG group) or 3 microg/kg of placebo added to the cardioplegic solution (placebo group). MDA increased significantly in the placebo group compared to the NTG group during the ischemic (P < 0.01) and reperfusion periods (P < 0.01). The level of troponin I decreased significantly in the NTG group compared to the placebo group during the ischemic and reperfusion periods (P < 0.001). The level of NO increased significantly in the NTG group compared to the placebo group during the ischemic and reperfusion periods (P < 0.01). LPO was increased in response to CPB during CABG, together with simultaneous decreases in serum nitric oxide levels, whereas LPO was significantly decreased in response to CPB with nitroglycerin, together with simultaneous increases in the levels of serum nitric oxide.

Cardioplegic Solutions↗

PubMed2005

Efficiency of prostacyclin in the treatment of protamine-mediated right ventricular failure and acute pulmonary hypertension.

Protamine is used after cardiopulmonary bypass was stopped in order to reverse the anticoagulant effects of heparin administered during open-heart operations. Adverse hemodynamic responses to protamine are common, ranging from minor perturbations to cardiovascular collapse. The aim of the present study was to investigate whether a prostacyclin is effective in the treatment of protamine-mediated acute pulmonary hypertension and right ventricular failure in the perioperative period of isolated coronary artery bypass grafting (CABG) operations. In sixty-eight (1.78%) of 3800 patients who underwent isolated CABG, acute pulmonary hypertension and right ventricular failure developed during or following the protamine infusion. These 68 patients were included in the study and were randomized into two groups. Thirty-eight of the patients received prostaglandin I(2) (PGI(2)), norepinephrine and dopamine (PGI(2) group), whereas 30 patients received nitroglycerin, norepinephrine and dopamine (control group). Hemodynamic data were recorded before and after the above drug combinations. The mean value of left ventricle ejection fraction significantly increased (p < 0.05) and mean values of central venous pressure, pulmonary artery systolic and diastolic pressure, pulmonary capillary wedge pressure and pulmonary vascular resistance significantly decreased (p < 0.05) in the PGI(2) group. The mean value of pulmonary capillary wedge pressure significantly decreased (p < 0.05) and the mean value of central venous pressure significantly increased (p < 0.05) in the control group. In conclusion, prostacyclin (PGI(2)) is effective in the treatment of protamine-mediated acute pulmonary hypertension and right ventricular failure in the perioperative period in isolated CABG operations. This finding may be an important contribution to the treatment of severe protamine complications during open-heart operations.

Acute Disease↗

PubMed2004

Vascular wall damage in rats induced by methidathion and ameliorating effect of vitamins E and C.

We examined the effect of subacute methidathion (MD) administration on vascular wall damage and evaluated the ameliorating effects of combination of vitamins E and C against MD toxicity. The experimental groups were: rats treated with corn oil (control group), rats treated with 5 mg/kg MD (MD), and rats treated with 5 mg/kg body weight MD plus vitamin E and vitamin C (MD+Vit). The groups were given MD by gavage on 5 days a week for 4 weeks at a daily dose 5 mg/kg (MD and MD+Vit) using corn oil as the vehicle. Vitamins E and C were injected at doses of 50 mg/kg intramuscularly and 20 mg/kg intraperitoneally, respectively, after the treatment with MD in the MD+Vit group. The levels of malondialdehyde (MDA) were determined in the aortic tissue. Histopathological examination was examined in the thoracic aortic tissue. MDA levels were higher in the MD group than the control group and lower in the MD+Vit group than MD group. MD administration led to irregulation, prominent breaks, and fragmentation of the elastic fibers but decrease in the irregulation and fragmantation of the elastic fibers with the combination of vitamins E and C in MD-treated rats. In conclusion, it is likely that subacute MD administration caused vascular wall damage, and that treatment with a combination of vitamins E and C after the administration of MD can reduce vascular wall damage caused by MD.

Administration, Oral↗

PubMed2004

Role of endogenous adenosine in atrial fibrillation after coronary artery bypass graft.

BACKGROUND: Atrial fibrillation (AF) is the most common complication following coronary artery bypass graft (CABG). The mechanism of AF after CABG is not well defined; however, it is suggested that endogenous adenosine, released in response to tissue hypoxia, may play a mechanistic role in these arrhythmias. HYPOTHESIS: The purpose of this study was to examine whether intravenous theophylline, via adenosine A1 receptor antagonism, would correct or modify new-onset early (<48 h post CABG) atrial fibrillation in patients post CABG, and thereby implicate endogenous adenosine as an inciting agent. METHODS: A prospective double-blind, placebo-controlled study design was applied to 385 consecutive patients with coronary artery disease who had undergone CABG. Any patient who developed AF within 48 h of the operative procedure was randomly assigned to receive 5 mg/kg of intravenous theophylline (Group A) or matched intravenous placebo (Group B). The patients who converted to sinus rhythm within 15 min of drug administration were accepted as showing positive responses. RESULTS: Thirty patients comprised the study group. In Group A, 8 of the 15 patients (53%) converted from AF to sinus rhythm within 15 min of theophylline administration. One patient who converted to sinus rhythm 20 min after theophylline administration was accepted as showing a negative response. In the placebo-treated group, no patient converted to sinus rhythm within 15 min (p<0.007 compared with Group A). CONCLUSIONS: The mechanism of AF after CABG is not well defined and is probably multifactorial. However, this study demonstrated that antagonism of the adenosine A1 receptor can promptly convert many of these patients back to sinus rhythm, and thereby implicates endogenously released adenosine in a mechanistic role for inciting early (<48 h) post-CABG AF.

Adenosine↗

PubMed2004

Surgically revascularized dual LAD.

Dual left anterior descending artery (or dual anterior interventricular artery, LAD) is a rare coronary artery anomaly. Dual but normally originated LAD has been usually reported to have no clinical significance. In this case report, we present a case of 75 year old male with anginal symptoms in whom coronary arteriography showed normally originated dual LAD with two branches of almost equal caliber. The course of both branches were supplying the usual territory of LAD and both of the branches had significant proximal stenosis. The patient underwent a coronary artery bypass grafting operation and both branches were grafted. This normally originated dual LAD case may be considered to be interesting, because dual LAD branches were symmetrically involved with the atherosclerotic process in their proximal segments. In addition, this condition was demonstrated intraoperatively and the two branches were revascularized with bypass grafting.

Aged↗

PubMed2004

Cardiotoxicity in rats induced by methidathion and ameliorating effect of vitamins E and C.

We have examined the effect of subchronic methidathion (MD) administration on heart damage, and have evaluated possible ameliorating effects of a combination of vitamins E and C against MD toxicity. The experimental groups were: control group, rats treated with 5 mg/kg MD and rats treated with 5 mg/kg body weight MD plus vitamin E and vitamin C (MD+Vit). The groups were given MD by gavage 5 days a week for four weeks at a dose level of 5 mg/kg/day (MD and MD+Vit) by using corn oil as the vehicle. Vitamin E and vitamin C were injected at doses of 50 mg/kg i.m. and 20 mg/kg i.p., respectively, after the treatment with MD in the MD+ Vit group. The levels of malondialdehyde (MDA) were determined in the heart tissue, and the levels of cardiac troponin I (TnI) in serum. An autoanalyser was used to determine the serum activities of cholinesterase (ChE). Histopathological examination was carried out in the heart tissue. MDA significantly increased in the MD group as compared to controls (P <0.01). When MD was given concurrently with vitamins E and C, the increase in MDA was significantly less (P <0.01). ChE activity significantly decreased in the MD group as compared to controls (P <0.01). When MD was given concurrently with vitamins E and C, the decrease in ChE activity was significantly higher (P <0.05). The serum TnI levels significantly increased in the MD group as compared to controls (P <0.01). When MD was given concurrently with vitamins E and C, the increase in the serum TnI was significantly less (P <0.01). MD caused the diffuse loss of striation and myocytolysis of the cardiomyocytes, whereas the combination of vitamins E and C caused a significant decrease in these effects of MD. In conclusion, subchronic MD administration caused heart damage and, in addition, treatment with a combination of vitamins E and C after the administration of MD reduced heart damage caused by MD.

Animals↗

PubMed2004

A case of mitral stenosis complicated with seronegative Brucella endocarditis.

Brucellosis is a multisystemic disease. The most common cause of death from the disease is endocarditis. The aortic valve is most commonly affected. The disease rarely involves the mitral valve. A 30 year-old woman presented with complaints of chills and fever up to 38 degrees C at night, fatigue, palpitations, and dyspnea for the previous 3 weeks. Cardiac auscultation revealed a diastolic murmur in the mitral area. Her temperature was 38.3 degrees C. On echocardiographic examination, the mitral valve area was 0.62 cm (2) and an isoechoic mass thought to be a vegetation was detected on the anterior mitral leaflet. A diagnosis of infective endocarditis was made and vancomycin administration was commenced. Brucella melitensis was isolated in all three blood samples, however, the patient remained seronegative with Brucella agglutination titers of up to 1/160. The antibiotic therapy was then shifted to doxycycline (200 mg/day), rifampicin (600 mg/day), and ciprofloxacin (1000 mg/day). After 30 days of treatment, surgery was performed for the severely stenotic mitral valve and to remove the vegetation. The operation was successful. The postoperative period was uneventful. On the follow-up she had no complaints. In cases with Brucella endocarditis, after diagnosis, antibiotic therapy must be started immediately and when the clinical condition improves, surgical intervention should be performed when indicated.

Adult↗

PubMed2002

Congenital cleft of anterior tricuspid leaflet in adolescent.

The diagnostic findings and treatment of an isolated congenital cleft of the anterior leaflet of the tricuspid valve in a 14-year-old boy are described. An atrial septal defect was closed by primary suturing, and the tricuspid valve was successfully reconstructed by De Vega annuloplasty.

Adolescent↗

PubMed2002

[The saphenous vein graft diseases].

Graft occlusions are the main problems that may arise during long-term follow-up period after coronary artery bypass surgery. Knowledge of pathologies developed in saphenous grafts and attempts to reduce their frequency are important for reduction of the incidence of saphenous graft vein occlusions. For today the patency rate for 10 years saphenous vein grafts are about 60%. Along with intraoperative technical factors, there are a lot of factors contributed to the development occlusion during long-term follow-up period. In this review we aimed to analyze the factors affecting saphenous vein pathologies and propose preventive measures.

Coronary Artery Bypass↗

PubMed2002

[Experiments on minimally invasive open heart surgery using right anterolateral minithoracotomy].

OBJECTIVE: Minimal invasive cardiac surgical techniques recently have been applied in the management of various cardiac lesions. The aim of the study was to evaluate right anterolateral minithoracotomy as an alternative procedure with a better cosmetic and clinical outcomes. METHODS: Fifteen male and 64 female patients underwent open heart surgery during cardiopulmonary bypass through a right anterolateral minithoracotomy at the fourth intercostal space. The average age was 41+/-6 years. Fifty-two (65.8%) patients underwent mitral valve replacement, 5 (6.3%) patients underwent mitral valve replacement + tricuspid annuloplasty, 5 (6.3%) patients underwent tricuspid valve replacement, 7 (8.9%) patients underwent closure of the atrial septal defect (ASD), 3 (3.8%) patients underwent closure of the ventricular septal defect (VSD), 1 (1.2%) patient underwent closure of the ASD+VSD and 5(6.3%) patients underwent mitral re-replacement. RESULTS: The postoperative average ventilation time was 6+/-2 h in 38 (48.1%) patients and 11+/-3 h in 41 (51.9%) patients. The postoperative average mediastinal drainage was 350+/-110 ml during first 24 hours, and postoperative stay in intensive care was 1.8+/-0.8 days. CONCLUSION: As a result, the right anterolateral minithoracotomy incision is a safe and effective alternative to the median sternotomy for open heart surgical procedures. Most of minimal surgical accesses can be achieved with better cosmetic results and faster recovery.

Adult↗

PubMed2002

Giant eustachian valve with echocardiographic appearance of divided right atrium.

The eustachian valve is an embryologic remnant of the valve of the inferior vena cava. It may be prominent in some individuals, but the echocardiographic appearance of a divided right atrium, as the consequence of a large eustachian valve, is extremely rare. Herein we describe an unusual giant eustachian valve with an echocardiographic appearance of a septal structure dividing the right atrium into 2 separate chambers. This abnormality should be differentiated from cor triatriatum dexter, a very rare cardiac malformation for which it could be mistaken.

Echocardiography↗

PubMedDate not supplied

Left atrial myxoma associated with acute myocardial infarction.

A 38-year-old male was admitted to our institution with left atrial myxoma complicated with acute myocardial infarction. The patient had no risk factor for coronary artery disease. A transthoracic echocardiographic study revealed the presence in the left atrium of an echogenic, mobile mass, compatible with myxoma. There were no endocrine hyperactivity, any other tumor and family history. Coronary angiography revealed normal coronary arteries and aorto-coronary bypass surgery was not required in this patient. The tumor was successfully removed surgically. In conclusion, there could be no other etiologic possibility identified and therefore left atrial tumor causing coronary embolization and MI was considered the most likely event in this patient.

Adult↗