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Biomedical subjects

Zehra Bayramoglu

Publications and source records attributed to Zehra Bayramoglu.

3 recordsLinked to original sources

Robotic-enhanced totally endoscopic mitral valve repair and ablative therapy.

PURPOSE: The aim of this article was to assess the feasibility of totally closed robotic mitral valve repair and ablative therapy. DESCRIPTION: Two patients with mitral valve disease and permanent atrial fibrillation underwent the combined procedure using the da Vinci robotic system (Intuitive Surgical, Sunnyvale, CA). Radiofrequency ablation was performed using the Cardioblate XL unipolar pen (Medtronic Inc, Minneapolis, MN). One patient underwent mitral commissurotomy and the other commissurotomy and Reed annuloplasty. EVALUATION: There were no procedure-related complications. Sinus rhythm was established in both patients after the operation, and transesophageal echocardiography revealed competent mitral valves without residual gradients. CONCLUSIONS: Robotic-enhanced mitral valve repair and ablation proved feasible in both patients with good clinical outcome. The described combined method may find broader application in a selected group of patients with the continuing evolution in technology.

Atrial Fibrillation↗

Combined off-pump coronary artery bypass grafting surgery and ablative therapy for atrial fibrillation: early and mid-term results.

BACKGROUND: The aim of this study was to evaluate the feasibility of off-pump coronary artery bypass grafting combined with radiofrequency ablation and to compare outcomes between patients with permanent and paroxysmal atrial fibrillation (AF) in terms of restoring sinus rhythm. METHODS: Thirty-three patients underwent the combined procedure. Mean age was 62.34 +/- 8.20 years; there were 12 female and 21 male patients. Twenty-one patients were diagnosed as permanent AF (group A) and 12 had paroxysmal AF (group B). After the off-pump revascularization patients underwent pulmonary vein ablation. Rhythm was evaluated at discharge and at 6 and 12 months' follow-up. Patients in stable sinus rhythm underwent transthoracic echocardiographic examination to evaluate atrial contractility at 6 and 12 months. RESULTS: There was no operative mortality or major complications. The mean ablation time was 11 +/- 3.4 minutes, including multiple applications. At the end of the procedure 84.5% of patients were free of AF. Sinus rhythm was established in 56% (group A, 52%; group B, 58.3%), 70.5% (group A, 58%; group B, 83.3%), and 71% (group A, 59%; group B, 83.3%) of patients at discharge and at 6 and 12 months, respectively (p = 0.249). Biatrial contractility was detected in 71% of group A and 76% of group B patients at 6 months' follow-up. More patients in group A returned to AF during follow-up when compared with group B (p = 0.016). Female sex (odds ratio, 2.1), chronic lung disease (odds ratio, 1.40), left ventricular disfunction (p = 0.016), and hypertension (odds ratio, 2.57) emerged as risk factors for AF recurrence after ablation. CONCLUSIONS: Concomitant off-pump coronary artery bypass grafting and bipolar radiofrequency ablation was safe and effective. These patients should be considered for adjunctive treatment at the time of off-pump revascularization.

Aged↗

Does off-pump CABG reduce gastrointestinal complications?

BACKGROUND: The aim of this study was to compare gastrointestinal complications and associated risk factors among patients undergoing cardiac surgery using off- and on-pump revascularization techniques. METHODS: A total of 1146 adult patients who underwent coronary artery surgery during a 6-year period were evaluated retrospectively. Group 1 consisted of 546 patients operated using off-pump techniques and group 2 consisted of 600 cases operated with cardiopulmonary bypass. Patients were compared and evaluated for gastrointestinal complications and possible associated risk factors using univariate and multivariate logistic regression analysis. RESULTS: Overall mortality was 1.6% in group 1 and 2.2% in group 2 (p = 0.523). Mortality due to gastrointestinal complications was 38.5% and 35.7% respectively in group 1 and group 2. The mean EuroSCORE value was 5.1 +/- 2.8 in group 1 and 3.8 +/- 2.4 in group 2 (p < 0.001). The most common gastrointestinal complication in the off-pump group was gastrointestinal bleeding. The leading complication in group 2 was intestinal ischemia. CONCLUSIONS: The incidence rates of gastrointestinal complications were similar in the on- and off-pump coronary artery bypass groups, the type of gastrointestinal complications, however, was different. Mortality rate due to these complications was also similar and remained high, regardless of the type of surgery. Cardiopulmonary bypass did not emerge as a risk factor for gastrointestinal complications, but prolonged cardiopulmonary bypass (longer than 98 minutes) resulted in a high incidence of such complications. Old age and advanced arteriosclerosis emerged as risk factors in both groups resulting in gastrointestinal complications suggesting the ischemic nature of the injury.

Aged↗