PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12469/4466
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Browsing PubMed İndeksli Yayınlar Koleksiyonu by Institution Author "Akpınar, Belhhan"
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Article Citation - Scopus: 26Effects of Intravenous Triiodothyronine During Coronary Artery Bypass Surgery(Asia Publishing Exchange Pte Ltd, 2002) Güden, Mustafa; Akpınar, Belhhan; Sağbaş, Ertan; Sanisoğlu, İlhan; Cakali, Emine; Bayındır, OsmanA prospective randomized and double-blind study was performed to evaluate whether perioperative triiodothyronine administration has any effect on cardiovascular performance after coronary artery bypass surgery. Sixty patients were assigned to 2 groups of 30 each. When crossclamping ended group A received an intravenous bolus of triiodothyronine followed by infusion for 6 hours. Group B received a placebo. Serum triiodothyronine levels and hemodynamic parameters were serially measured. Mean postoperative cardiac index was slightly but not significantly higher in group A whereas systemic vascular resistance was significantly lower in group A. Compared with preoperative values serum triiodothyronine levels dropped significantly in group B at the end of cardiopulmonary bypass and remained low 12 hours postoperatively while levels rose significantly in group A. No significant differences were detected between the groups in the incidence of arrhythmia the need for inotropic support intensive care unit stay mortality and morbidity. Perioperative administration of triiodothyronine increased cardiac output slightly and decreased systemic vascular resistance but it had no effect on operative outcome. Routine use after coronary surgery is thus not recommended.Article Citation - Scopus: 21Left Versus Bi-Atrial Intraoperative Saline-Irrigated Radiofrequency Modified Maze Procedure for Atrial Fibrillation(2003) Güden, Mustafa; Akpınar, Belhhan; Çaynak, Barış; Türkoğlu, Çavlan; Özyedek, Zeki; Sanisoğlu, İlhan; Sağbaş, Ertan; Aytekin, Saide; Oztekin, Seher DenizBackground: This study was conducted to evaluate the effectiveness of the saline-irrigated radiofrequency modified maze operation for the treatment of chronic atrial fibrillation (AF) and compare the results of the left and bi-atrial procedures. Material and method: During a period of two years 105 patients with chronic AF having concomitant cardiac surgery underwent the procedure. Patients underwent either a bi-atrial (n = 48) or left atrial (n = 57) maze procedure. The first twenty patients underwent a bi-atrial maze procedure regardless of the pathology. In the following patients we adopted the bi-atrial approach in patients with a history of atrial flutter and where the right atrium has to be opened. Otherwise the procedure is restricted to the left atrial side. Mean age was 52 ± 11 years in bi-atrial group and 54 ± 9 years in left atrial group. Results: Three patients died early postoperatively (2.9%). There were 4 revisions for bleeding (3.8%). Two patients in bi-atrial group received a permanent pacemaker (4.1%). Patients in both groups were free of AF at the end of the procedure. (Bi-atrial group: sinus: 79.2% pacemaker: 20.8%) (Left atrial group: sinus: 82.5% pacemaker: 17.5%) (p > 0.05). During the last follow-up sinus rhythm was maintained in 79.6% of cases in bi-atrial group while this rate was 75.6% in left atrial group (p > 0.05). Conclusion: Saline irrigated radiofrequency modified maze procedure was performed safely and efficiently. Both the left and bi-atrial procedures were successful in terms of restoring sinus rhythm. Our current policy is to adopt the bi-atrial approach in patients with a history of atrial flutter and where the right atrium has to be opened. Otherwise the procedure is restricted to the left atrial side. © 2003 Kluwer Academic Publishers.Article Citation - WoS: 17Off-Pump Coronary Artery Bypass Grafting With Use of the Octopus 2 Stabilization System(2000) Akpınar, Belhhan; Güden, Mustafa; Sağbaş, Ertan; Sanisoğlu, İlhan; Aytekin, Vedat; Bayındır, OsmanBackground: The treatment of coronary artery disease has evolved rapidly over the last two decades. The gold standard of surgical revascularization, the on-pump coronary artery bypass graft, has been challenged by the development of percutaneous transluminal coronary angioplasty. Our experience with the alternative of the off-pump ("beating heart") coronary artery bypass (OPCAB) technique during a period of 18 months suggests that OPCAB avoids the complications of cardiopulmonary bypass and offers patients the benefit of long-term graft patency that greatly exceeds that of current endovascular technologies. Methods: The early results of 126 OPCAB procedures performed through a medial sternotomy incision during a period of 18 months were evaluated. There were 80 male and 46 female patients, with a mean age of 69 +/- 4.3 years. Emergency cases and reoperations were not included. A total of 268 anastomoses were performed, with a mean number of 2.12 anastomoses per patient. Conduits used, with their percentage of use, were: left internal thoracic artery (LITA) (100%), right internal thoracic artery (11.1%), greater saphenous vein (84%), and radial artery (31%). In 72% of the cases, off-pump surgery was chosen because of patient risk factors such as atherosclerotic aortic disease, previous cerebrovascular accident or carotid artery disease, renal dysfunction, malignancy or poor left ventricular function. Results: There was no operative mortality. One-month postoperative mortality was three patients (2.3%). Two died because of mesenteric ischemia, and the other death was due to cardiac failure. Seventy-one patients had a control angiogram before discharge. The patency of LITA anastomosis was 100% while overall patency rate was 95%. In 43 patients for whom an angiogram could not be performed, a Thallum 201 stress test was performed three months postoperatively. Thirty-eight patients had a normal test while five patients showed signs of ischemia. These patients had a control angiogram: in four patients anastomoses were patent, but in one patient there was a severe narrowing of a venous anastomosis to the distal right coronary artery (RCA) which was corrected with angioplasty. In the whole series eight patients (6.3%) refused to have any control examination. Conclusions: Our early results suggest that off-pump CABG with Octopus 2 (Medtronic, Inc., Minneapolis, MN) can be a good alternative in high risk patients who need multiple vessel revascularization.Article Citation - WoS: 8Citation - Scopus: 9A Radiofrequency modified maze and valve procedure through a port-access approach(Forum Multimedia Publishing LLC., 2003) Güden, Mustafa; Akpınar, Belhhan; Sağbaş, Ertan; Sanisoğlu, İlhan; Ergenoğlu, Mehmet U.; Özbek, UğurBackground: The aim of the study was to assess the feasibility and effectiveness of the irrigated radiofrequency modified maze procedure through a port-access approach during mitral valve surgery. Methods: Forty-three patients with atrial fibrillation (AF) and mitral valve disease underwent a combined procedure through a port-access approach. The indication was a history of continuous AF for more than 6 months in patients eligible for minimally invasive mitral valve surgery. Results: The incidence of early mortality was 1 patient (2.3%) and that of freedom from AF was 100% at the end of the operation (70% of patients with normal sinus rhythm 30% with a pacemaker). One patient (2.3%) required permanent pacemaker implantation after surgery. One patient (2.3%) required reoperation for bleeding. There were no reoperations for failed valve repairs. The incidences of freedom from AF were 87% and 92% at 6 and 12 months respectively. At 12 months functional capacity had improved significantly (P < .05). There were no procedure-related complications. No thromboembolic events were detected during follow-up. Conclusion: The port-access approach provided a good access for both valve surgery and the radiofrequency maze procedure. The combination of direct and videoscopic vision allowed an adequate view and led to a safe and efficient combined procedure. Short- and intermediate-term follow-up results were favorable.Article Citation - Scopus: 1Screening of a Stentless Valve With Electron Beamed Tomograpy 5 Years After Operation(2001) Akpınar, Belhhan; Güden, Mustafa; Memişoğlu, Esat I.[Abstract Not Available]Article Citation - Scopus: 5The Surgical Treatment of Atrial Fibrillation [atriyal Fibrilasyonun Cerrahi Tedavisi](2007) Akpınar, Belhhan; Sağbaş, Ertan; Güden, Mustafa; Sanisoğlu, İlhanThe surgical treatment of atrial fibrillation (AF) has entered a new era with the development of new tools and advanced techniques. The Maze III operation remains as the gold standard for the surgical treatment of AF. However new energy sources have been adopted for treating this arrhythmia in an effort to reduce the invasiveness and technical concerns with the original procedure. Success rates ranging between 70-98% have been reported using these new techniques. On the other hand interventional cardiologists have further improved their techniques so that percutaneous techniques are competing with minimally invasive ablation techniques for the treatment of drug resistant and symptomatic lone AF. These developments have aroused the interest of cardiac surgeons in AF surgery and have found themselves a wide application. It has been estimated that thirty thousand patients have undergone surgical ablation for AF so far. Inevitably procedure related complications have occurred and caused skepticism by some groups. However surgical ablation has become a widely accepted treatment modality for AF patients undergoing concomitant cardiac surgery. The aim of this text is to make an overall review of the surgical treatment of AF and evaluate the current situation in view of the literature and the personal experience of the authors.Article Citation - Scopus: 4The use of autologous pericardium for complicated mitral valve annulus(Asia Publishing Exchange Pte Ltd, 2004) Güden, Mustafa; Kazimoğlu, Kamran; Sanisoğlu, İlhan; Sağbaş, Ertan; Yaman, Reşit; Akpınar, BelhhanThe study aims to discuss annular repair using the autologous pericardial patch in cases with severe mitral ring calcification and endocarditis during mitral valve replacement. In the study annular reconstruction was applied during mitral valve replacement to 8 patients who had extensive annular calcification or annular destruction due to endocarditis. After annular resection a two-centimeter wide autologous pericardial patch was sutured continuously to the left ventricular wall close to the posterior annulus. After the valve sutures with pledgets were placed at the back of the pericardial patch the other edge of the patch was sutured continuously to the left atrial posterior wall. Suturing was complete after the whole annulus was encircled. Thereafter an appropriately sized mechanical prosthesis valve was used. One patient died postoperatively due to low cardiac output (early mortality 12.5%). Echocardiographical paravalvular leakage was not detected in any of the cases during follow-up. Annular dehiscence and other annular pathologies were also not detected. This reconstructive approach may positively influence mortality and morbidity in cases with complicated mitral pathologies.Article Citation - WoS: 23Citation - Scopus: 32The Use of the 5-Ht3 Antagonist Ondansetron for the Treatment of Postcardiotomy Delirium(W.B. Saunders Co Ltd, 2000) Bayındır, Osman; Akpınar, Belhhan; Can, Erol; Güden, Mustafa; Sönmez, Bingür; Demiroğlu, CemşidObjective:To evaluate the effect of the 5-HT3-receptor antagonist ondansetron in patients with postcardiotomy delirium. Design: Prospective study. Setting: University hospital. Participants: Thirty-five patients who had undergone coronary artery bypass graft surgery. Interventions: Thirty-five patients 23 men and 12 women who developed delirium in the intensive care unit after coronary artery bypass graft surgery were included. Mean patient age was 51.3 years (range 36 to 79 years). A mental status scoring scale was developed and patients were scored 0 to 4 according to their delirium status after confirming that there were no correctable metabolic abnormalities as an underlying cause for delirium. Normal behavior was scored as 0 and severe verbal and physical agitation was scored as 4. Patients received a single dose of ondansetron 8 mg intravenously and were reevaluated 10 minutes later. Measurements and Main Results: Before the treatment 7 patients had a score of 2 (20)
