Browsing by Author "Aygun, Fatih"

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Association of neutrophil/lymphocyte ratio with obstructive coronary artery disease and coronary artery calcium score detected by multislice computed tomography in type 2 diabetes mellitus patients
(2015) Aygun, Fatih; Efe, Duran; 26229449
Objective: The aim of the present study was to investigate the association of neutrophil/lymphocyte ratio (NLR) with coronary artery calcium score (CACS) and obstructive coronary artery disease (CAD) detected by multislice computed tomography (MSCT) angiography in type 2 diabetes mellitus (T2DM) patients. Methods: Two hundred and ninety-two T2DM patients, who were either asymptomatic or symptomatic (but noncharacteristic) for coronary artery disease (CAD) and underwent MSCT angiography in our clinic between May 2009 and June 2014, were enrolled. All patients were divided into two groups according to their mean NLR values. Patients with NLR. 2.05 were assigned to Group 1 and patients with NLR. 2.05 were assigned to Group 2. The association of NLR with CACS and obstructive CAD, which were detected by MSCT angiography, was investigated in T2DM patients. Results: According to the Agatston scoring method, the mean CACS was 129.5 +/- 209.8 Au in Group 1 and 290.3 +/- 399.6 Au in Group 2 (P<0.001). Obstructive CAD was detected in 40 (26.8%) patients in Group 1 and in 56 (39.2%) patients in Group 2 (P<0.05, P=0.021). Conclusion: The rate of obstructive CAD was significantly higher in the T2DM patients with NLR. 2.05 than that in the T2DM patients with NLR. 2.05. In addition, the CACS was also significantly higher in the T2DM patients with NLR. 2.05 than that in the T2DM patients with NLR. 2.05.
Comparison of Surgical Techniques Used in Ventricular Septal Defect Closure
(2023) Celik, Mehmet; Aygun, Fatih; Gunaydin, Asim Cagri; Gokdemir, Mahmut; Cindik, Nimet; 0000-0002-5018-0068; 36592069; AAT-2031-2021
Introduction: We compared transatrial closure, tricuspid valve septal detachment, and tricuspid valve chordal detachment techniques for ventricular septal defect (VSD) closure. Methods: Patients who had VSD closure with three different techniques in our clinic between September 2016 and December 2020 were retrospectively reviewed. A total of 117 patients were included in the study. The patients were divided into three groups: group 1, classical transatrial closure; group 2, closure with tricuspid valve septal detachment; and group 3, closure with tricuspid valve chordal detachment. The groups were evaluated by serial transthoracic echocardiography (preoperative, postoperative 1st day, postoperative 1st month). Cardiac rhythm checks and recordings were performed. Results: No residual VSD was observed in early or late periods in any of the groups whose VSD closure was performed with the three different techniques. No severe tricuspid regurgitation (TR) was detected during the early and late postoperative periods of all operating procedures. When the groups were compared in terms of early/late TR after the operation (without TR+trace amount of TR and mild TR+moderate TR were compared), no statistically significant difference was found (P>0,05; P=0,969 and P>0,05; P=0,502). Conclusion: In this study, we found no statistically significant difference between three VSD closure techniques in terms of early TR, late TR, residual VSD, and permanent atrioventricular complete block during postoperative period. We hope that our results will be supported by the results of researches that are being made about this subject in large series.
Effect of L-arginine on Hemodynamic, Biochemical, and Histopathological Outcomes in a New Zealand Rabbit Model of Renal Ischemia-Reperfusion Injury
(2016) Ozulku, Mehmet; Aygun, Fatih
Objective: In this study, we investigated the effect of L-arginine on hemodynamic, biochemical, and histopathological changes in a rabbit model with renal ischemia. Methods: Forty white New Zealand rabbits were used. The rabbits were divided into two groups as the control group (n=20) and L-arginine group (n=20). They were monitored by cannulating the auricular and femoral arteries. An aortic occlusion catheter was inserted through the contralateral femoral artery and was extended to the distal aspect of the left subclavian artery; it was then inflated, and occlusion was performed for 30 min. All rabbits received 4 mL/kg/h of NaCl infusion during the course of occlusion and within the first 60 min of reperfusion. In the L-arginine group, L-arginine was infused at a dosage of 3 mg/kg/h through the auricular vein during the first 60 min of occlusion and perfusion. Blood samples for biochemical parameters [glucose, lactate, hematocrit, blood urea nitrogen (BUN), and serum creatinine] were obtained in the peri-ischemic period, in the 20th minute of reperfusion, and just before sacrificing (48th hour). A histopathological examination was performed in both renal tissues. Histopathological scoring was performed by taking tubular epithelial cell flattening, brush border loss, cytoplasmic vacuolization, cell necrosis, and tubular lumen obstruction into consideration. All animals were sacrificed 48 h after the procedure. Results: A significant difference was found between the L-arginine and control groups in terms of the hemodynamic outcomes and 48th hour BUN and serum creatinine levels (p<0.05). The histopathological examination revealed a mean score of 3.2 +/- 0.89 in the control group and 2.60 +/- 0.68 in the L-arginine group (p<0.05) (p=0.022). Conclusion: It can be suggested that L-arginine reduces renal ischemia-reperfusion injury and in particular, the histopathological effects.
Effect of LIMA Harvesting Technique on Postoperative Drainage in Off-Pump CABG
(2016) Ozulku, Mehmet; Aygun, Fatih; 27556310
Objective: We investigated the effects of pedicled and semiskeletonized left internal mammary artery (LIMA) harvesting techniques on postoperative drainage in patients subjected to off-pump CABG, ignoring other advantages or disadvantages of those techniques. Methods: The present study comprises a total of 160 subjects that underwent coronary artery bypass surgery in our clinic. Data were collected consecutively and retrospectively. An attempt was made to have similar groups in terms of demographic characteristics. Patients that underwent off-pump coronary artery bypass surgery by two surgical teams which differed only in LIMA harvesting technique were dichotomized and compared according to these techniques. The first group (Group 1) consisted of patients in whom LIMA was harvested with surrounding tissues using the pedicled technique. The second group (Group 2) consisted of patients in whom LIMA was harvested using the semiskeletonized technique, with the veins separated from surrounding connective tissues. Results: The mean amount of drainage in the first 24 hours was 706.1 +/- 234.2 ml vs. 591 +/- 258.8 ml (Group 1 vs. Group 2; P=0.005), the mean amount of drainage in the second 24 hours was 270 +/- 133.6 ml vs. 189.4 +/- 140.4 ml (Group 1 vs. Group 2; P < 0.001), and the mean amount of total drainage was determined to be 976.1 +/- 306.9 ml vs. 781.2 +/- 335.5 ml (Group 1 vs. Group 2; P < 0.001). Conclusion: It was observed that semiskeletonized LIMA presents reduced amount of postoperative drainage in the first and second 24-hour periods and total amount of drainage than pedicled LIMA, independent of pleural integrity.
Effect of using pump on postoperative pleural effusion in the patients that underwent CABG
(2015) Ozulku, Mehmet; Aygun, Fatih; 27163421
Objective: The present study investigated effect of using pump on postoperative pleural effusion in patients who underwent coronary artery bypass grafting. Methods: A total of 256 patients who underwent isolated coronary artery bypass grafting surgery in the Cardiovascular Surgery clinic were enrolled in the study. Jostra-Cobe (Model 043213 105, VLC 865, Sweden) heart-lung machine was used in on-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting was performed using Octopus and Starfish. Proximal anastomoses to the aorta in both on-pump and off-pump techniques were performed by side clamps. The patients were discharged from the hospital between postoperative day 6 and day 11. Results: The incidence of postoperative right pleural effusion and bilateral pleural effusion was found to be higher as a count in Group 1 (on-pump) as compared to Group 2 (off-pump). But the difference was not statistically significant [P>0.05 for right pleural effusion (P=0.893), P>0.05 for bilateral pleural effusion (P=0.780)]. Left pleural effusion was encountered to be lower in Group 2 (off-pump). The difference was found to be statistically significant (P<0.05, P=0.006). Conclusion: Under the light of these results, it can be said that left pleural effusion is less prevalent in the patients that underwent off-pump coronary artery bypass grafting when compared to the patients that underwent on-pump coronary artery bypass grafting.
Effects of Cardiopulmonary Bypass on Mediastinal Drainage and the Use of Blood Products in the Intensive Care Unit in 60-to 80-Year-Old Patients Who Have Undergone Coronary Artery Bypass Grafting
(2015) Aygun, Fatih; Ozuklu, Mehmet; Gunday, Murat; 26934397
Objective: The present study consisted of patients who underwent on-pump coronary artery bypass grafting (CABG) and off-pump CABG and investigated effect of using cardiopulmonary bypass (CPB) on the amount of postoperative drainage and blood products, red blood cell (RBC), free frozen plasma (FFP) given in the intensive care unit in 60-80-year-old patients who underwent CABG. Methods: The present study comprises a total of 174 patients who have undergone coronary artery bypass graft (off-pump or on-pump CABG) surgery in our clinic in between 2012-2015 year. Results: It was observed that the amount of drainage in the first 24 postoperative hours was lower in the on-pump CABG group (Group 1) when compared to off-pump group (Group 2) (Group 1 vs. Group 2; 703.5 +/- 253.8 ml vs. 719.6 +/- 209.4 ml; P=0.716). However, the amount of drainage in the second 24 hours was statistically significantly lower in the off-pump CABG group (Group 1 vs. Group 2; 259.8 +/- 170.6 ml vs. 190.1 +/- 129.1 ml; P=0.016). With regard to the amount of overall drainage, no statistically significant difference was observed between the two groups. Group 1 needed RBC transfusion higher than Group 2 (Group 1 vs. Group 2; 2.2 +/- 1.3 bag vs. 1.2 +/- 0.9 bag; P<0.001). Conclusion: We can say that CPB influences the amount of second 24-hour drainage which indexed body surface area. In addition, CPB decreases hct, hb, thrombocyte count in ICU arrived, after 24 hours in postoperative period. Reduced thrombocyte counting effect can be appeared after 48 hours in the postoperative period of CPB.
Investigation of Relation Between Visceral and Subcutaneous Abdominal Fat Volumes and Calcified Aortic Plaques Via Multislice Computed Tomography
(2015) Efe, Duran; Aygun, Fatih; Acar, Turker; Yildiz, Melda; Gemici, Kazim; 0000-0002-9060-2691; 25245049; P-7416-2014; P-5653-2014
Objective: The present study investigated effect of subcutaneous fat volume and abdominal visceral fat volume on aortic atherosclerosis via multislice computed tomography. Materials and methods: The present study comprised 424 subjects who underwent non-contrast-enhanced abdominal CT in our clinic between June 2012 and June 2013. Using dedicated software visceral fat volume was calculated for each individual and then subcutaneous fat volume was calculated by subtracting visceral fat volume from total fat volume. By dividing visceral fat volume/subcutaneous fat volume participants were assigned to three groups according to their mean visceral fat volume/subcutaneous fat volume: Group 1 consisted of subjects with visceral fat volume/subcutaneous fat volume lower than 0.48 (Group 1< 0.48); Group 2 consisted of subjects with visceral fat volume/subcutaneous fat volume equal to or higher than 0.48 and lower than 0.69 (0.48 <= Group 2< 0.69); and Group 3 consisted of subjects with visceral fat volume/subcutaneous fat volume equal to or higher than 0.69 (Group 3 >= 0.69). Results: The mean abdominal aortic calcium scores according to Agatston scoring (au) were 136.8 +/- 418.7 au in Group 1, 179.9 +/- 463 au in Group 2 and 212.2 +/- 486.9 in Group 3, respectively. Conclusions: We have demonstrated a significant correlation between visceral fat volume and abdominal aorta atherosclerosis, while there was absence of significant correlation between subcutaneous fat volume and abdominal atherosclerosis.
New Approach in Stage 1 Surgery for Hypoplastic Left Heart Syndrome: Preliminary Outcomes
(2023) Celik, Mehmet; Gokdemir, Mahmut; Cindik, Nimet; Gunaydin, Asim C.; Aygun, Fatih; Ozkan, Murat; 0000-0002-5018-0068; 0000-0002-5676-2747; 36004405; AAT-2031-2021; N-4174-2014
Objectives: We present the short-term results of an alternative method in stage 1 surgery for hypoplastic left heart syndrome. Methods: Data of 16 consecutive patients who were treated with the novel method in our clinic between February 2019 and March 2021 were analysed retrospectively. Preoperative data and postoperative follow-up were recorded. Results: Of the 16 operated patients, 12 were diagnosed with hypoplastic left heart syndrome, while four were diagnosed with hypoplastic left heart syndrome variants. Seven patients died during early postoperative period. One patient died at home waiting stage 2 surgery. Three patient underwent stage 2 surgery. Pulmonary artery reconstruction was performed in one patient due to left pulmonary artery distortion. Conclusions: We believe that our method can be an effective alternative in the surgery of hypoplastic left heart syndrome and its variants. It is hoped that with increasing number of studies and more experience better outcome will be achieved.
Sternotomy with electrocautery and sternal wound infection in congenital heart surgery in patients under 1 year of age
(2021) Celik, Mehmet; Aygun, Fatih; Ozkan, Murat; 33896040
Objective The present study aimed to compare the rate of wound site infection in patients <1 year of age who underwent sternotomy using electrocautery, a routinely performed procedure in our clinic, with those reported in the literature. Methods This double-center study included patients In our study, seven patients developed SSI, which was superficial in six (1.3%) patients and in the form of mediastinitis in one (0.2%) patient. Conclusion Sternotomy with electrocautery, which we consider an easy and safe method, was also not found to be statistically different from the other methods in terms of SWI.