Browsing by Author "Gultekin, Bahadir"

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A Comparison of Two Coronary Artery Bypass Graft Surgery Techniques with Respect to Acute Kidney Injury
(2015) Beyazpinar, Deniz Sarp; Gultekin, Bahadir; Kayipmaz, Afsin Emre; Kayipmaz, Cagri; Sezgin, Atilla; Giray, Tufan Akin; Kavalci, Cemil; 0000-0003-2529-2946; 0000-0003-4619-4034; AAC-2597-2020; AGG-1308-2022; ABA-7388-2021; ABA-9675-2021; AGQ-5015-2022
Background: This study aims to compare the conventional coronary artery bypass graft (CABG) surgery and on-pump beating heart bypass grafting (OPBHB) with respect to acute kidney injury and subsequent dialysis requirement. Methods: Between January 2012 and October 2013, medical records of 77 patients who underwent conventional CABG and 76 patients who underwent OPBHB for coronary artery disease in our clinic were retrospectively analyzed. Results: There was no significant difference in preoperative renal function test results between the groups. However, there was a significant difference in cardiopulmonary bypass time and length of intensive care unit stay (p<0.05). Seven (9.21%) of 76 patients in OPBHB group and 11 (14.28%) of 77 patients in CABG group developed acute kidney injury; however, it did not indicate a statistically significant difference between the groups (p>0.05). One patient in OPBHB group and four patients in CABG group also needed dialysis. Conclusion: Our study results suggest that OPBHB is superior to the conventional CABG in terms of acute kidney injury and, more importantly, development of acute renal failure in patients with a serum creatinine level of 1-1.3 mg/dL.
Decompression of Left Ventricle During Venoarterial Extracorporeal Membrane Oxygenation Support as a Step to Transplant
(2016) Gultekin, Bahadir; Ersoy, Ozgur; Akkaya, Ilknur; Kayipmaz, Cagri; Pirat, Aras; Sezgin, Atilla; 27805509; ABA-7388-2021
Objectives: Left ventricular distention can be recognized during the use of venoarterial extracorporeal membrane oxygenation as a key complication. Left ventricular decompression may decrease pulmonary pressure, minimize ventricular distention, and allow myocardial recovery. Materials and Methods: We applied venoarterial extracorporeal membrane oxygenation to 4 patients while on a wait list for cardiac transplant. Results: Two patients with severe heart failure developed high end-diastolic pressures leading to left ventricular distention. We used atrial venting methods to decrease the pressure. Conclusions: Here, we discussed the strategies to manage ventricular distention by conservative, interventional, and surgical means.
Diagnosis and Treatment of Takayasu Arteritis in Turkey: A Single Center Results
(2015) Akay, Tankut; Harman, Ali; Yucel, Eftal; Ozyer, Umut; Gultekin, Bahadir; 0000-0002-4300-009X; 0000-0002-7386-7110; AAK-9071-2021; ABA-7388-2021; K-9824-2013
Background: This study aims to evaluate clinical, laboratory, and radiological features as well as the surgical and endovascular procedure outcomes of patients with Takayasu arteritis in our hospital. Methods: Hospital records of 38 patients who were followed with the diagnosis of Takayasu arteritis between April 2002 and January 2014 were retrospectively evaluated. Records included the clinical history of Takayasu arteritis, comorbid diseases, laboratory and angiographic findings at the time of diagnosis, and mode of treatment. Results: The female/male ratio was 3.75:1. According to angiographic classification; 11 patients were type 1, three patients were type 2a, three patients were type 2b, four patients were type 3, six patients were type 4, and 11 patients were type 5. Eighteen of 38 patients were administered endovascular or surgical intervention (8 surgeries and 10 endovascular procedures). There was no early mortality. Conclusion: Demographic and angiographic features of our patients were similar to those of Japan and Mediterranean populations. The long-term follow-up of endovascular procedure success, and the management of restenosis may be among challenges to be faced in the future. Bypass surgery remains the gold standard for achieving long-term patency. Endovascular treatment may provide short-term symptom relief in patients who are not suitable for surgical treatment.
Diagnostic Impact of Quantitative Dual-Energy Computed Tomography Perfusion Imaging for the Assessment of Subsegmental Pulmonary Embolism
(2021) Celtikci, Pinar; Hekimoglu, Koray; Kahraman, Gokhan; Bozbas, Serife; Gultekin, Bahadir; Akay, Hakki Tankut; 0000-0002-1655-6957; 0000-0002-0805-0841; 33186173; AAD-9097-2021; ABA-7388-2021
Objective The aim of this study was to investigate the quantitative differences of dual-energy computed tomography perfusion imaging measurements in subsegmental pulmonary embolism (SSPE), between normal lung parenchyma (NLP) and hypoperfused segments (HPS) with and without thrombus on computed tomography angiography (CTA). Methods Lung attenuation, iodine density, and normalized uptake values were measured from HPS and NLP on iodine maps of 43 patients with SSPE. Presence of pulmonary embolism (PE) on CTA was recorded. One-way repeated-measures analysis of variance and Kruskal-Wallis analyses with post hoc comparisons were conducted. Results The numbers of HPS with and without SSPE on CTA were 45 (55.6%) and 36 (44.4%), respectively. Lung attenuation of NLP was significantly different from HPS (P < 0.001). Iodine density and normalized uptake values of HPS with PE were significantly lower than those of HPS without PE, which is significantly lower than NLP (P < 0.001). Conclusions Subsegmental pulmonary embolism causes HPS on dual-energy computed tomography perfusion imaging, which demonstrates different iodine density and normalized uptake values depending on the presence of thrombus.
Effect of Left Ventricular Assist Devices on Red Blood Cell Distribution Width
(2015) Ersoy, Ozgur; Gultekin, Bahadir; Ozkan, Murat; Akkaya, Ilknur; Umaroglu, Sevi; Sezgin, Atilla; 26640934; ABA-7388-2021
Objectives: Red blood cell distribution width is a measure of the variability in the size of circulating erythrocytes, which is calculated by automated blood cell counters as part of a routine blood cell count analysis. Our aim was to examine whether continuous flow left ventricular assist devices affected red blood cell distribution width. Materials and Methods: Our study included 16 of 24 patients who received a HeartWare HVAD Pump (HeartWare Inc, Framingham, MA, USA) implant (continuous flow left ventricular assist device) between April 2012 and February 2015 at our institution. The mean age of the patients was 46.6 years. We compared patient erythrocyte, leucocyte, and platelet counts, hemoglobin and hematocrit levels, mean corpuscular volume, and red blood cell distribution width values before and 6 months after implant. Results: Hemoglobin level (P=.008), hematocrit level (P=.027), and mean corpuscular volume (P=.003) were significantly decreased; however, we observed no significant change in red blood cell distribution width. Conclusions: Although we did not find significant results in our group of patients with left ventricular assist device implant, a larger group of patients may show more significant results, and an increase in red blood cell distribution width can be used as an indicator of a negative prognosis in these patients.
The effects of a low international normalized ratio on thromboembolic and bleeding complications in patients with mechanical mitral valve replacement
(2014) Bal, Ugur; Aydinalp, Alp; Yilmaz, Kerem; Ozcalik, Emre; Hasirci, Senem; Atar, Ilyas; Gultekin, Bahadir; Sezgin, Atilla; Muderrisoglu, Haldun
Background: Mechanical heart valve replacement has an inherent risk of thromboembolic events (TEs). Current guidelines recommend an international normalized ratio (INR) of at least 2.5 after mechanical mitral valve replacement (MVR). This study aimed to evaluate the effects of a low INR (2.0-2.5) on thromboembolic and bleeding complications in patients with mechanical MVR on warfarin therapy. Methods: One hundred and thirty-five patients who underwent mechanical MVR were enrolled in this study. The end points of this study were defined as TEs (valve thrombosis, transient ischemic attack, stroke) and bleeding (all minor and major bleeding) complications. Patients were followed up for a mean of 39.6 months and the mean INR of the patients was calculated. After data collection, patients were divided into 3 groups according to their mean INR, as follows: group 1 (n = 34), INR < 2.0; group 2 (n = 49), INR 2.0-2.5; and group 3 (n = 52), INR > 2.5. Results: A total of 22 events (10 [7.4%] thromboembolic and 12 [8.8%] bleeding events) occurred in the follow-up period. The mean INR was an independent risk factor for the development of TEs. Mean INR and neurological dysfunction were independent risk factors for the development of bleeding events. A statistically significant positive correlation was found between the log mean INR and all bleeding events, and a negative correlation was found between the log mean INR and all TEs. The total number of events was significantly lower in group 2 than in groups 1 and 3 (P = 0.036). Conclusions: This study showed that a target INRs of 2.0-2.5 are acceptable for preventing TEs and safe in terms of bleeding complications in patients with mechanical MVR.
HLA Sensitization in End-Stage Heart Failure Patients Supported By Extracorporeal Membrane Oxygenation
(2018) Aliyev, Anar; Ersoy, Ozgur; Gultekin, Bahadir; Beyazpinar, Sarp; Basturk, Bilkay; Sezgin, Atilla; Aslamaci, Sait; 0000-0002-8784-1974; ABA-7388-2021; AAD-6918-2021
Impact of Renal Injury on Survival Following Left Ventricular Assist Device
(2018) Beyazpinar, Sarp; Ersoy, Ozgur; Gultekin, Bahadir; Sezgin, Atilla; Aslamaci, Sait; ABA-7388-2021
Incidence and Outcomes of Acute Kidney Injury After Orthotopic Cardiac Transplant: A Population-Based Cohort
(2015) Gultekin, Bahadir; Beyazpinar, Deniz Sarp; Ersoy, Ozgur; Ozkan, Murat; Akay, Hakki Tankut; Sezgin, Atilla; 26640905; ABA-7388-2021; ABA-9675-2021
Left Ventricular Assist Device Management Strategy
(2018) Ersoy, Ozgur; Gultekin, Bahadir; Beyazpinar, Sarp; Sade, Elif; Sezgin, Atilla; Aslamaci, Sait; ABA-7388-2021
Left Ventricular Assist Device Results: Single Center Experience
(2015) Gultekin, Bahadir; Ersoy, Ozgur; Ozkan, Murat; Akkaya, Ilknur; Umaroglu, Sevi; Sezgin, Atilla; 26640938; ABA-7388-2021
Objectives: The number of patients with end-stage cardiac failure who are waiting for transplant has been increasing, although number of heart donations stays limited. This has resulted in an increased use of left ventricular assist devices. Here, we present results of patients who received left ventricular assist device implants at Baskent University Ankara Hospital. Materials and Methods: We retrospectively evaluated 24 patients who received a HeartWare left ventricular assist device (HeartWare Inc, Framingham, MA, USA) between April 2012 and February 2015; 2 patients (8.33%) were female. Results: Patients had end-stage heart failure as a result of the following causes: 11 patients (45%) had ischemic cardiomyopathy, 12 patients (50%) had dilated cardiomyopathy, and 1 patient (4.1%) had acute myocarditis. Regarding use of the left ventricular assist device, 10 patients (41.6%) had the device as destination therapy, and the remaining 14 patients (48.6%) had it as bridge to transplant. The Interagency Registry for Mechanically Assisted Circulatory Support Profile was 1 for 3 patients (12.5%), 2 for 9 patients (37.5%), and 3 for 12 patients (50%). Mean follow-up was 239.8 days, and the mortality rate was 33.3% (8 patients died). During follow-up, we found that 3 patients (12.5%) had received a heart transplant and 1 patient (4.1%) eventually recovered, with the device extracted. Six patients had driveline infections, and 3 patients had cerebrovascular events. Conclusions: With the insufficient number of cardiac donors, use of a left ventricular assist device for patients with end-stage cardiac failure who are awaiting transplant may be the best option.
Low Molecular Weight Heparine As Alternative Anticoagulation Therapy in Patients with Left Ventricular Assist Devices
(2016) Ersoy, Ozgur; Gultekin, Bahadir; Kutllovci, Arber; Akkaya, Ilknur; Akay, H. Tankut; Sezgin, Atilla; ABA-7388-2021
Raising the bar to ultradisciplinary collaborations in management of chronic thromboembolic pulmonary hypertension
(2021) Akat, Tankut; Kaymaz, Cihangir; Akar, Ahmet Runchan; Orhan, Gokcen; Yanartas, Mehmed; Gultekin, Bahadir; Sirlak, Mustafa; Kervan, Umit; Tas, Serpil Gezer; Bicer, Murat; Yagdi, Tahir; Ispir, Selim; Dogan, Riza; 0000-0003-1581-5352; 34589266
Chronic thromboembolic pulmonary hypertension is an underdiagnosed and potentially fatal subgroup of pulmonary hypertension, if left untreated. Clinical signs include exertional dyspnea and non-specific symptoms. Diagnosis requires multimodality imaging and heart catheterization. Pulmonary endarterectomy, an open heart surgery, is the gold standard treatment of choice in selected patients in specialized centers. Targeted medical therapy and balloon pulmonary angioplasty can be effective in high-risk patients with significant comorbidities, distal pulmonary vascular obstructions, or recurrent/persistent pulmonary hypertension after pulmonary endarterectomy. Currently, there is a limited number of data regarding novel coronavirus-2019 infection in patients with chronic thromboembolic pulmonary hypertension and the changing spectrum of the disease during the pandemic. Challenging times during this outbreak due to healthcare crisis and relatively higher case-fatality rates require convergence; that is an ultradisciplinary collaboration, which crosses disciplinary and sectorial boundaries to develop integrated knowledge and new paradigms. Management strategies for the "new normal" such as virtual care, preparedness for further threats, redesigned standards and working conditions, reevaluation of specific recommendations, and online collaborations for optimal decisions for chronic thromboembolic pulmonary hypertension patients may change the poor outcomes.
Removal of Left Ventricular Assist Device: First Case from Turkey
(2016) Gultekin, Bahadir; Ozkan, Murat; Ersoy, Ozgur; Varan, Birgul; Sezgin, Atila; 0000-0002-6719-8563; ABA-7388-2021; ABB-1767-2021
In recent years, due to the donor shortage for heart transplantation, the utilization of the left ventricular assist devices has been increasing in Turkey, as well as the worldwide. Herein, we report the first case from Turkey, a 12-year-old male case of left ventricular assist devices due to cardiomyopathy developing after monomorphic atrial tachycardia which was explanted after 109 days follow-up.
Terlipressin Increases Blood Pressure and Facilitates Weaning from Cardiopulmonary Bypass in Heart Transplant Recipients with Refractory Hypotension
(2016) Akovali, Nukhet; Firat, Aynur Camkiran; Taskin, Duygu; Zeyneloglu, Pinar; Gultekin, Bahadir; Sezgin, Atilla; Pirat, Arash; ABA-7388-2021
Treatment of Left Ventricular Assist Device Thrombosis: Single-Center Experience
(2018) Beyazpinar, D. Sarp; Ersoy, Ozgur; Gultekin, Bahadir; Aliyev, Anar; Avsever, Mert; Akay, H. Tankut; Ozkan, Murat; Sezgin, Atilla; Aslamaci, Sait; 29528019; ABA-9675-2021; ABA-7388-2021
Heart failure is the one of the biggest health problem in the world. Because of limited donors for heart transplant procedures, the ventricular assist device has become a solution for heart failure therapy. With the increase in number of ventricular assist devices, the incidence of complications has also increased. One of the most important life-threatening complications is ventricular assist device thrombosis. Medical therapy and changes in the ventricular assist device are the main therapy methods for ventricular assist device thrombosis. In this study, we showed our clinical experience with treatment of ventricular assist device thrombosis.
What Should be the Treatment Approach in Patients with Cardiac Allograft Vasculopathy?
(2018) Ersoy, Ozgur; Beyazpinar, Sarp; Gultekin, Bahadir; Sezgin, Atilla; Aslamaci, Sait; ABA-7388-2021