Browsing by Author "Tunel, Huseyin Ali"

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Evaluation of Coronary Artery-Saphenous Vein Composite Grafts: The Aortic No-Touch Technique
(2014) Coskun, Isa; Colkesen, Yucel; Demirturk, Orhan Saim; Tunel, Huseyin Ali; Turkoz, Riza; Gulcan, Oner; 24512396
We retrospectively compared the results of conventional coronary artery bypass grafting (CABG) performed on patients who showed no preoperative evidence of serious atherosclerosis of the ascending aorta with the results of the aortic no-touch technique (using coronary artery-saphenous vein composite grafts) on CABG patients who did show such evidence. From 2003 through 2012, 3,152 consecutive patients underwent isolated primary CABG at our hospital. We chose 360 for the current study. The study group (n=120) comprised patients who had undergone operation via the aortic no-touch technique. Propensity-score-matching (1: 2) was used to select the control group of 240 patients who had undergone conventional CABG. Early and late survival rates, reintervention-free survival rates, and freedom from cardiac death were compared. Early and late mortality rates were similar in the study and control groups (P=0.19 vs P=0.29, respectively), as were cardiac-related death (2.5% vs 2.1%, respectively; P=0.53) and overall death (8.3% vs 7.9%, respectively; P=0.51). Overall survival rates were 91.7% vs 92.1% and freedom-from-cardiac-death rates were 97.4% vs 97.5% (P=0.71 vs P=0.78, respectively; mean follow-up period, 5.27 +/- 2.51 yr). Reintervention-free survival rates were also similar (96.7% vs 98.8%, respectively; P=0.2). As a result of the similar rates of early and late survival, reintervention-free survival, and freedom from cardiac death, we conclude that the aortic no-touch technique with composite grafts might be a reasonable option in patients who have atherosclerotic ascending aorta that cannot be clamped.
Long-Term Results of Pericardial Autologous Patch Enlargement of the Aortic Annulus Using the Manouguian Technique
(2016) Demirturk, Orhan Saim; Kiziltan, H. Tarik; Coskun, Isa; Tunel, Huseyin Ali; Tekin, Hatice Goknur; 0000-0002-6193-0848; 0000-0003-1175-1961; 27146233; ABD-7488-2021; AAD-5531-2021
Background: The management of a small aortic root at the time of aortic valve replacement is controversial. In cases in which the aortic root is very small the choice of aortic valve type and of root-enlargement method is difficult. The technical challenge of the small aortic root has instigated the creation of methods for annular enlargement. Severe mismatch as a predictor of overall 30-day mortality or midterm mortality reports about long-term results of aortic valve replacement using autologous pericardial patch are scarce. Moreover, no reports about patient series are present in the English medical literature. This retrospective study was designed to address this gap in evidence. Methods: Twenty consecutive patients undergoing aortic valve replacement (with or without mitral valve replacement and/or coronary artery bypass grafting) at Baskent University Adana Medical Center between June 30, 1999 and April 10, 2006 were retrospectively evaluated. All clinical and echocardiographical data belonging to this population were specified. Their perioperational data were assessed. Results: Twenty patients operated using the Manouguian technique for narrow aortic root from June 1999 to April 2006 were followed for 8.54 +/- 3.35 years. Fourteen patients were alive at the end of the follow-up. Six patients had died. Early mortality rate was 5% and late mortality after 8.54 +/- 3.35 years was 30%. Late mortality related to cardiac reasons was 5%. Only one death could be attributed to a cardiac cause which occured in a 36-year-old male patient 3 years and 6 months after the operation. 70% of the patients were alive after a mean follow-up period of 8.54 +/- 3.35 years. Conclusion: The main finding of the present study is that aortic root enlargement using untreated fresh autologous pericardium in Manouguian type operations is a durable option, especially in conditions when homograft or stentless valve use is difficult or economically not feasible. We found that no patient had aneurysmal dilatation or mitral regurgitation after a mean follow-up of 8.54 +/- 3.35 years with autologous untreated pericardium as the enlargement patch.
Open Surgical Repair After Endovascular Treatment with Endologix Stent Graft: A Case Report
(2015) Coskun, Isa; Demirturk, Orhan Saim; Tunel, Huseyin Ali; Andic, Cagatay; Gulcan, Oner
Endovascular treatment of abdominal aortic aneurysm repair is increasingly being used today. We report a 72-year-old male patient who underwent open surgical repair due to separation of Intu Trak Powerlink XL (Endologix) endovascular stent graft four months after endovascular intervention for abdominal aortic aneurysm with 9.5 cm diameter.
Positive Clinical Outcomes of The Saphenous Vein Interposition Technique for Ruptured Popliteal Artery Aneurysm
(2014) Coskun, Isa; Demirturk, Orhan Saim; Tunel, Huseyin Ali; Andic, Cagatay; Gulcan, Oner; https://orcid.org/0000-0003-1175-1961; https://orcid.org/0000-0001-8581-8685; 24682572; AAD-5531-2021; AAM-3180-2021
Popliteal artery aneurysms (PAAs) can be treated successfully by surgical and endovascular methods; however, the best treatment strategy for a ruptured PAA has yet to be established. We assessed the clinical results of using saphenous vein interposition to treat ruptured PAAs in our hospital. The subjects of this study were seven men (average age 59 years, range 43-71 years), who underwent emergency surgery for a ruptured PAA at our hospital between January 2007 and November 2012. The patients were assessed after 1, 6, and 12 months, postoperatively. All included patients underwent saphenous vein graft interposition via a medial approach. No complications or graft thromboses were encountered in the immediate postoperative period. The patients were discharged after an average of 4 days postoperatively (range 3-5 days). The patients were followed up for an average of 32 months (range 2-60 months). The medium-term graft patency was 100 %. No patients suffered early or medium-term limb loss and there was no mortality. Based on our positive results, saphenous vein graft interposition should be considered as the first choice of surgical treatment for a ruptured PAA.