Fakülteler / Faculties

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Author: search.filters.author.Bingol, Hakan

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    Can Preoperative Erythrocyte Sedimentation Rate Serve as an Indicator for Midterm Adverse Events after Coronary Bypass Grafting?
    (2015) Togan, Turhan; Gunday, Murat; Ciftci, Ozgur; Bingol, Hakan; 0000-0002-6463-6070; 25924030; A-7318-2017
    Objective: Erythrocyte sedimentation rate (ESR) may serve as a reasonably-good indicator for coronary heart disease as usually ESR is elevated in these patients. The measurement of ESR is a very simple and cheap laboratory test that can he performed in routine blood examinations. In this study, we investigated the association between preoperative erythrocyte sedimentation rate and postoperative midterm adverse events after coronary artery bypass grafting (CABG). Methods: In the study, only male patients were included. The patients were divided into two groups: group 1 (preoperative sedimentation rate [<20 mm/h] normal [n = 232, 63.9%]) and group 2 (preoperative sedimentation rate [>20 mm/h] above normal [n = 131, 36.1%]). The hemogram and biochemistry panel values were measured one day before operation, on the postoperative first day, on the postoperative seventh day, and on the postoperative third month. Results: Among the laboratory values, there was a statistically significant difference between the two groups with respect to postoperative first-day ESR and postoperative third-month high-sensitivity C-reactive protein (P < .05). In terms of postoperative morbidity, there was also a statistically significant difference (P < .05) between the two groups with regard to pleural effusion, infection of the soft tissue over the sternum, pulmonary infection, return to the intensive care unit, rehospitalization, and mortality. Conclusion: Elevated preoperative sedimentation rate is associated with postoperative adverse events in patients who undergo CABG. For this purpose, we suggest that patients with higher sedimentation rates undergo detailed examination to prevent mortality and morbidity.
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    Is crystalloid cardioplegia a strong predictor of intra-operative hemodilution?
    (2014) Gunday, Murat; Bingol, Hakan
    Introduction: Complications due to hemodilution (hematocrit value less than 22%) after cardiopulmonary bypass inevitably resulted with significantly greater intensive care requirements, long hospital stays, more operative costs, and increased mortality rates. We tried to identify whether crystalloid cardioplegia is the strongest predictor of intraoperative hemodilution or not. Materials and methods: One hundred patients were included into this randomized prospective study. Patients were divided into the two groups. Crystalloid cardioplegia were given to the odd-numbered patients (Group 1, n = 50 patients) and blood cardioplegia were given to the even-numbered patients (Group 2, n = 50 patients). St. Thomas-II solution was used in Group-1 and Calafiore cold blood cardioplegia was in Group-2. Results: Average intraoperative hematocrit value was 18.4% +/- 2.3 in crystalloid group 24.2% +/- 3.4 in blood cardioplegia group (p < 0.001). The lowest hematocrit value was 15% and 20% in two groups respectively (p < 0.001). In crystalloid group average intraoperative packed red blood cell (RBC) transfusion was 2.3 +/- 0.41 units, 0.7 +/- 0.6 units blood cardioplegia group (p = 0.001). Average transfused RBC was 2.7 +/- 0.8 units in crystalloid group, 0.9 +/- 0.4 units blood cardioplegia group (p < 0.001). Multivariate analyses confirmed age (p = 0.005, OR = 3.78), female gender (p = 0.003, OR = 2.91), longer cross-clamp time (>60 minutes) (p = 0.001, OD = 0.97), body surface area <1.6 m(2) (p = 0.001, OR = 6.01) and crystalloid cardioplegia (p < 0.001, OR = 0.19) as predictor of intraoperative hemodilution. Conclusion: Crystalloid cardioplegia, compared to blood cardioplegia not only causes much more intra-operative hemodilution but also increases the blood transfusion requirement. Hemodilution and increased transfusion increases the intensive care unit and hospital stay, in the early postoperative period.
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    Novel variant of dual left anterior descending artery arising from single right coronary artery anomaly presenting with angina inversa
    (2015) Cingoz, Faruk; Arslan, Gokhan; Bingol, Hakan; 26702282
    A 55-year-old female without a history of coronary artery disease, hypertensive for the past 17 years, was admitted with resting chest pain. Electrocardiography revealed a negative T-wave in anterior chest leads. Coronary angiography visualised anomalous coronary anatomy, with a common origin of the right coronary artery and the left main coronary artery in the right sinus of Valsalva serving as a common coronary trunk. It should be emphasised that T-wave abnormalities and chest angina may be related to this congenital coronary anomaly.