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Öğe Acute Arterial Embolus(WESTMINSTER PUBL INC, 1991) Solak, Hasan; Yeniterzi, Mehmet; Yüksek, Tahir; Özpınar, Cevat; Ceran, SamiBetween December, 1983, and December, 1988, 100 patients (54 men, 46 women) with acute arterial embolus, ranging in age from twenty-three to eighty-three years, were treated in our clinics. The main symptom of the patients was pain (94%), followed by coldness (72%), pallor (64%), sensory defect (42%), motor disorder (37%), muscular rigidity (10%), and tissue necrosis (7%). We have determined the etiology to be atrial fibrillation in 53 cases, 36 of which arose from mitral stenosis: acute myocardial infarction (MI) in 14 cases; thromboembolus based on arteriosclerosis obliterans (ASO) in 27 cases; and tumor embolus in 2 cases; 4 cases could not be explained etiologically. The most common site of embolism was the femoral artery (33%). Arterial exploration was done under local anesthesia in the 76 patients who did not have distal localization of the embolus. Embolectomy was performed in 49 of these cases and embolectomy plus localized tromboendarterectomy in 27. Owing to developing necrosis, amputation was necessary in 6 cases-4 above the knee and 2 above the elbow. Motor and sensory defect persisted to various degrees in 27 cases. The death rate was 4%.Öğe Bilateral Aneurysms of the Pulmonary Artery with Pectus Excavatum - A Case Report(WESTMINSTER PUBL INC, 1993) Özpınar, Cevat; Ceran, Sami; Yeniterzi, Mehmet; Yüksek, Tahir; Özergin, Ufuk; Solak, HasanAn eleven-year-old boy was operated on for a left-sided pulmonary artery aneurysm. The same patient had also been operated three years earlier because of a right sided aneurysm.Öğe Comparison of different dose regimens of enoxaparin in deep vein thrombosis therapy in pregnancy(SPRINGER, 2008) Narin, Cueneyt; Reyhanoglu, Hasan; Tuelek, Baykal; Onoglu, Rasit; Ege, Erdal; Sariguel, Ali; Yeniterzi, MehmetIntroduction: Pregnant women have a higher risk of developing deep vein thrombosis (DVT) and consequent thrombogenic events, including pulmonary embolisms. Low-molecular-weight heparin (LMWH) products have been shown to successfully treat DVT with few significant side effects. The purpose of this study was to compare the effects of two dose regimens of enoxaparin (a LMWH) in the management of DVT in pregnancy. Methods: A total of 35 pregnant patients with DVT were enrolled in this study. As first-line anticoagulation therapy, patients were administered an intravenous unfractionated heparin infusion for 5 days, followed by a subcutaneous injection of enoxaparin 1 mg/kg twice a day until discharge. The enoxaparin therapy continued at home with 1 mg/kg twice a day for 18 patients (group I) and 1.5 mg/kg once a day for the other 17 patients (group II). Enoxaparin was discontinued 12-24 hours before delivery and restarted within 8-12 hours after delivery. Warfarin was given as adjuvant therapy along with enoxaparin in the post-partum period. Enoxaparin was discontinued when an international normalised ratio of 2 or above was reached. Differences between the two groups in terms of therapy response, complications and efficacy were recorded. Results: Thrombophilic disease was observed in three patients in each group. The iliac vein had the highest incidence of DVT in both groups. During therapy, two patients in group I were diagnosed with a mild haemorrhage; one patient (in group II) had abortion. There were no significant differences between groups in terms of recanalisation (measured by venous ultrasonography examination), post-thrombotic symptoms or safety parameters. Results: Enoxaparin can be used safely in DVT therapy during pregnancy. Our results indicate that therapy consisting of a single daily dose of 1.5 mg/kg enoxaparin is as effective as twice-daily administration.Öğe Dizaltı periferik arteriyel hastalığa cerrahi yaklaşım(2008) Narin, Cüneyt; Ege, Erdal; Sarkılar, Gamze; Önoğlu, Raşit; Sarıgül, Ali; Yeniterzi, MehmetAmaç: Bu çalışmanın amacı, dizaltı periferik baypas cerrahisi uygulanan hastalara cerrahi yaklaşımımızı değerlendirmektir. Yöntem: Haziran 2005 ile Ağustos 2007 tarihleri arasında kliniğimizde dizaltı periferik baypas cerrahisi uygulanan 21 hasta cerrahi yaklaşımımız açısından değerlendirilmiştir. Hastaların ikisi bayan, diğerleri erkektir. Yaş ortalaması 6015.4 yıldır. Tüm hastalarda greft olarak otojen safen ven kullanılmıştır. Postoperatif dönemde hastalara Dextran 40 infüzyonu ve düşük molekül ağırlıklı heparin verilmiştir. Postoperatif ilk gün aspirin, klopidogrel ve statin tedaviye eklenmiştir. Greft açıklığı, manyetik rezonans anjiyografi (MRA) ile değerlendirilmiştir. Bulgular: Erkek hastaların tümünde sigara anamnezi mevcuttur. Öyküde, daha önce 11 hastaya uygulanan periferik damar cerrahisi bulunmaktadır ve en sık uygulanmış damar cerrahisi femoral embolektomidir. Hastalar ortalama 12.77.5 ay takip edilmiştir. Distal damar yatağı kötü olan bir hastanın cerrahi uygulanan alt ekstremitesi operasyondan 16 gün sonra dizaltı amputasyona gitmiştir. Diğer hastaların greftlerinin açık olduğu MRA ile gösterilmiştir. Sonuç: Dizaltı revaskülarizasyon yöntemleri için, safen ven greftinin kullanılmasının, etkin postoperatif antitrombotik tedavinin ve epidural anestezinin greft açıklığını sağlamada önemli etkenler olduğu düşünülebilir. MRA, greft açıklığını değerlendirmede değerli bir yöntemdir. (Damar Cer Der 2008;17(l): 1-8).Öğe The Effect of Coronary Revascularization on New-Onset Complete Atrioventricular Block Due to Acute Coronary Syndrome(FORUM MULTIMEDIA PUBLISHING, LLC, 2009) Narin, Cueneyt; Ozkara, Ahmet; Soylu, Ahmet; Ege, Erdal; Duzenli, Akif; Sarigul, Ali; Yeniterzi, MehmetBackground: Coronary artery disease is one of the most common causes of complete atrioventricular block (AVB) in adults. In this study, we evaluated whether prompt revascularization of the coronary artery occlusion can ameliorate newonset complete AVB due to acute coronary syndrome (ACS). Methods: Five patients (4 men and 1 woman) with a mean age of 69.8 +/- 7.1 years with diagnosed new-onset complete AVB and proven coronary artery disease were enrolled in the study. At the time of AVB diagnosis, 3 of the patients had acute myocardial infarction, and the other 2 patients had unstable angina pectoris. All patients underwent complete coronary bypass surgery after the diagnosis of complete AVB. A patient who underwent 2 coronary bypasses also underwent aortic valve replacement. Results: No mortality was observed in the study group. All but one of the patients converted back to sinus rhythm after a mean interval of 30 +/- 13.6 hours following revascularization procedures. Complete AVB persisted in 1 patient, and a permanent pacemaker was implanted. All patients were discharged uneventfully. The mean hospital stay was 11.4 +/- 4.5 days. All patients are still being followed up after surgery; at a mean follow-up of 27.4 +/- 0.9 months, there have been no further problems. Conclusion: Coronary revascularization may ameliorate ACS-related new-onset complete AVB with an acceptable rate of successful reversion to sinus rhythm. An especially appropriate time for surgery, complete coronary revascularization, and management of myocardial protection during surgery might improve the results of coronary bypass procedures in these patients.Öğe İnaortik Balon Pompasına Bağlı Damar Komplikasyonlarını Önlemede Dekstran 40 Kullanımı(2007) Narin, Cüneyt; Özkara, Ahmet; Sarkılar, Gamze; Can, İlknur; Ege, Erdal; Sarıgül, Ali; Yeniterzi, MehmetAmaç: Intraaortik balon pompası (IABP), dolaşım desteği sağlamak amacıyla, kardiyoloji ve kalp cerrahisinde yaygın olarak kullanılmaktadır. IABP kaynaklı tromboembolik damar komplikasyonlarını önlemek amacıyla, antitrombotik ajanlardan Dekstran 40 kullanılması araştırılmıştır. Gereç ve yöntemler: Kasım 2004 ile Ekim 2006 tarihleri arasında, koroner bypass operasyonu olan 37 hastaya IABP yerleştirilmiştir. Böbrek yetmezliği ve aşırı cerrahi drenaj tanısı alan hastalar dışındaki tüm hastalar, kateterin çekilmesinden 0.5 saat öncesine kadar Dekstran 40 infüzyonu almışlardır. Bu grupta heparin kullanılmamıştır. Bulgular: Olguların 26'sı (%70) erkek, 11'i (% 30) kadındır. Ortalama yaş, 63.4 + 8.4 yıl ve ortalama IABP kullanma süresi, 56.3 saat (6 ile 162 saat arası) bulunmuştur. Yirmidokuz hastaya (% 78.4) sadece koroner bypass operasyonu (CABG), 8 hastaya da (% 21.6) CABG'ye eşlik eden diğer açık kalp operasyonları uygulanmıştır. Hiçbir hastada Dextran 40 kullanımına bağlı yan etki görülmemiştir. Üç olguda (%8) bacak iskemisi gelişmiş olup, 2 olguda kateterin çekilmesi ile iskemi düzelmiş, I olguda Fogarty kateteri ile tromboembolektomi gerekli olmuştur. Hiçbir hastada büyük cerrahi girişim gereksinimi olmamıştır. Kateterin giriş yerinde belirgin kanama görülmemiştir. Olguların hiçbirinde trombositopeni gözlenmemiştir. Sonuç: Dekstran 40, IABP ilişkili damarsal yan etkileri azaltmak için güvenle kullanılabilir. Bu çalışma, IABP kaynaklı damar komplikasyonlarını önlemek açısından Dekstran 40 ile heparinin karşılaştırılacağı yeni çalışmalara öncülük edebilir.Öğe Lower Extremity Deep Vein Thrombosis and its Treatment(Springer-Verlag, 1992) Solak, Hasan; Yeniterzi, Mehmet; Yüksek, Tahir; Özpınar, Cevat; Ceran, Sami; Ünal, A. ErkanStudies on venous thrombosis depend on Virchow's triad related to venous thrombosis. This triad includes stasis, coagulation defect, and vein wall lesion. Venous thrombectomy was applied first by LeRiche in 1927. In subsequent years, Fogarty, De Weese, and Edwards defined the basic rules of venous thrombectomy and medical treatment more thoroughly.Öğe Myocardial Cystic Hydatids Causing Cardiac-Tamponade - Report of Cases(WESTMINSTER PUBL INC, 1991) Solak, Hasan; Yüksek, Tahir; Yeniterzi, Mehmet; Akkoç, Özkan; Anıl, Nazif; Ceran, SamiFour patients with cystic hydatids located in pericardium and myocardium were admitted. Cardiac tamponade was determined in 1 of these cases. Surgical treatment was instituted for all cases. Transpericardial cardiac palpation was emphasized in cases where thoracotomy was necessary due to the lung cystic hydatids.Öğe Pulmonary Right-upper lobar arteriovenous fistula in an infant with progressive cyanosis(2004) Baysal, Tamer; Görmüş, Niyazi; Avunduk, Mustafa Cihat; Oran, Bülent; Yeniterzi, Mehmet; Karaaslan, Sevim[Abstract not Available]Öğe Renal Arter Anevrizmalı Bir Hastanın Başarılı Cerrahi Tedavisi: Olgu Sunumu(2007) Özkara, Ahmet; Ege, Erdal; Narin, Cüneyt; Şahsıvar, Mehmet Orkun; Sarkılar, Gamze; Paksoy, Yahya; Sarıgül, Ali; Yeniterzi, MehmetRenal arter anevrizması viseral anevrizmalar içerisinde oldukça ender rastlanmaktadır. Hızla ilerlemekte olan görüntüleme teknikleri sayesinde birçok renal arter anevrizmasının sessiz kaldığı saptanmıştır. Yirmisekiz yaşında ve yeni teşhis edilmiş hipertansiyonu olan erkek hastada yapılan incelemede sol renal arterde, aortadan ayrıldığı yerin 3 cm distalinde yaklaşık 3 cm genişliğinde anevrizma belirlenmiştir. Yapılan cerrahi müdahalede; sol renal arter bağlanıp, anevrizma rezeke edildikten sonra safen ven bypass operasyonu uygulanmıştır. Anevrizma dokusunun patolojik incelenmesinde, aterosklerotik zeminde geliştiği saptanmıştır. Hasta, operasyon sonrası 5. günde düşük doz beta blokerle taburcu edildi. iki ay sonra yapılan kontrol manyetik rezonans (MR) anjiografik incelemede safen greftin patent olduğu saptanmıştır. Renal arter anevrizmalarında perkütan girişime uygun olmayan vakalarda, safen ven grefti ile bypass operasyonları kabul edilir tedavi seçeneği olabilir.Öğe Repair of Coarctation-Related Aortic Arch Aneurysm and Ventricular Septal Defect in an Adolescent(TEXAS HEART INST, 2008) Narin, Cuneyt; Ege, Erdal; Orhan, Atilla; Yeniterzi, MehmetA saccular aortic arch aneurysm that is secondary to aortic arch coarctation and that is accompanied by a ventricular septal defect is a rare combination in the adolescent patient. Total simultaneous repair of all of these conditions is desirable, because of the higher morbidity and mortality rates of staged procedures-particularly when resection of the saccular aneurysm is delayed. Herein, we discuss the case of a 16-year-old boy who underwent simultaneous surgical correction of these malformations. With the aid of cardiopulmonary bypass on the beating heart, the coarctation and the aneurysmal segment were resected, and a tubular Dacron graft was interposed. The ascending aorta and femoral artery were both then cannulated to ensure whole-body perfusion during cardiopulmonary bypass. The ventricular septal defect was closed with the patient under cardioplegic arrest. After 70 days, he was discharged from the hospital without sequelae. We conclude that single-staged repair of cardiac abnormalities and of an aortic arch aneurysm that is secondary to coarctation of the aortic arch can be performed safely and effectively in adolescent and adult patients by use of our technique. (Tex Heart Inst J 2008;35(4):466-9)Öğe Successful Mitral Valve Surgery in a Patient with Myasthenia Gravis(WILEY-BLACKWELL PUBLISHING, INC, 2009) Narin, Cueneyt; Sarkilar, Gamze; Tanyeli, Omer; Ege, Erdal; Yeniterzi, MehmetMyasthenia gravis (MG) is an autoimmune disease characterized by a weakness of the muscles with remissions and exacerbations due to antibodies against acetylcholine receptors. Most of the patients die because of a respiratory failure toward the end of the disease. A 49-year-old male patient with MG in whom a thymectomy operation had been performed five years ago had dyspnea, palpitation, and chest pain during his admission. After his examination, a severe mitral regurgitation was detected, and he underwent a successful mitral valve replacement. A general anesthesia management was performed using sufentanyl and propophol without any muscle relaxant agent. He was extubated seven hours after the surgery. He had difficulty in swallowing at postoperative day three, and his medication doses were increased. He was discharged from the hospital at postoperative day seven without any complication. MG is a rare disease and may cause morbid complications during the cardiac surgery, but can be successfully managed. (J Card Surg 2009;24:210-212).
