Browsing by Author "Gür, A.K."

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The Effects of Perioperative Autotraiisfusion on Postoperative Blood Transfusion in Cardiopulmonary Bypass Patients
(Turkish Anaesthesiology and Intensive Care Society, 2017) Gür, A.K.; Eker, E.; Yargi, M.; Kaplan, M.
Objective: It is known that cardiopulmonary bypass has negative effects on patient blood values during cardiac surgeries. In our study, we aimed to investigate the effects of acute normovolemic hemodilution in patients who underwent coronary artery bypass surgery. Material and Method: In our study we included a total number of 40 patients who underwent elective coronary arter)' bypass grafting using a cardiopulmonary bypass in Siyami Ersek Chest and Cardiovascular Surgery Training and Research Hospital. Male, and female patients whose preoperative hematocrit values ivere ≥36% and, ≥ 40% were included in our study. Results: Group 1 (n=20) consisted of 18 male and 2 female patients with a mean age of 54.7±6 years who received autotraiisfusion. Control group (Group 2: n=20), consisted of 17 male, and 3 female patients with a mean age of 58.1±9 years. Hematocrit values were found to be lower in the autotraiisfusion group during the cardiopulmonary bypass procedure than those of the control group, and higher at the end of the operation and at the discharge from the hospital (p<0.05). Conclusion: In our study, if there were no additional comorbidities in patients who will undergo open heart surgery, blood drawn for autotraiisfusion during the perioperative period reduced the need for allogeneic blood during the postoperative period. Based on all these factors, we think that autotraiisfusion in cardiac surgery can be performed safely because of its positive effects on hemodynamics, metabolic and functional outcomes.
The Effects of Serum Crp Level on Postoperative Atrial Fibrillation in Patients Who Had Coronary Bypass Surgery
(Yuzuncu Yil Universitesi Tip Fakultesi, 2018) Gür, A.K.; Aykaç, M.C.; Şişli, E.
Coronary artery bypass grafting (CABG) is the most common cardiac operation performed worldwide. We aimed to evaluate the relationship between post-operative serum C-reactive protein (CRP) level and atrial fibrillation (AF) in patients who received CABG. A total of 198 patients who had undergone CABG between January 2016 and February 2018 in our cardiovascular surgery clinics were included in the study. According to CRP levels, patients were into 2 groups; Group 1 serum CRP level <8.0mg/L and Group 2 serum CRP level ≥8.0mg/L. There were 82 patients in Group 1 (31 Female, 51 Male) and 116 patients (48 Female, 68 Male) in Group 2. Patients who died within 30 days after CABG were excluded. While the mean age of the cohort was 61.2 ± 8.1 years; it was 59.8 ± 9.4 years and 61.5 ± 7.4 years in Group 1 and 2, respectively. AF was observed in 65 patients (32.8%) including 13 patients in Group 1 (15.8%) and 52 patients (44.8%) in Group 2. The rate of AF was significantly higher in Group 2 (p<0.05). Coronary artery disease itself is significant risk factor of mortality and morbidity. Our study showed that post-operative serum CRP level would be an indicator of AF. Although increased levels of CRP alone cannot be the primary cause of AF, the rate of post-operative AF was higher in CABG patients with high CRP level. © 2018, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Mid-Term Outcome of Arteriovenous Fistula in Paediatric Patients With End-Stage Renal Disease: a Single Centre Experience
(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Şişli, E.; Gür, A.K.
The aim of the study was to evaluate the patency rates of arteriovenous fistula (AVF) in paediatric patients with end-stage renal disease (ESRD) in the mid-term. The study was conducted retrospectively. The medical archive was searched between January 2015 and February 2018. A total of 26 patients comprised the study population. The median age and weight of the patients at the time of AVF creation were 13.2 years (IQR = 11.9 – 15.6 years) and 41.5 kg (34.8 – 50.5 kg), respectively. Eight (69.2%) patents were male. The AVF created was radio-cephalic in 21 (80.8%) and brachial-level in five (19.2%) patients; brachio-cephalic in 3 and brachio-basilic in 2 patients. The patients with a radial-level AVF were younger (p = 0.001), and their body weights were lower (p<0.001). In patients with radio-cephalic AVF, analysis of age (rs =-0.48, p = 0.028) and weight (rs =-0.56, p = 0.008) revealed a negative correlation with duration of AVF maturation. The duration of follow-up was 21.2 months (IQR = 14.5 – 28.3 months). While the primary rates at 1 and 2 years were 92.3% and 84.6%, the secondary patency rates were 96.2% and 92.3%, respectively. Our results showed that AVF is the most suitable and durable renal replacement therapy in patients with ESRD. The weight and level of AVF have a considerable influence on the duration of AVF maturation. In summary, AVF still remains the procedure of choice in regions where the paediatric kidney transplantation programmes are not completely set up that have resultant long transplantation waiting periods. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Results of Coronary Artery Bypass Grafting Surgery in Female Smokers and Female Patients Who Make Tandoori Who Had Chronic Obstructive Pulmonary Disease
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Gür, A.K.; Şahinalp, Ş.; Unal, H.
Among the risk factors for coronary artery disease, the most important is smoking. Another major risk factor for coronary artery disease is the smoke from tandoor ovens, to which many rural women are exposed over a period of years. Of 856 patients who underwent elective CABG surgery in our clinic between January 2011 and January 2017, 345 female patients were investigated retrospectively. The patients were divided into two groups: Group 1 (smokers, n=47) and Group 2 (tandoor bakers, n=91). The mean age was 59.4 ± 5.2 years for Group 1 and 62.3 ± 4.2 years in Group 2. The mean duration of extubation of the patients in intensive care unit was 5.4 ± 2.1 in Group 1, and 8.2 ± 2.4 hours in Group 2 (p <0.001). The average length of stay in the intensive care unit was 2.1 ± 1.5 days for Group 1 and 4.4 ± 2.2 days for Group 2 (p <.05). Chronic obstructive pulmonary disease is an independent risk factor for CABG. Aside from smoking, which frequently results in COPD, pulmonary functions are exacerbated in people (usually women) who bake using tandoor ovens. In these patients, the duration of postoperative intubation, length of stay in the intensive care unit and in the hospital are extended, and the need for Continuous Positive Airway Pressure (CPAP) machines in the intensive care unit increases. Therefore, women who use tandoor ovens should be considered high risk patients for CABG surgery, and these patients should be managed and followed up with caution. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Surgical Approaches To Iatrogenic Vascular Injuries in Adults
(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Gocer, S.; Ilkeli, E.; Gür, A.K.; Düzgün, A.C.; Katırcıoglu, S.F.
Surgical procedures can result in unforeseen vascular injuries. In cases of severe vascular injuries, the involvement of an experienced vascular surgeon in the operation can be life-saving. The aim of this study is to elucidate the surgical approaches and outcomes in vascular injuries that occurred during elective operations of various branches within our institution. Between October 2014 and June 2018, 18 patients required surgery due to unexpected severe vascular injuries. Gender, age, injury site, elective operation, intervention to vascular injury, hemodynamic status, type of anesthesia, mean operation time, and post-operative status of the patients were retrospectively obtained from hospital database. Diagnostic tests and imaging methods were recorded, and the utilization of blood products used during the operation has been investigated. The intensive care unit and service follow-ups of the patients as well as their post-discharge controls were collected from hospital records. Among the patients undergoing vascular intervention, 60% (n=11) experienced arterial injuries, while 40% (n=7) had venous injuries. When examining the type of intervention, all patients, except for one, underwent intervention by placing a side or cross-clamp on the vascular structure. Primary repair was performed in 11 patients, end-to-end repair in 2 patients, PTFE graft placement in 1 patient, saphenous vein interposition in 3 patients, and ligation in 1 patient. Two patients (11%) died during the surgery. As a result, the surgeon should accurately and quickly evaluate findings such as unexplained hypotension, tachycardia, loss of pulse or heat loss during the operation, and should suspect vascular injury. It is possible to reduce mortality and morbidity rates when iatrogenic vascular injuries are diagnosed early. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.