Browsing by Author "Kutay, V."

Now showing 1 - 4 of 4

Effects of Giant Left Atrium on Thromboembolism After Mitral Valve Replacement
(Asia Publishing Exchange Pte Ltd, 2005) Kutay, V.; Kirali, K.; Ekim, H.; Yakut, C.
The aim of this study was to evaluate the incidence of thromboembolic events in patients with giant left atrium ( > 6.5 cm) after mitral valve replacement. From January 2000 to September 2002, a total of 126 patients who had undergone mitral valve replacement were divided into two groups according to the presence or absence of giant left atrium. Group A comprised 34 patients with left atrium over 6.5 cm without compression symptoms and Group B comprised 92 patients. The preoperative variables did not distinguish the patients in each group, except for atrial fibrillation; Group A 85.2% and Group B 61.9% ( p < 0.01). After mitral valve replacement, left atrium mean diameter was significantly decreased in Group A from 8.1 ± 1.3 mm to 6.2 ± 1.6 mm ( p < 0.01). There were no significant differences in thrombosis, hemorrhage and thromboembolism rates in both groups. Postoperative clinical and hemodynamic parameters demonstrated a positive clinical response to mitral valve replacement in patients with giant left atrium. During follow-up no direct relationship between thromboembolism and giant left atrium was evident.
Leucocyte-Depleted Blood Cardioplegia
(Sage Publications Ltd, 2007) Ozkara, C.; Guler, N.; Kutay, V.; Guducuoglu, H.; Kitmaz, A.; Ozcan, S.
The effect of the depletion of leucocytes from cardioplegic and initial myocardial reperfusion blood on the inflammatory response and myocardial protection in patients with unstable angina undergoing cardiopulmonary bypass (CPB) was studied. Patients were allocated randomly to a leucocyte-depleted (LD) group or a control group. The LD group received continuous retrograde LD isothermic blood cardioplegia and the control group received isothermic blood cardioplegia. Blood samples were collected at seven time-points before, during and after the procedure. Total leucocyte counts of cardioplegia blood in the LD group were significantly lower than in the control group, but systemic leucocyte and neutrophil counts after CPB did not differ between the groups. The levels of adhesion molecules, cytokines, elastase and malondialdehyde were significantly increased after CPB in both groups and reached peak values 2 - 6 h after surgery; no other significant differences were found. LD cardioplegia and myocardial reperfusion did not attenuate the endothelial and neutrophilmediated components of the CPB-induced inflammatory response, which may lead to myocardial reperfusion injury.
Management of Prosthetic Mitral Valve Thrombosis
(2005) Ekim, H.; Akbayrak, H.; Başel, H.; Hazar, A.; Karadaǧ, M.; Kutay, V.; Yakut, C.
Prosthetic mitral valve thrombosis is a lifethreatening complication. Data on complications and outcome are limited. The purpose of this study was to review the clinical experience with the thrombolytic therapy and surgical management of prosthetic mitral valve obstruction in our hospital. Between the January 2001 and April 2005, twelve patients with obstructed prosthetic mitral valve were admitted to our hospital. There were 8 female and 4 male patients ranging in age from14 to 60 years, with a mean age of 34±12 years. In all patients, the diagnosis of prosthetic valve thrombosis was confirmed by echocardiography including transesophageal echocardiography. All patients showed absence or muffering of prosthetic valve sounds. Two of 12 patients received thrombolytic therapy by using streptokinase. In the remaining 10 patients, operations were performed on an emergency basis with median sternotomy and cardiopulmonary bypass techniques using antegrade-retrograde combinated isothermic blood cardioplegia and moderate hypothermia. The principal risk factors of prosthetic valve thrombosis are inadequate anticoagulation or fluctuation in anticoagulation levels. Its treatment is either surgical or with thrombolytics. Although both treatment methods are effective, the latter is gaining favor. However, surgery is often required due to large thrombi and a presence of pannus formation.
Management of the Lower Extremity Arterial Injuries
(2004) Ekim, H.; Kutay, V.; Demirbaǧ, R.; Hazar, A.; Karadaǧ, M.
Objective: The incidence of vascular injuries has increased considerably during the past 40 years. However, although they represent less than 1% of all injuries, they deserve special attention because of their severe complications. Method: From May 1999 to March 2003, 30 patients with lower limp vascular injury were surgically treated in our clinic. Diagnosis was made by physical examination alone, or in combination with angiography. Primer vascular repairwas carried out where possible; if not possible the interposition graft was used. When an interposition graft was necessary either polytetrafluoroethylene(PTFE) or saphenous vein was used for vascular reconstruction. Results: The study group consisted of 24 males and 6 females, ranging in age from 14 years to 39 years with a mean age of 26.2±8.1 years. Penetrating trauma was the cause of a high proportion of cases. There were 31 arterial injuries. Only one patient had bilateral arterial injuries (right and left tibial arteries). Arterial injuries were most common in the femoral artery area, followed by the tibial and popliteal arteries. Surgical procedures performed were primary repair in 12 arterial injuries, saphenous vein interposition graft in 15, and PTFE interposition graft in 4. There were 18 patients with associated venous injury, of which 11 cases had primary repair, and 7 had vein graft interposition. There were concomitant femur fracture in 3 patients, and fibula fracture in 1. Conclusion: Patients who suffer lower extremity arterial injury should be transferred to vascular surgery centers as soon as possible. Anticoagulant treatment should be started as soon as possible to prevent the propagation of the thrombosis. Early fasciotomy is warranted if there is any suspicion of occurrence of compartment syndrome.