Browsing by Author "Sahinalp, Sahin"

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A 5 Years Follow-Up for Ischemic Cardiac Outcomes in Patients With Carotid Artery Calcification on Panoramic Radiographs Confirmed by Doppler Ultrasonography in Turkish Population
(British inst Radiology, 2020) Akkemik, Ozlem; Kazaz, Hakki; Tamsel, Sadik; Dundar, Nesrin; Sahinalp, Sahin; Ellidokuz, Hulya
Objective: To evaluate the diagnostic accuracy of digital panoramic radiograph (DPR) for detection of carotid artery calcification (CAC) confirmed by Doppler Ultrasonography (DUSG) and to clarify the relationship between between CAC identified by DPR and cardiovascular events through a 5 year follow-up period. Methods: Of 3600 consecutive patients examined, 158 patients presented with CAC as detected by DPR. The final study group was composed of 96 patients who had CAC confirmed by DUSG or CT angiogram. The control group was composed of 62 patients who has normal DUSG. The end point of the study was the occurrence of any cardiovascular event. Results: 72 (75%) of the 96 patients with CAC confirmed by DUSG (16 patients had significant stenosis) had bilateral and 24 (25%) had unilateral CAS as detected by DUSG. There was a low agreement between the examination results with a kappa value of 0.488 (p < 0.005) for calcification. Study data revealed that smoking, chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM) and diastolic hypertension were significantly more common in patients with CAC than the control group (p < 0.05). During the follow-up period, 13 subjects had myocardial infarction and 1 subject died; in the control group, 1 patient died after MI and 1 patient died of a non-cardiac event. Conclusion: Patients with CAC detectable by DPR concomitant with COPD, DM, smoking or diastolic hypertension are more likely to suffer from vascular events. Therefore, patients with detectable carotid plaque in DPR require referral to a cardiovascular surgery clinic for further investigations.
Arteriovenous Fistula in Dialysis Patients Remains Patent With Strict Control of Blood Pressure
(Springer india, 2020) Sahinalp, Sahin
Patency rates of autologous arteriovenous fistulae in patients with end-stage renal failure constitute a serious problem. In the present study, we aimed to evaluate the effect of early stage blood pressure values on fistula patency in patients with autologous arteriovenous fistulae (AVF). Sixty-six patients with end-stage renal failure who were scheduled for autologous arteriovenous fistula were prospectively enrolled in the study. Systolic and diastolic blood pressure measurements were taken for a period of 24 h following the operation. At the end of the first month, patients were evaluated for fistula patency. Higher AVF thrombosis (p = 0.039) was found in patients with high postoperative systolic blood pressure (> 140 mmHg), while higher rates of fistula patency (p = 0.014) where observed in patients with diastolic blood pressure below 80 mmHg. Early-stage low diastolic and normal systolic (< 140 mmHg) blood pressure values were found to have a positive effect on AVF patency. This situation suggests that in patients with arteriovenous fistula formation, rates of fistula patency can be increased with close monitoring and strict control of blood pressure.
Cardiac Output Values and Correlation of Renal Injury With Neutrophil Gelatinase-Associated Lipocalin Levels in Off-Pump Coronary Artery Bypass Patients
(Soc Brasil Cirurgia Cardiovasc, 2020) Sahinalp, Sahin; Temizturk, Zeki; Ceviker, Kadir; Ozisik, Kanat; Kiziltepe, Ugursay
Objective: To investigate the correlation between cardiac output values and renal neutrophil gelatinase-associated lipocalin (NGAL) levels as a biomarker of renal ischemia. Methods: Forty patients, who underwent off-pump coronary artery bypass (OPCAB) surgery and in whom the positioning of the heart was fixed with simple suspension sutures without a mechanical stabilizer, were included in the study. Continuous cardiac output (CO) measurements were recorded using the arterial pressure waveform analysis method (Flo Trac sensor system) in the perioperative period. CO was recorded every minute during nonanatomical cardiac positioning for left anterior descending artery (LAD), diagonal artery (D), circumflex artery (Cx), and right coronary artery (RCA) bypasses. Serum NGAL samples were analyzed in the preoperative, perioperative, and postoperative periods. Results: The CO values measured at various non-anatomical cardiac positions during distal anastomosis for LAD, D, Cx, and RCA were significantly lower than pre- and postoperative values measured with the heart in normal anatomical position (3.45 +/- 0.78, 2.9 +/- 0.71, 3.11 +/- 0.56, 3.19 +/- 0.81, 5.03 +/- 1.4, and 4.85 +/- 0.78, respectively, P=0.008). There was no significant difference between CO values measured at various non-anatomical cardiac positions during distal anastomosis. Although there was no significant correlation between NGAL levels and age, duration of surgery, preoperative CO, D-CO, RCA-CO, and postoperative CO measurements, there was a significant correlation between NGAL levels and LAD-CO (P=0.044) and Cx-CO (P=0.018) at the postoperative 12th hour. Conclusion: Full revascularization may be achieved by employing the OPCAB technique while using simple suspension sutures without a mechanical stabilizer and by providing safe CO levels and low risk of renal ischemia.
Effect of Preoperative Hba1c Levels on Postoperative Acute Renal Failure in Diabetic Patients Undergoing Coronary Bypass Surgery
(Discovery Publication, 2020) Gur, Ali Kemal; Sahinalp, Sahin; Eker, Esra; Unal, Harun
Introduction: Open heart surgery in patients with diabetes mellitus (DM) is associated with a higher mortality and morbidity than other patients. Diabetes mellitus (DM) is present in 30 to 40% of patients undergoing coronary bypass surgery (CABG). In this study, we aimed to clarify the relationship between preoperative glycohemoglobin (HbA1C) levels and postoperative acute renal failure (ARF) in patients with DM undergoing isolated coronary bypass surgery. Methods: We retrospectively enrolled a total of 295 patients who underwent elective, isolated CABG between January 2014 and February 2017 in our clinic and whose information was recorded. DM was detected in 118 of 295 patients. These patients were divided into two groups as Group 1 (HbA1c levels <7%, n = 72) and Group 2 (HbA1c levels >7%, n = 46). All patients were treated with standard insulin therapy after consulting the internal medicine department before the operation. Results: Of the 118 patients included in the study, 82 were males and 36 were females. There were 72 patients (51 M, 21 F) in Group 1 and 46 patients (31 M, 15 F) in Group 2. The mean age was 62.4 +/- 3.2 years in Group 1 and 61.5 +/- 4.5 years in Group 2. The mean duration of DM diagnosis was 10.2 +/- 3.3 years in Group 1 and 11.7 +/- 2.6 years in Group 2. The mean duration of hospitalization in intensive care unit was 6.10 +/- 2.3 days in Group 1 and 9.1 +/- 2.5 days in Group 2, which was found to be statistically significant (p=0.008). Discussion and conclusion: Hemodialysis (HD) may be required after coronary bypass surgery in diabetic patients. Although there is no direct correlation between high HbA1c levels and postoperative HD, we believe that these patients should be more closely monitored with more frequent measurements of urea, creatinine, blood gas and electrolyte levels.
Evaluation of Hemorrhoidal Disease and Lower Extremity Venous Insufficiency in Primary Adult Varicocele: a Prospective Controlled Study
(Sage Publications inc, 2019) Aslan, Rahmi; Erbin, Akif; Celik, Sebahattin; Ucpinar, Burak; Sahinalp, Sahin; Yildizhan, Murat; Taken, Kerem
Background The study investigated the association between varicocele, lower extremity venous insufficiency and hemorrhoidal disease. Methods The study included 62 patients with varicocele and 60 voluntary subjects with no varicocele. Patients who were diagnosed as having varicocele on physical examination and Doppler ultrasonography were included in the study group. Examination of lower extremity venous insufficiency was performed by physical examination and Doppler ultrasonography. Examination of hemorrhoidal disease was performed by a general surgery specialist. Results The patients with varicocele had a statistically significant (p < 0.05) higher rates of venous insufficiency of the lower extremities and had a borderline significant difference of higher hemorrhoidal disease rates (p = 0.05). Therewithal incidences of hemorrhoidal disease and lower extremity venous insufficiency were significantly higher in body mass index > 25 and age > 30 years of varicocele patients. Conclusion There is a statistically significant relation between varicocele, lower extremity venous insufficiency, and hemorrhoidal disease. In particular, varicocele patients who are aged over 30 years and overweight are at higher risk.
Evaluations of Antioxidant Enzyme Activities, Total Sialic Acid and Trace Element Levels in Coronary Artery Bypass Grafting Patients
(Soc Brasil Cirurgia Cardiovasc, 2021) Yildiz, Damla; Ekin, Suat; Sahinalp, Sahin
Introduction: In this study, patients before and after cardiac surgery with cardiopulmonary bypass (CPB) and control subjects were evaluated for erythrocyte glutathione peroxidase, catalase and superoxide dismutase enzyme activities, in addition to glutathione, malondialdehyde, serum total sialic acid, lipid-bound sialic acid, total antioxidant status, trace elements and mineral levels. The correlation of these variables with coronary artery disease (CAD) was also assessed. Methods: A total of 30 CAD patients and 30 control subjects were included in the study. CAD patients were divided into three groups: before surgery (BS), first day after surgery (1st day AS) and seventh day after surgery (7th day AS). Results: Malondialdehyde (MDA) and total sialic acid (TSA) levels were significantly higher in CAD (BS) than in the control group (P<0.05, P<0.05). In addition, GSH and TAS levels were significantly lower in the 1st day AS group than in the control group (P<0.001, P<0.01). Moreover, Co, Cu, Mg, Se, V and Zn levels were significantly lower in CAD (BS) group than in the control group (P<0.01, P<0.01, P<0.01, P<0.01, P<0.05, P<0.001). Conclusions: It was concluded that the levels of LDL-C, total cholesterol, triglycerides and CRP significantly associated with parameters, as well as Cu, Ca and SOD activity, should be measured together to monitor CAD. It is also considered that measuring TSA and MDA might be an appropriate choice for biomarkers of CAD.
An Unusual Complication Following Saphenous Vein Graft Harvesting for Coronary Artery Bypass Surgery: Pseudo-Kaposi Sarcoma
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2020) Sahinalp, Sahin; Aras, Ibrahim
Pseudo-Kaposi sarcoma is a rare, vasoproliferative skin disease usually caused by an underlying vascular malformation or venous insufficiency. Unusual forms such as amputation stumps and lower extremity paralysis have been also reported. However, its emergence in the leg from which the saphenous vein was harvested following peripheral artery disease and coronary artery bypass surgery has not been previously reported. We, herein, present a 78-year-old female case who developed pseudo-Kaposi syndrome in her left leg, which was affected by peripheral artery disease following the removal of the saphenous vein six months after coronary artery bypass grafting.