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Öğe Are really the early postoperative outcomes of coronary artery bypass grafting surgery in elderly women worse compared to men?(Excerpta Medica Inc-Elsevier Science Inc, 2017) Yüksel, Ahmet; Kan, İris İrem; Yolgösteren, Atıf; Velioğlu, Yusuf; Çayır, Mustafa Çağdaş[No Abstract Available]Öğe Are the early postoperative outcomes of coronary artery bypass grafting surgery in elderly women worse compared to men's?(Soc Brasil Cirurgia Cardiovasc, 2017) Yüksel, Ahmet; Kan, İrem İris; Yolgösteren, Atıf; Velioğlu, Yusuf; Çayır, Mustafa ÇağdaşObjective: To investigate the impact of gender difference in early postoperative outcomes in elderly patients (aged 70 or older) undergoing coronary artery bypass grafting surgery. Methods: Between October 2009 and December 2013, a total of 223 elderly patients (aged 70 or older) undergoing isolated primary coronary artery bypass grafting surgery were included in this retrospective observational cohort study. Patients were divided into two groups according to their gender. The patients' medical records were collected, their baseline preoperative characteristics, operative data, and postoperative outcomes were retrospectively reviewed, and the effect of gender difference in the early postoperative outcomes was analyzed. Results: Group 1 (female patients) and Group 2 (male patients) consisted of 71 and 152 patients, respectively. Mean age of patients was 74.4 +/- 3.6 years (range: 70-84 years). The level of EuroSCORE I, the incidence of hypertension and hyperlipidemia were significantly higher in Group 1, while the rate of smoking was significantly higher in Group 2. Mean postoperative intubation time, length of intensive care unit and hospital stay were longer in female patients than in male patients, but these differences were not statistically significant. No statistically significant difference between two groups in terms of the transfusion of blood products was observed. The rates of in-hospital mortality and major postoperative complications were statistically similar between the two groups. Conclusion: In conclusion, the female gender was not associated with worse early postoperative outcomes in elderly patients undergoing coronary artery bypass grafting surgery.Öğe Biatrial approach provides better outcomes in the surgical treatment of cardiac myxomas(Soc Brasil Cirurgia Cardiovasc, 2016) Yüksel, Ahmet; Saba, Davit; Velioğlu, Yusuf; Ener, Serdar; Özkan, HayatiObjective: We aimed to present clinical features, surgical approaches, importance of surgical technique and long-term outcomes of our patients with cardiac myxoma who underwent surgery. Methods: We retrospectively collected data of patients with cardiac myxoma who underwent surgical resection between February 1990 and November 2014. Biatrial approach is the preferred surgical method in a large proportion of patients that are operated due to left atrial myxoma because it provides wider exposure than the uniatrial approach. To prevent recurrence during surgical resection, a large excision is made so as to include at least 5 mm of normal area from clean tissue around the tumor. Moreover, special attention is paid to the excision that is made as a whole, without digesting the fragment of tumor with gentle dissections. Results: Forty-three patients (20 males, mean age of 51.7 +/- 8.8 years) were included. Most common symptom was dyspnea 48.8%). Tumor was located in the left atrium in 37 (86%) patients. Resections were achieved via biatrial approach in 34 patients, uniatrial approach in 8 patients, and right atriotomy with right ventriculotomy in 1 patient. One patient died due to low cardiac output syndrome in the early postoperative period. Mean follow-up time was 102.3 +/- 66.5 months. Actuarial survival rates were 95%, 92% and 78% at five, 10 and 15 years, respectively. Recurrence was observed in none of the patients during follow-up. Conclusion: Although myxomas are benign tumors, due to embolic complications and obstructive signs, they should be treated surgically as soon as possible after diagnosis. To prevent recurrence, especially in cardiac myxomas which are located in left atrium, preferred biatrial approach is suggested for wide resection of the tumor and to avoid residual tumor.Öğe A comparison of early clinical outcomes of off-pump and on-pump coronary artery bypass grafting surgery in elderly patients(Acta Medical Belgica, 2018) Yüksel, Ahmet; Yolgösteren, Atif; Kan, İris İrem; Çayır, Mustafa Çağdaş; Velioğlu, Yusuf; Yalçın, Mustafa; Tok, MustafaBackground: The reply of question of "which coronary artery bypass grafting (CABG) technique is superior in elderly patients, off-pump or on-pump CABG surgery?" is controversial. We aimed to compare the early clinical outcomes in elderly patients undergoing off-pump and on-pump CABG. Methods: From January 2009 to January 2015, 344 elderly patients (aged 70 or older) underwent off-pump (n = 137) or on-pump (n = 207) CABG. Patients' medical records were retrospectively reviewed, and their baseline preoperative characteristics, operative data and postoperative outcomes were analyzed, thereby a comparison of early outcomes between off-pump and on-pump patients was performed. Results: Mean age of patients was 74.4 +/- 3.8 years. Both groups were statistically similar in terms of baseline preoperative characteristics. Number of distal bypass was significantly lower in off-pump group than in on-pump group. Postoperative length of intensive care unit and hospital stay were similar between two groups. Amounts of transfused blood products were significantly lower in off-pump CABG group. There were no significant differences in terms of postoperative complications and mortality between two groups. Conclusions: Our results did not reveal a significant benefit of either surgical technique with respect to early-term clinical outcomes in elderly CABG patients. Further investigations are needed to determine whether off-pump CABG is superior than on-pump CABG in elderly patients.Öğe Complete blood count parameters in peripheral arterial disease(Taylor & Francis Ltd, 2019) Velioğlu, Yusuf; Yüksel, AhmetObjective: To determine whether complete blood count parameters could be used as the biomarkers of inflammation in patients with in peripheral arterial disease. Methods: Seventy-five patients with peripheral arterial disease (study group) and 75 healthy subjects (control group) were included in this retrospective study. Their baseline clinical characteristics and laboratory data were recorded and compared. Data were compared using univariate tests including independent samples t-test, Mann-Whitney U-test and chi-square test. Moreover, multivariate logistic regression analysis was also conducted to determine independent predictors of peripheral arterial disease. Results: The groups were statistically similar with regards to baseline clinical and demographic features. The values of C-reactive protein, white blood cell and neutrophil-to-lymphocyte ratio values were found to be statistically significantly higher in study group versus control group, but none of them were considered as an independent predictor of peripheral arterial disease according to multivariate logistic regression analysis. Only mean platelet volume was demonstrated to be a statistically significant predictor of peripheral arterial disease. Conclusion: Our study deduced that mean platelet volume was an independent predictor of peripheral arterial disease, and could be used as a marker of inflammation in patients with peripheral arterial disease.Öğe Complications and management strategies of totally implantable venous access port insertion through percutaneous subclavian vein(2019) Velioğlu, Yusuf; Yüksel, Ahmet; Sınmaz, EmrahBackground: The aim of this study was to present clinical characteristics, peri-procedural outcomes, early and late complications, and management strategies in patients undergoing totally implantable venous access port insertion through percutaneous subclavian vein. Methods: A total of 2,084 port devices were inserted to 2,000 cancer patients (1,066 males, 934 females; mean age 58.4±12.7 years; range, 18 to 88 years) through subclavian vein using percutaneous landmark method between March 2012 and June 2018. Medical data including demographic features, primary diagnosis, technical success, procedural time, duration of device use, reasons for the device removal, and early and late complications were retrospectively analyzed. Results: The most common type of cancer was colon cancer in males and breast cancer in females. Technical success rate of the procedure was 98.5%. Right subclavian vein was accessed in the majority of patients (92.4%). Early complications including inadvertent arterial puncture, catheter malposition, superficial hematoma, and pneumothorax occurred in 143 patients (6.9%), while late complications including infection, catheter occlusion, venous thrombosis, wound problems, catheter migration and embolization and pinch-off syndrome was developed in 118 patients (5.7%). Inadvertent arterial puncture in 63 patients (3%) was the most common early complication, while infection in 44 patients (2.1%) was the most common late complication. A total of 192 devices were removed due to the completion of chemotherapy or development of complications. Conclusion: Our study confirmed the safety and tolerability of totally implantable venous access port insertion through percutaneous subclavian vein with high technical success and low complication rates.Öğe Contribution of current comorbid conditions to carotid artery stenosis in patients undergoing coronary artery bypass and stroke distribution in carotid artery stenosis groups(Forum Multimedia Publishing, Llc, 2021) Işık, Mehmet; Velioğlu, YusufObjective: The aim of this study was to contribute to the issue of “Who should we perform Doppler ultrasonography on?” and determine the contribution of comorbid diseases to the development of carotid artery stenosis (CAS) and pre-operative CAS by examining comorbid diseases in patients undergoing coronary artery bypass graft operation (CABG) and also discussing the effect of carotid stenosis levels on postoperative stroke.Method: Between 2011-2015, a total of 921 patients who underwent cardiac surgery retrospectively were examined. Of these, 594 CABG patients aged 60 and over who underwent preoperative carotid Doppler examination were analyzed.Results: Sixty-five percent of patients were male, and 35% were female. The mean age was 69.3 years. Sixty-nine percent of patients were in the 0-29% stenosis group, 12.9% in the 30-49% group, 14.6% in the 50-69% group, 3% in the 70-99% group, and 0.3% in the 100% occlusion group. Peripheral artery disease (PAD), age, gender, and diabe-tes mellitus (DM) were found to have significant (P < 0.05) effects on the occurrence of CAS. CAS increased by 0.9% with an increase of one year in age, 10.8% with the presence of PAD, 3% with male sex, 3.8% with presence of chronic obstructive pulmonery disease (COPD), 1.9% with presence of left main coronary disease (LMCAD), and 0.9% with pres-ence of hypertension. In the decision tree analysis, the rate of 50% and above CAS in the presence of PAH + DM and age older than 65 years was 62.5%. Cerebrovascular accident (CVA) distribution was 2.1% in the 0-29% group, 2.5% in the 30-49% group, 4.5% in the 50-69% group, and 11.1% in the 70-99% group. Postoperative CVA was not observed in 10 patients who underwent carotid endarterectomy (CE). Postoperative CVA developed in six patients with 50% or more stenosis who did not undergo CE. Conclusion: For the preoperative detection of CAS in patients undergoing CABG, the association of advanced age, PAD, DM, male gender, COPD, LMCAD, and hyperten-sion risk factors should be considered. We suggest that carotid screening should be performed in those over 65 years of age and with PAD+DM. Studies with large populations are needed to observe the effects of aortic atherosclerosis load, surgical proce-dure, and unilateral/bilateral CAS presence on the development of stroke in patients with severe CAS and postoperative CVA.Öğe Current status of arterial revascularization for the treatment of critical limb ischemia in infrainguinal atherosclerotic disease(Thieme Medical Publ Inc, 2018) Yüksel, Ahmet; Velioğlu, Yusuf; Çayır, Mustafa Çağdaş; Kumtepe, Gencehan; Gürbüz, OrçunCritical limb ischemia (CLI) is the most severe form of peripheral arterial disease (PAD) that may result in limb loss and even death; thus, the fast and proper treatment should be employed as earlier as possible to prevent these catastrophic consequences. Arterial revascularization is almost always an indispensable treatment option for CLI. Although both endovascular and surgical revascularization procedures have an important role, nowadays, the hybrid revascularization as a combination of these revascularization procedures has also gained increasing popularity in the treatment of patients with CLI. This review provides an update on the arterial revascularization strategies for the treatment of CLI.Öğe Development of venous thromboembolism in patients with hereditary thrombophilic risk factors and evaluation of genetic and biochemical parameters affecting development of venous thromboembolism(2020) Korkmaz, Ufuk Turan Kürşat; Çetinkaya, Ayhan; Yüksel, Ahmet; Velioğlu, Yusuf; Uçaroğlu, Erhan Renan; Arslan, Ali Osman; Erdem, KemalettinObjectives: To evaluate patients diagnosed with venous thromboembolism (VTE) in terms of hereditary thrombophilic risk factors and to assess genetic and biochemical factors affecting the development of VTE. Methods: Sixty patients with VTE and 23 control subjects without VTE were retrospectively evaluated. Prevalence of thrombophilic risk factors and parameters like demographic data, clinical follow-up duration were examined with genetic, biochemical and radiological investigations. Results: Mutations were detected in the genes of Factor V Leiden in 37.4%, Factor II in 13.4%, Methylenetetrahydrofolate reductase C677 in 47.5%, Methylenetetrahydrofolate reductase A1298C in 53.3%, Plasminogen activator inhibitor-1 in 31.6%, Angiotensin converting enzyme in 39.0%, and Factor V H1299R in 8.3% of patients. Protein C deficiency was detected in 25 patients (41.7%), free Protein S deficiency was detected in 25 patients (41.7%) in study group and 3 subjects (13.0%) in control group, and this difference was statistically significant (p=0.023). Antithrombin III deficiency was detected in 1 patient (1.7%) in study group. Elevated homocysteine was higher in study group compared to controls, and the difference was statistically significant (p=0.02). Conclusion: Determination of hereditary risk factors in VTE patients will provide family members who have hereditary risk factors, but did not suffer attack to be protected against thromboembolic attacks by taking simple measures against acquired factors.Öğe Does pulmonary hypertension affect early-term outcomes of off-pump coronary artery bypass surgery?(Assoc Medica Brasileira, 2022) Velioğlu, Yusuf; Yüksel, Ahmet; Topal, Dursun; Korkmaz, Ufuk Turan Kürşat; Dönmez, İbrahim; Badem, Serdar; Uçaroğlu, Erhan RenanOBJECTIVE: This study aimed to investigate the effect of preoperative pulmonary hypertension (PHT) on postoperative early mortality and morbidity in patients undergoing off-pump coronary artery bypass grafting (CABG).METHODS: A total of 1107 patients undergoing elective first-time off-pump CABG between January 2011 and April 2022 were included in this retrospective observational cohort study. The patients were categorized into two groups according to their preoperative systolic pulmonary artery pressure (SPAP) values. The PHT group (n=104) consisted of patients with a SPAP value >30 mmHg, while the non-PHT group (n=1003) consisted of patients with a SPAP value <= 30 mmHg. Patients' preoperative demographics and clinical features, operative data, and postoperative outcomes were recorded and then compared between the groups.RESULTS: In the PHT group, the median age was significantly higher (66 vs. 63 years, p=0.001) and the median left ventricular ejection fraction level was significantly lower (45 vs. 50%, p=0.045) as compared to the non-PHT group. Additionally, the PHT group included a significantly greater percentage of patients with chronic obstructive pulmonary disease (22.1 vs. 7.4%, p=0.019). As perioperative early-term outcomes, complications, and mortality were considered, the groups were statistically similar, and there were no significant differences between the groups, except for the development of atrial fibrillation.CONCLUSION: For the first time in the literature, this study revealed that mild PHT (mean SPAP=38.9 +/- 8.7 mmHg) did not significantly affect early -term outcomes of off-pump CABG.Öğe Dynamic thiol/disulphide homeostasis metrics as a risk factor for peripheral arterial disease(Sage Publications Ltd, 2021) Korkmaz, Ufuk Turan Kürşat; Yüksel, Ahmet; Çetinkaya, Ayhan; Velioğlu, Yusuf; Uçaroğlu, Erhan Renan; Erdem, KemalettinObjective To examine dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in patients with peripheral arterial disease. Methods One hundred patients with lower extremity peripheral arterial disease (a study group) and 100 control subjects were included in this prospective case-control study. Participants' baseline clinical characteristics and laboratory data including some oxidant/antioxidant status parameters such as albumin, ferroxidase and myeloperoxidase, and thiol/disulphide homeostasis parameters such as native thiol, total thiol and disulphide, as well as native thiol/total thiol, disulphide/native thiol and disulphide/total thiol ratios were all recorded and then compared between the groups. Results Mean albumin and ferroxidase, and median myeloperoxidase levels were found to be significantly higher in patients with the peripheral arterial disease than in control group (p = 0.045,p = 0.000 andp = 0.000, respectively). Mean native thiol and total thiol, and median disulphide levels were found to be significantly lower in the study group as compared with the control group (p = 0.000,p = 0.000 andp = 0.037, respectively). According to the results of logistic regression analysis, systolic blood pressure, ferroxidase and myeloperoxidase levels were detected to be the independent predictors of peripheral arterial disease. Conclusion Our report is the first one in the literature investigating dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in peripheral arterial disease. Dynamic thiol/disulphide homeostasis metrics may be used as a valuable risk factor of oxidative stress in patients with the peripheral arterial disease since it is readily available, easily calculated and relatively cheap.Öğe Early-term outcomes of off-pump versus on-pump beating-heart coronary artery bypass surgery(Georg Thieme Verlag Kg, 2019) Velioğlu, Yusuf; Işık, MehmetBackground The current study analyzed and compared early-term outcomes of off-pump versus on-pump beating heart coronary artery bypass surgery. Methods From January 2011 to January 2018, a total of 736 patients underwent isolated first-time elective beating-heart coronary artery bypass surgery without the use of aortic cross-clamping and cardioplegic arrest at our institution, and they were included in this study. Data of patients were collected and retrospectively analyzed. Patients were divided into two groups according to the use of cardiopulmonary bypass during the operation, as off-pump group ( n = 399) and on-pump beating-heart group ( n = 337). Both groups were compared with each other in terms of preoperative, intraoperative, and postoperative data. Results Groups were statistically similar with regard to baseline clinical characteristics and demographics. When compared with off-pump group, on-pump beating-heart group had a greater number of distal bypass, longer length of hospital stay, and lower postoperative hematocrit level, and received more blood product transfusion. No statistically significant differences were detected between the groups with respect to mortality and postoperative complications except for atrial fibrillation. Atrial fibrillation was significantly frequent in on-pump beating-heart group. Conclusion Our study suggested that off-pump and on-pump beating-heart coronary artery bypass procedures had similar early mortality and major complication rates except for atrial fibrillation. However, it seemed that off-pump procedure was superior to on-pump beating-heart procedure with regard to length of hospital stay, blood product transfusion, and atrial fibrillation development. Further prospective randomized studies with larger patient series are needed to support our research and attain more accurate data.Öğe An easy and reliable way to prevent electrocardiographic deteriorations of patients undergoing off-pump coronary artery bypass surgery: Preoperative anxiolytic treatment(Soc Brasil Cirurgia Cardiovasc, 2019) Demirhan, Abdullah; Velioğlu, Yusuf; Yoldaş, Hamit; Karagöz, İbrahim; Coşgun, Mehmet; Çalışkan, Duygu; Yıldız, İsa; Erdem, Kemalettin; Bilgi, MuratObjective: To investigate the effects of preoperative anxiety relieving on electrophysiological changes in patients undergoing off-pump coronary artery bypass surgery. Methods: A total of 61 patients at ASA III risk group in the age range of 18-65 years were enrolled in the present study. Patients were randomly divided into two groups. Group S (Sedation group) was administered 0.04 mg/kg lorazepam per os (PO) twice before the operation. Group C (control group) was not administered with any anxiolytic premedication. State Trait Anxiety Inventory (STAI-I) and Beck Anxiety Inventory (BAI) were used to evaluate the level of anxiety. Electrocardiography (ECG), pulse oximeter and standard monitoring were performed for each patient. QT and P dispersions in each derivation of all ECGs were calculated. Results: Preoperative STAI-I scores were significantly lower in sedation group compared to the controls. Mean values of QT dispersion measured before induction, at the 1st minute of induction, 30th second of intubation and 4th minute of intubation in sedation group were significantly reduced compared to controls (P=0.024; P=0.027; P=0.001; P=0.033, respectively). The mean values of P dispersion measured before induction, at the 3rd minute of induction, 30th second of intubation and 4th minute of intubation in sedation group were significantly reduced compared to controls (P=0.001; P=0.020; P=0.023; P=0.005, respectively). Conclusion: Elevated anxiety levels in patients undergoing coronary bypass surgery have a negative effect through prolonged QT and P-wave dispersion times. Anxiolytic treatment before surgery may be useful to prevent ventricular and atrial arrhythmias and associated complications through decreasing the QT and P-wave dispersion duration.Öğe Effects of coronary artery bypass grafting surgery on olfactory and taste functions(Forum Multimedia Publishing, Llc, 2019) Erdem, Kemalettin; Uçaroğlu, Erhan Renan; Şehitoğulları, Abidin; Yüksel, Ahmet; Tekçe, Hikmet; Velioğlu, Yusuf; Demirhan, Abdullah; Ünal, Osman; Ülkü, AynurBackground: Olfactory and taste sensations have a high impact on the quality of life. Impaired olfactory and taste functions may have a negative effect on physical and mental well-being, personal hygiene, and nutritional satisfaction, leading to the occurrence of depressive symptoms and impaired quality of life. Therefore, the recovery period of patients with disturbed olfactory and taste functions may be prolonged, and return to active life may be delayed. We designed this study to determine whether on-pump and off-pump coronary artery bypass grafting (CABG) surgeries have any effects on olfactory and taste functions and compare these functions between the surgical groups. Methods: A total of 60 patients, who underwent elective isolated first-time CABG, were included in this study. Patients were divided into two groups as Off-Pump and On-Pump CABG groups with 30 patients in each group. In addition to patients' primary clinical and laboratory data, olfactory and taste functions were evaluated pre- and postoperatively in both groups separately, and then these functions were compared between the groups. Olfactory functions were evaluated by the Brief Smell Identification Test, while taste functions by the Burghart Taste test. Results: Olfactory functions significantly were disrupted in the postoperative period in patients undergoing on-pump CABG (P value < .05), while these functions significantly were not affected in patients undergoing off-pump CABG (P value > .05). During the preoperative period, advanced age and smoking were detected to be independent predictors of impaired olfactory function for the study population. During the postoperative period, smoking, amount of postoperative bleeding and serum low-density lipoprotein (LDL) level were found to be independent predictors of impaired olfactory function for just the On-Pump CABG Group. In both groups, no significant deterioration in taste functions occurred during the postoperative period (P value > .05). Conclusion: Our study demonstrated that olfactory function was impaired in patients, who underwent on-pump CABG in the postoperative period, and significant impairment in taste function was present in neither off-pump nor on-pump CABG patients. However, the results of our study should be supported by more comprehensive, prospective, randomized controlled trials with more extensive patient series and by further tests.Öğe Effects of lidocaine oropharyngeal spray applied before endotracheal intubation on qt dispersion in patients undergoing coronary artery bypass grafting: A prospective randomized controlled study(Soc Brasil Cirurgia Cardiovasc, 2020) Bilgi, Murat; Velioğlu, Yusuf; Yoldaş, Hamit; Coşgun, Mehmet; Yüksel, Ahmet; Karagöz, İbrahim; Yıldız, İsa; Eş, Abdülhamit; Erdem, Kemalettin; Demirhan, AbdullahObjective: To investigate the effects of lidocaine oropharyngeal spray applied before endotracheal intubation on hemodynamic responses and electrocardiographic parameters in patients undergoing coronary artery bypass grafting. Methods: A total of 60 patients who underwent coronary artery bypass grafting surgery were included in this prospective randomized controlled study. Patients were randomly divided into two groups, the topical lidocaine group (administration of 10% lidocaine oropharyngeal spray, five minutes before laryngoscopy and endotracheal intubation) and the control group. Both groups were compared with each other in terms of main hemodynamic parameters including mean arterial pressure and heart rate, as well as P and QT wave dispersion durations, before and after endotracheal intubation. Results: The groups were similar in terms of age, gender, and other demographics and basic clinical characteristics. There was a statistically significant difference between the groups in terms of QT dispersion durations after laryngoscopy and endotracheal intubation. The increase in QT dispersion duration was not statistically significant in the topical lidocaine group, whereas the increase in QT dispersion duration was statistically significant in the control group. When the groups were compared in terms of P wave dispersion durations, there were significant decreases in both groups, but there was no significant difference between the groups. Conclusion: Our study revealed that the topical lidocaine administration before endotracheal intubation prevented increase of QT dispersion duration in patients undergoing coronary artery bypass grafting.Öğe The effects of thyroid hormones levels on prognosis after pediatric heart surgery(2019) Gürcü, Engin; Yüksel, Ahmet; Velioğlu, Yusuf; Sığnak, Işık ŞenkayaIn this study, we aimed to evaluate the effects of thyroid hormone levels on the prognosis of patients who underwent congenital heart surgery under cardiopulmonary bypass. A total of 40 children who underwent congenital heart surgery were enrolled to this prospective study. The patients were divided into two groups according to the presence or absence of postoperative low cardiac output state. Plasma free thyroxine, free triiodothyronine and thyroid stimulating hormone levels were measured preoperatively and at 24 and 48 hours postoperatively. Postoperative low cardiac output state was observed in five patients (12.5 %). Preoperative free thyroxine levels were significantly higher in the low cardiac output state group (p=0.021). Postoperative free triiodothyronine and free thyroxine levels were significantly lower, and lactate levels, inotropic index were significantly higher in the low cardiac output state group. Duration of mechanical ventilation, intensive care unit stay, operation and cardiopulmonary bypass were significantly higher in the low cardiac output state group. Four patients (10 %) died in the early postoperative period, and all of them were in the low cardiac output state group. Our findings showed that the occurrence of low cardiac output state after congenital heart surgery was associated with the high levels of preoperative free thyroxine and the reduction in percentage of free triiodothyronine and free thyroxine levels at the 24th and 48th hours postoperatively.Öğe Evaluation of the dynamic thiol/disulfide homeostasis in patients with chronic venous insufficiency(Elsevier, 2024) Müdüroğlu, Ayhan; Velioğlu, Yusuf; Çelik, Hümeyra; Yüksel, Ahmet; Aldemir, Mustafa; Atasoy, Mustafa Selçuk; Kılıç, Ali ÖnderObjective: There is no study in the literature evaluating the dynamic thiol/disulfide homeostasis in patients with chronic venous insufficiency. Thus, we designed this study to evaluate the dynamic thiol/disulfide homeostasis as a novel indicator of oxidative stress in patients with chronic venous insufficiency.Methods: This was a prospective case-control study performed at the department of cardiovascular surgery of a tertiary referral hospital in Turkey. A total of 80 (CEAP C3-C6) patients with lower extremity chronic venous insufficiency (as the study group) and 80 healthy subjects (as the control group) were enrolled to the study. The participants' basic demographic and clinical characteristics as well as serum levels of some laboratory parameters including albumin, ferroxidase, myeloperoxidase, native thiol, total thiol, disulphide, native thiol/total thiol, disulphide/native thiol, and disulphide/total thiol were determined, and then compared between the groups. Results: In terms of basic demographic and clinical characteristics, both groups were statistically similar, and there were no significant differences between the groups. When the laboratory parameters were considered, serum ferroxidase and myeloperoxidase levels were detected to be significantly higher, whereas albumin, native thiol, total thiol, and disulphide levels were detected to be significantly lower in the study group than in the control group. Conclusions: Dynamic thiol/disulphide homeostasis could be considered as an indicator reflecting the oxidative stress status in patients with chronic venous insufficiency. (J Vasc Surg Venous Lymphat Disord 2024;12:101689.)Öğe Frequency of asymptomatic stenotic carotid artery disease in patients with lower extremity peripheral arterial disease(2019) Velioğlu, Yusuf; Yüksel, AhmetObjectives: This study aims to investigate the frequency of asymptomatic carotid artery stenosis (CAS) in patients with peripheral arterial disease (PAD) of the lower extremity. Patients and methods: Between January 2017 and May 2018, a total of 100 patients (74 males, 26 females; mean age 60.6±9.7 years; range, 37 to 78 years) with lower extremity PAD without previous cerebrovascular event were retrospectively analyzed. All patients received carotid Duplex ultrasonography as a non-invasive screening test to detect the coexistence of CAS. Significant CAS was defined as a stenosis of ?70% of an internal carotid artery. Data including demographic and clinical characteristics of the patients were recorded and compared between the patients with and without significant CAS. Results: A significant CAS was present in 16 patients with PAD. Of them, 14 patients had an internal CAS of 70 to 99% and the remaining two patients had a totally occluded internal carotid artery. Bilateral significant CAS was observed in four patients. Only hyperlipidemia was found to be significantly more frequent in patients with significant CAS, compared to those without significant CAS. Conclusion: The frequency of significant asymptomatic CAS is high in patients with PAD. We recommend routine screening for patients with lower extremity PAD for the existence of asymptomatic CAS.Öğe Gunshot injury of head and neck region with an atypical bullet trajectory: the importance of whole body computed tomography scan(Coll Physicians & Surgeons Pakistan, 2018) Velioğlu, Yusuf; Yüksel, Ahmet; Durgun, BarışNowadays, gunshot injuries have become a common medical-legal issue because of easy accessibility of firearms. Gunshot injuries of head and neck region are highly morbid and fatal, particularly when they affect vital organs. In rare cases, atypical tract lines resulting from such injuries can cause difficulties in the diagnosis and treatment. In this report, a high energy gunshot injury involving head and neck region with an atypical bullet trajectory is presented. A24-year male soldier was brought to the emergency department on account of gunshot injury following a conflict. Although the entrance and exit holes of bullets were confined to head and neck region, the whole body computed tomography scan was carried out in spite of his borderline hemodynamics. Whole body computed tomography revealed massive hemopneumothorax, mediastinal shift, hepatic laceration, and foreign body (bullet) in the liver. The patient was operated successfully by a multidisciplinary surgical team on emergency basis. This report highlights the necessity and importance of whole body computed tomography scan in such cases.Öğe An iatrogenic femoral artery pseudoaneurysm caused by endovascular stenting for the treatment of anastomotic stenosis: An unusual complication and its successful surgical management(Coll Physicians & Surgeons Pakistan, 2019) Velioğlu, Yusuf; Yüksel, AhmetThe incidence of iatrogenic femoral artery pseudoaneurysm (FAP) has dramatically increased due to marked increase of endovascular procedures in recent years. Once diagnosed, a prompt and optimal treatment should be done as soon as possible to avoid potential complications like thromboembolism, ischemia, rupture and bleeding. There are several treatment options for this disorder. Among them, open surgical repair is preferred when other therapeutic options fail. Here, we present a case of a large iatrogenic femoral artery pseudoaneurysm as a rare complication of endovascular stenting for the treatment of an anastomotic stenosis of previous bypass graft, which was successfully treated with open surgery.
