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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 THE EFFECT OF ILOPROST ON RENAL DYSFUNCTION AFTER RENAL I/R USING CYSTATIN C AND beta(2)-MICROGLOBULIN MONITORING(LIPPINCOTT WILLIAMS & WILKINS, 2009) Sahsivar, M. Orkun; Narin, Cueneyt; Kiyici, Aysel; Toy, Hatice; Ege, Erdal; Sarigul, AliThe purpose of this study was to investigate the effect of iloprost, a cytoprotective prostacyclin analog, on renal injury during unilateral renal I/R in rats and to determine whether the levels of serum cystatin C (CyC) and beta(2)-microglobulin (B2M), as markers of glomerular function, might denote this injury. Thirty-two Wistar rats were randomized into four groups (n = 8) as follows: control (sham laparotomy), renal I/R (60-min left renal ischemia and 120-min reperfusion), renal I/R + iloprost (20 ng kg(-1) min(-1) infusion during renal I/R period, i.v.), and control + iloprost. Blood and kidney tissue samples were obtained for biochemical and histological analysis from all rats. Serum urea, creatinine, CyC, and B2M levels were evaluated for biochemical analysis. Histopathological changes in renal structure were examined for histological analysis. Serum urea, creatinine, and CyC levels were significantly increased in the renal I/R group. Iloprost treatment decreased these three markers in the renal I/R + iloprost group. beta(2)-Microglobulin levels were not significantly changed in any group. Histological analyses showed that renal I/R elicited significant renal injury, whereas iloprost significantly decreased I/R-induced renal injury. Serum CyC level is one of the good indicators of acute renal damage due to I/R produced by renal artery occlusion. In contrast, we have shown that there are no significant changes in the levels of serum B2M levels that would make it an accurate diagnostic tool for detecting acute changes in renal injury subject to renal I/R in rats.Öğe Left ventricular rhabdomyoma with severe left ventricular outflow tract obstruction(WILEY, 2007) Sarigul, Ali; Oezkara, Ahmet; Narin, Cueneyt; Cimen, Derya; Sarkular, Gamze; Sahsivar, Orkun; Toy, HaticeThe incidence of cardiac tumors increased with the improvement of imaging techniques in infants. Rhabdomyomas are the most common tumors in this group of patients. We herein report a 40-day-old male patient with left ventricular rhabdomyoma. The tumor caused syncope attack and supraventricular tachycardia. An emergency operation was planned and the life-threatening lesion was excised via left ventriculotomy. The patient was extubated on postoperative sixth hour and discharged from hospital on the sixth day of the postoperative period without any problem. This successful operation encourages us not to hesitate to perform an operation in newborns with cardiac neoplasms causing hemodynamic instability.Öğe Mitral valve replacement in a renal transplant patient(GALENOS YAYINCILIK, 2007) Narin, Cueneyt; Ege, Erdal; Dereli, Yueksel; Sarigul, Ali[Abstract not Available]Öğe The Potential Effect of Epidural Anesthesia on Mesenteric Injury after Supraceliac Aortic Clamping in a Rabbit Model(ELSEVIER SCIENCE INC, 2016) Onoglu, Rasit; Narin, Cuneyt; Kiyici, Aysel; Sarkilar, Gamze; Hacibeyoglu, Gurhan; Baba, Fusun; Sarigul, AliBackground: Epidural anesthesia is known to increase blood flow by producing vasodilatation on mesenteric circulation. In this experimental study, we aim to examine the effect of epidural anesthesia on mesenteric ischemic-reperfusion ( IR) injury induced by supracoeliac aortic occlusion in a rabbit model. Methods: Twenty-eight male white New Zealand rabbits were assigned into 4 separate groups, with 7 rabbits in each group: group I, control group; group II, IR-only group; group III, IR plus epidural anesthesia group; group IV, epidural anesthesia-only group. IR model was produced by clamping supraceliac aorta with an atraumatic vascular clamp for 60 min, followed by reperfusion for 120 min. An epidural catheter was placed via Th12-L1 intervertebral space by using open technique before aortic clamping in those assigned to epidural anesthesia. IR injury was assessed using blood markers interleukin-6 and IMA and tissue markers superoxide dismutase and malondialdehyde. Also histopathological examination was performed to evaluate the degree of injury. Results: All biochemical markers in group II were significantly elevated in comparison with the other 3 groups ( p < 0.05). This was paralleled by a more severe histopathological injury in IR-only group ( group II). The group receiving IR plus epidural anesthesia ( group III) had lower biochemical marker levels as compared with the IR-only group ( group II). Conclusions: Mesenteric IR injury that can occur during abdominal aorta surgery can be reduced by epidural anesthesia, which is commonly used during or after major operations for pain control. Controlled clinical studies are required to evaluate these findings.Öğe Surgery of left atrial myxoma as a second primary tumor in a patient previously treated for breast cancer(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2012) Narin, Cuneyt; Ege, Erdal; Onoglu, Rasit; Yazici, Mehmet; Sarigul, AliA rising level of experience and advances in cardiac surgery are leading to more operations being performed on elderly patients with other complicated diseases. But cardiac surgery in patients with malignant diseases remains a problem. Although most malignant diseases are curable, surgeons are usually reluctant to perform open heart surgery in patients with advanced tumors and a short life expectancy. Among patients undergoing open heart surgery, the incidence of malignancy is 1.2%. In this article, we present a successful atrial myxoma excision in an elderly patient with treated breast cancer using cardiopulmonary bypass and cardiac arrest.Öğe Surgical treatment of postinfarction pseudoaneurysms of the left ventricle(WILEY, 2008) Narin, Cueneyt; Ege, Erdal; Ozkara, Ahmet; Tanyeli, Omer; Sarkilar, Gamze; Soylu, Ahmet; Sarigul, AliBackground: Left ventricular pseudoaneurysm is a rare and frequently fatal complication of acute myocardial infarction. It occurs as a consequence of rupture of the ventricular free wall that gets confined by a portion of the pericardium. The purpose of this study was to present our surgical experience of postinfarction left ventricular pseudoaneurysms and to evaluate mid-term results. Methods: The study population comprised five symptomatic patients diagnosed with left ventricular pseudoaneurysm and treated surgically in a short period of time. There were three males and two females. The mean age of the patients was 66.8 +/- 10.8 years. The diagnosis was made initially by echocardiography and subsequently confirmed by angiography. An additional cardiac magnetic resonance imaging study was performed in three patients. Surgical resection of the pseudoaneurysm was combined with an endoaneurysmorrhaphy procedure in all patients. Associated cardiac operations were performed in three patients. Definitive diagnosis of pseudoaneurysm was confirmed by histopathological evaluation of the excised wall in all patients. Results: All patients survived the operation and were discharged to home care. The mean duration of hospital stay was 11.6 +/- 4.6 days. Patients were either in class I or II of New York Heart Association classification at discharge. All patients are still being followed after surgery with a mean follow-up period of 10.4 +/- 6.6 months with no further problems. Conclusion: Surgical repair is indicated in left ventricular pseudoaneurysm as it carries a high risk of rupture and sudden cardiac death. Surgical repair combined with an endoaneurysmorrhaphy procedure carries a low mortality risk and improves functional capacity.
