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  • Küçük Resim Yok
    Öğe
    Hemodynamic changes with Recombinant Human Erythropoietin (r-HuEPO) therapy in uremic hemodialyzed patients
    (1994) Yeksan M.; Tamer N.; Turk S.; Cirit M.; Telli H.H.; Bayram A.; Erdogan Y.
    The aim of this study was to evaluate the effect of Recombinant Human Erythropoietin (r-HuEPO) treatment on echocardiographic parameters, plasma renin activity (PRA), plasma aldosterone and plasma atrial natriuretic peptide (ANP) levels in uremic hemodialysis patients. Over a period of 4 months, we administered r-HuEPO at a dose of 60 U/kg, three times a week after dialysis to 21 patients on chronic maintenance hemodialysis. Sixteen uremic patients were taken as control group. M-mode echocardiography was carried out by the same specialized examiner. Heart rate and blood pressure were recorded at the same time. Students-t test was used for statistical analysis. The mean values of diastolic blood pressure increased. There were no changes in heart rates. In the measurements of M-mode echocardiography, left ventricular internal dimensions during systole and diastole decreased but there were no significant changes in intraventricular septal and left ventricular posterior wall thickness. While the ejection fraction did not change, stroke volume and cardiac output decreased respectively. PRA and aldosterone levels significantly decreased. ANP levels increased. No hemodynamic parameter change was seen in the control group. Probably, the increase in whole blood viscosity associatad with the increase in peripheral resistance was responsible for those hemodynamic alterations caused by r-HuEPO therapy.
  • Küçük Resim Yok
    Öğe
    Pseudoaneurysm of ascending aorta: A rare complication of mediastinitis following coronary artery bypass surgery [Assandan aortanin psödoanevrizmasi: Koroner arter baypas cerrahisinden sonra gelişen mediyastinitin nadir bir komplikasyonu]
    (2010) Görmüş N.; Telli H.H.; Yüksek T.
    Postoperative mediastinal infection after open-heart surgery via median sternotomy is a devastating complication. A 58-year-old male patient had mediastinitis in the early postoperative period of coronary artery bypass graft operation because of three vessel coronary artery disease. The sternum was reopened; all necrotic and infected tissues were resected. Then sternum was closed with modified Robicsek technique and pectoralis major muscle flap. Broad-spectrum antibiotic was given according to the antibiogram results of drainage fluid. He did well and discharged 20 days after the second surgery. He delayed his control visits and two months later, he was admitted with pulsating sternum and bleeding over the incision line. Chest X ray and computed tomography (CT) of the chest showed enlargement of upper mediastinum and a huge retrosternal pseudoaneurysm originating from the ascending aorta (Fig. 1, 2). He was taken to the operation theatre urgently and initially femoral artery cannulations were prepared. However, massive bleeding occurred at the time of sternotomy. He died although urgent cardiopulmonary bypass was tried. A huge and ruptured pseudoaneurysm originating from the proximal anastomosis site of saphenous vein graft was observed over the ascending aorta. As a result of this experience, we advice to take a control chest CT two or three weeks after a successful treatment of mediastinitis or on discharge. © 2010 by AVES Yayincilik Ltd.