Publications (16) View all
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Article: Randomized comparison of vasodilator effects of iloprost versus diltiazem on flow and pathologic changes in radial arteries: mid-term angiographic control study of the comparison of vasodilators on radial artery vasospasm.
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ABSTRACT: The increasing prevalence of routine radial artery (RA) use in coronary artery bypass grafting (CABG) has rendered the pharmacologic prevention of spasm of this artery a critical consideration in the early postoperative period and in the long-term outcome. In this study, we compared the effects of iloprost and diltiazem on vasospasm. Seventy patients who underwent CABG with the RA were randomized into 2 groups, and the vasodilator effects of iloprost and diltiazem were studied prospectively. RA flow was measured with Doppler ultrasonography. Following harvesting, a 5-mm piece was removed from the RA distally for pathologic examination. In group B, diltiazem was infused before removing the RA, whereas in group A, iloprost infusion was initiated 5 days before surgery. At the end of a 2-year follow-up, each patient underwent coronary angiography. Doppler flow measurements made during harvesting revealed a statistically significant reduction in flow, and a pathologic examination of the RAs revealed significant luminal narrowing in group B. A 2-year angiographic follow-up revealed all of the RA grafts in group A to be patent. Our evaluation of the results revealed the superior efficacy of iloprost over diltiazem in preventing RA spasm in the early period, and the 2-year angiographic findings showed that the use of iloprost produced superior mid-term patency.Heart Surgery Forum 09/2009; 12(4):E202-7. · 0.63 Impact Factor -
Article: Off-pump pulmonary valve implantation.
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ABSTRACT: In congenital heart surgery, especially after Tetralogy of Fallot (TOF), problems from the right ventricular outflow tract may lead to serious complications as morbidity and mortality. To resolve these problems by reoperating using cardiopulmonary bypass (CPB) with valves or conduits is affecting surgical morbidity and mortality rates. The ability of a newly developed Shelhigh Pulmonic Valved Injectable No-React-Treated Conduit (NR 4000-PA MIS Shelhigh Inc., Union, NJ, USA) to be implanted into a beating heart provides great advantages for both patient and surgeon. Early results of the first application in our clinic are presented in this article.Journal of Cardiac Surgery 06/2008; 23(5):464-7. · 0.87 Impact Factor -
Article: Mitral annuloplasty with biodegradable ring for infective endocarditis: a new tool for the surgeon for valve repair in childhood.
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ABSTRACT: The incidence of bacterial endocarditis and valvular involvement is rare in the childhood period. If the patient is unresponsive to medical treatment and some complications occur, early surgical treatment is indicated. Debridement of vegetation combined with valve repair techniques sparing the native valve is the ideal surgical procedure instead of replacement, especially for children. Annuloplasty is the key step during valve repair procedures. On the other hand, absence of appropriate sized annuloplasty rings on the market for this group of patients is the main problem. Nondegradable annuloplasty rings might lead to stenosis as the child grows. Thus, biodegradable tissue engineered materials are new solutions for such patients since the fibrous tissue induced by implanted ring grows with time. We describe a pediatric patient with Brucella endocarditis at the mitral position who was treated successfully with valve repair using a biodegradable annuloplasty ring (Kalangos Biodegradable Ring).Interactive cardiovascular and thoracic surgery 09/2005; 4(4):378-80. -
Article: Long tortuous aorta in a child with Larsen syndrome.
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ABSTRACT: A three-year-old boy with unusually flattened facies, multiple joint dislocations and eye abnormalities suggesting the presence of Larsen syndrome presented with a broad mediastinum on routine chest radiography. Computed tomography revealed a huge dilated tortuous aortic arch. Transthoracic echocardiography demonstrated aortic valve dilation, aneurysmal dilation of the ascending aorta with a high aortic arch and a kink in the arch at the isthmus level. Aortography showed a dilated elongated aorta with two acute curves, one at the ductal level and the second at the diaphragmatic level. These aortic lesions may have prognostic significance for the future risk of rupture or dissection. The present article reports the presence of a tortuous aorta in a child with Larsen syndrome.The Canadian journal of cardiology 04/2005; 21(3):299-301. · 3.36 Impact Factor -
Article: Intrapericardial fibrinolytic therapy in purulent pericarditis.
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ABSTRACT: Purulent pericarditis is a rare disease that is being conventionally managed with intravenous antibiotics and pericardial drainage. In our study, we used intrapericardial fibrinolytic treatment together with pericardiocentesis and antibiotic therapy. We evaluated the role of intrapericardial fibrinolytic treatment in nine purulent pericarditis patients. Six children and three adult patients with purulent pericarditis, aged between 5 and 50 years, were treated with intrapericardial fibrinolysis by streptokinase. Intrapericardial drainage catheter was placed into the subxyphoidal localization under local anaesthesia and echocardiography guidance, streptokinase was infused into the pericardial sac as the fibrinolytic agent. Repeat echocardiograms showed no reaccumulation of pericardial effusions, pericardial thickening or constrictions. No patients had systemic bleeding, arrhythmias, or hypotension. There was one death which was due to sepsis and congestive heart failure. We believe that early pericardial drainage and intrapericardial fibrinolysis appears to be safe and effective in the treatment of purulent pericarditis.European Journal of Cardio-Thoracic Surgery 10/2002; 22(3):373-6. · 2.55 Impact Factor
