Onur S Göksel

Istanbul University, İstanbul, Istanbul, Turkey

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Publications (22)15.73 Total impact

  • Onur S Göksel, Helin El, Akif Onalan, Ufuk Alpagut
    The journal of vascular access 05/2012; · 0.97 Impact Factor
  • O S Göksel, Y Enç, B Cinar
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    ABSTRACT: Open surgical repair of complex aortic pathologies using cardiopulmonary bypass and deep hypothermic circulatory arrest still carries a substantial rate of mortality and morbidity. Endovascular stent-graft placement has developed as a safe and effective treatment modality for various diseases of the aorta. We report on the case of a 65-year-old female presenting with symptomatic type B aortic dissection with aneurysm of the ascending aorta and the aortic root. The patient was treated with a flanged composite graft custom made from a branched 24-mm Dacron graft for entire prosthetic transposition of the supra-aortic branches. Metachronously, the patient underwent endovascular stent-grafting of the descending aorta. She was discharged free of complications on day 10.
    The Thoracic and Cardiovascular Surgeon 02/2010; 58(1):49-51. · 0.93 Impact Factor
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    ABSTRACT: Isolated partial anomalous pulmonary venous connection (PAPVC) of the entire left lung is a rare congenital anomaly with incidental diagnosis and vague symptoms, if any, until late adulthood. If left untreated, PAPVC may result in severe right ventricular failure and pulmonary vascular disease. We present the case of a 34-year-old woman with isolated PAPVC of the entire left lung. The patient underwent operation with a side-to-side left atrio-vertical vein anastomosis while on cardiopulmonary bypass and under cardioplegic arrest. She was discharged without complications and with a gradient of 2 mm Hg across the anastomosis. Left-sided PAPVC can be repaired with minimal morbidity and mortality. Surgical correction is warranted when patients are symptomatic or show evidence of right-sided overload due to unpredictability of the natural course. Recent data demonstrate that both on-pump and off-pump surgical procedures produce excellent long-term outcomes when performed without persisting gradients.
    Heart Surgery Forum 07/2009; 12(3):E182-3. · 0.63 Impact Factor
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    ABSTRACT: Primary bronchogenic cysts of cardiac origin or extension are rare. We report here on a 5-year-old girl with a bronchogenic cyst with a diameter of 5.0 x 4.5 x 4.5 cm extending to the right atrial wall. Tumor enucleation and resection of the cyst together with the invaded right atrial wall was performed through a right posterolateral thoracotomy and an opening in the lateral pericardium. Resection of intrapericardial bronchogenic cysts is possible, although extensive invasion of cardiac structures may necessitate the use of cardiopulmonary bypass through a sternotomy.
    The Thoracic and Cardiovascular Surgeon 11/2008; 56(7):435-6. · 0.93 Impact Factor
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    Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 03/2008; 8(1):E5-6. · 0.72 Impact Factor
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    ABSTRACT: None of the nursing studies on PA catheter removal pointed out any differences in complications after removal and procedural activities for removal of PA catheter by CCNs vs MDs in Turkey. This quasi-experimental study was conducted to determine the occurrence and type of complications and to indicate the differences between CCNs and medical doctors' (MDs) activities for removal of PA catheter. Totally, 60 critical care unit patients were scheduled as a sample, and they were assigned randomly to the CCN (n = 30) or to the MD (n = 30) groups. For the comparison purposes of the different activities and complications of PA catheter removal procedure between the two groups, 'Instruction Form' was followed step by step. The differences in the prevalence of variables were tested using Student's t statistics. For categorical data, Fisher's exact test was used. Significance was declared by P value of <0.05. Preprocedural activities like patient positioning (P < 0.001) and instructing the patient for breathing (P = 0.001) demonstrated statistically significant differences between the two groups. The PA catheters were removed properly in both groups (P > 0.05). The majority of postprocedural activities were completed successfully. The complications of the catheter removal were documented more carefully by nurses compared with doctors (P < 0.01). Additionally, singular premature ventricular complexes were observed on electrocardiogram in both groups (P > 0.05). Instructing CCNs to remove a PA catheter has been highlighted in keeping the number of complications associated with removal procedure of PA catheter.
    Nursing in Critical Care 02/2008; 13(2):105-15. · 0.95 Impact Factor
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    ABSTRACT: We present a patient with right-sided endocarditis associated with abdominal aortic pseudo-aneurysm presenting only with high fever and pulsating abdominal mass. A higher clinical awareness of aortic pseudoaneurysms associated with intracardiac lesions disease, leading to early computed tomography evaluation and prompt surgical intervention appears to offer the best chance of survival. In this aspect, single-stage surgical treatment of both endocarditis and the aortic pathology is necessary.
    Journal of Cardiac Surgery 01/2008; 23(2):168-71. · 1.35 Impact Factor
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    ABSTRACT: It is not clear how levels of serum lipids and glucose and plasma osmolality change during propofol infusion in the pre- and postoperative period of coronary artery bypass graft surgery (CABG). This prospective, randomized, controlled trial evaluated changes in these parameters during propofol or midazolam infusion during and in the early postoperative period following surgery. Twenty patients undergoing CABG were randomized preoperatively into two groups: 10 patients received propofol (induction 1.5 mg/kg, maintenance 1.5 mg kg(-1) h(-1)) and 10 patients received midazolam (induction 0.5 mg/kg, maintenance 0.1 mg kg(-1) h(-1)). Both groups also received fentanyl (induction 20 mug/kg, maintenance 10 microg kg(-1)). Serum lipids, glucose, and plasma osmolality were measured preinduction, precardiopulmonary bypass, at the end of cardiopulmonary bypass, at the end of surgery, and 4 and 24 h postoperatively. In the propofol group, we observed a significant increase in triglycerides and very low-density lipoprotein levels 4 h postoperatively. In the midazolam group, we observed a significant decrease in low-density lipoprotein, cholesterol at the end of cardiopulmonary bypass, end of surgery, and 4 and 24 h postoperatively and significant increase in osmolality at the end of cardiovascular bypass. Changes in glucose levels did not differ significantly different between the two groups. In patients with normal serum lipids, glucose, and plasma osmolality undergoing CABG, propofol infusion for maintenance anesthesia is not associated with dangerous changes in serum lipids, glucose, and plasma osmolality compared with midazolam. A propofol infusion technique for maintenance of anesthesia for cardiac surgery where serum lipids and glucose may be of concern could be recommended as an alternative to midazolam.
    Yakugaku zasshi journal of the Pharmaceutical Society of Japan 02/2007; 127(1):173-82. · 0.46 Impact Factor
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    ABSTRACT: Critical care nurses and physicians are familiar with the principles of patient controlled analgesia and the opioid analgesics' regimens and observations necessary for pain control in the postoperative cardiac surgical patients. The objective of the study was to compare the effects of morphine, fentanyl, meperidine, remifentanil and tramadol which were administered by patient controlled analgesia and continuous intravenous infusion combination on the various parameters. This study was designed as prospective randomised trial. Fifty patients undergone open heart surgery with sternotomy were entered equally into five randomized groups. Visual analog scale was used by researcher nurse to assess the patient' pain status. Respiratory rate, heart rate and blood gases (pO2, pCO2, SaO2), radial arterial blood pressures were measured in the first 24 hrs postoperatively. Bolus requirements were determined by physicians and side effects of the analgesics were documented. Fentanyl group showed statistically higher levels of mean pO2 (p=0.002). Meperidine had the lowest number of bolus doses (p=0.001). There were no significant differences between the groups for pain management except higher visual analog scales on tramadol. Headache, stomach-ache and, palpitations were observed in our patients. Remifentanil, meperidine, fentanyl and morphine showed similar effect with each other for pain relief except tramadol.
    Yakugaku zasshi journal of the Pharmaceutical Society of Japan 08/2006; 126(7):499-504. · 0.46 Impact Factor
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    ABSTRACT: Data on long-term outcome of pericardiectomy are limited. This retrospective study aimed to investigate risk factors and early and late outcomes of pericardiectomy for constrictive tuberculous pericarditis. Seventy patients with chronic constrictive pericarditis who underwent pericardiectomy between January 1990 and August 2005 were reviewed for perioperative and long-term survival. Patients (49 males; median age 40 years) had a median duration of symptoms of 24 months (range 8-72) before surgery. Perioperative mortality was 8.6%. During follow-up (mean 66.4 +/- 56.4), late mortality rates at 5 and 10 years were 1.6% and 9.7%, respectively. The mean censored survival in all patients was 155.2 months (SEM 8.3, 95%CI 138.8-171.6). Readmission-free survival was 68.6% over 10 years (mean 125.4 months, SEM 10.3, 95%CI 105.2-145.6). Ascites and duration of symptoms were found to be predictors of perioperative mortality (P = 0.047 and 0.036, respectively). The optimal time of pericardiectomy is most important in its management. Total or near-total pericardiectomy should always be performed as early as possible.
    The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease 07/2006; 10(6):701-6. · 2.61 Impact Factor
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    Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 04/2006; 6(1):74-6. · 0.72 Impact Factor
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    ABSTRACT: Abdominal aortic aneurysm surgery associated with a horseshoe kidney (HSK) is a serious technical challenge for the surgeon. We reviewed our experience with 127 patients electively operated on between 1990 and 2004 for abdominal aortic aneurysm. Pre- and perioperative medical, surgical, and radiologic data were retrospectively reviewed. Preoperative diagnosis was achieved with computed tomography with or without angiography or with additional conventional aortography. Seven patients were recognized to have had a HSK, with a mean age of 67.29 +/- 2.43 years. Preoperative serum creatinine levels were similar in patients with or without HSK (1.0 +/- 0.08 vs 0.9 +/- 0.12 mg/dL; not significant). In five of the patients with HSK, reimplantation of the anomalous renal artery was necessary. In all 127 patients, hospital mortality consisted of 5 patients, none of whom had an HSK. Dealing with HSK seemed to increase aortic clamp times (30.43 +/- 3.55 vs 27.04 +/- 3.92 minutes; p < .05) slightly. Patients with or without HSK were given similar amounts of intravenous fluid replacement (2,214.2 +/- 441.3 vs 1,923.3 +/- 433.6 mL/patient; not significant) and allogeneic blood transfusion (0.71 +/- 0.49 vs 0.9 +/- 0.4 U/patient; not significant) and had a similar intensive care unit stay. Abdominal aortic aneurysms associated with HSK have been managed without division of the isthmic tissue. The left retroperitoneal approach provided adequate exposure for all patients with HSK.
    Vascular 01/2006; 14(1):27-31. · 0.86 Impact Factor
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    Bayer Cinar, Onur S Göksel, Ibrahim Yekeler
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    ABSTRACT: Dialysis access surgery is currently one of the most common vascular operations as the dialysis patient population increases. Although autogenous arteriovenous fistulae stand as the preferred method of access due to excellent patency and lower complication rates, grafts may provide alternative approaches when an autogenous fistula is impractical usually due to depleted veins. We aimed in this study to assess early and midterm outcome with the use of Expedial heterografts (LeMaitre Vascular Ltd., Wrexham, UK) for angioaccess between October 2000 and December 2004. Patients were prospectively followed for pre- and peri-operative course with 1st, 6th and 12th month outpatient controls for patency and complication rates. A total of 34 heterografts were implanted in 30 patients (22 males and 8 females; median age 60.6 years, range 32 - 70). The mean followup for 30 patients were 16.3 +/- 6.1 (range 4 - 30) months. 28 grafts (82.4%) were placed in forearm position. Primary and secondary patencies were found as 81% and 94%, respectively (p = 0.15), with the median censored primary and secondary patencies of 27 +/- 1.7 months (95% CI, 23.38 to 30.67) and 30.42 +/- 1.1 months (95% CI, 28.30 to 32.54), respectively. Only presence of diabetes was found as a significant risk factor in the regression model (p = 0.01). We suggest that the polycarbonate urethane heterografts with acceptable patency/complication rates and shorter maturation times for dialysis access serve an alternative for these patients.
    The Tohoku Journal of Experimental Medicine 12/2005; 207(3):233-8. · 1.37 Impact Factor
  • Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 10/2005; 5(3):259-60. · 0.72 Impact Factor
  • Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 04/2005; 5(1):87. · 0.72 Impact Factor
  • European Journal of Anaesthesiology - EUR J ANAESTH. 01/2005; 22.
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    ABSTRACT: Endocarditis due to fungal etiology is rare, but it is the most severe form of infective endocarditis. Fungal endocarditis is commonly complicated by systemic embolizations, and the difficulty in isolating the fungi with routine blood cultures complicates the diagnostic process. In these culture-negative cases of endocarditis, etiologic diagnosis is made with histopathologic examination of the cardiac valve, embolic materials, and systemic ulcers. In this case report, the presented patient with fungal endocarditis and its neurologic complications was treated with a surgical and medical approach.
    Heart Surgery Forum 02/2004; 7(4):E312-4. · 0.63 Impact Factor
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    ABSTRACT: Carotid body paragangliomas were diagnosed by Doppler ultrasound, carotid artery angiography, and cranial computed tomography in a 35-year-old man with a mass in the neck and hearing loss, and in a 42-year-old man with headache, syncope, and a mass in the neck. They underwent successful surgical excision.
    Asian cardiovascular & thoracic annals 07/2002; 10(2):173-5.
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    O S Göksel, E Tireli, H El, H Oflaz, E Dayioğlu
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    ABSTRACT: We present the case of a 12-year-old girl with familial hypercholesterolemia and coronary artery disease. She underwent triple-vessel coronary artery bypass grafting with bilateral pedicled internal mammary artery grafting without adverse events. Pediatric patients with familial hypercholesterolemia may present with premature coronary atherosclerosis requiring coronary artery bypass grafting. In situ internal mammary artery grafts should be the graft of choice.
    Acta chirurgica Belgica 109(1):117-8. · 0.36 Impact Factor

Publication Stats

22 Citations
15.73 Total Impact Points

Institutions

  • 2006–2012
    • Istanbul University
      • Department of Cardiovascular Surgery
      İstanbul, Istanbul, Turkey
  • 2004
    • Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center
      İstanbul, Istanbul, Turkey