Yavuz Sensoz

Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, İstanbul, Istanbul, Turkey

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Publications (20)28.58 Total impact

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    ABSTRACT: We investigated the efficacy of pleural drainage with the use of different chest tube methods in patients after coronary artery bypass graft (CABG) surgery. Prospective randomized study of 60 patients undergoing elective on-pump single CABG surgery. The left internal mammary arterial grafts were harvested from all patients. The patients were separated into three groups: In one group (IC6, n=20), pleural tubes were inserted through the sixth intercostal space at the midaxillary line; in the second group (SX-r, n=20), rigid straight pleural tubes were inserted from the mediastinum through the subxiphoid area; and in the third group (SX-s, n=20), soft curved drainage tubes were inserted from the mediastinum through the subxiphoid area. The residual pleural effusion was examined by multislice CT scans within 8 hours of removal of the drainage tubes. Pain was evaluated according to standard methods. The groups did not differ with respect to volume of residual pleural effusion (P >.05). The IC6 group had a higher mean pain score than the other two groups (P <.05), whose mean pain scores did not differ significantly from each other (P >.05). IC6 group patients had a higher requirement for analgesics. The rate of atelectasis was higher in group IC6 (P <.05). CT scans revealed that different chest tube insertion sites have the same efficiency for draining of pleural effusion, although drainage tubes inserted through the thoracic cage may result in more severe pain.
    Annals of Saudi medicine 01/2011; 31(4):383-6. · 1.10 Impact Factor
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    ABSTRACT: The presence of bilateral carotid artery occlusions in patients that require coronary artery bypass surgery is rare. Here, we report the successful coronary revascularization of two patients with cardiopulmonary bypass under moderate hypothermia. Routine preoperative carotid artery duplex sonographies revealed bilateral total internal carotid occlusions. However, no neurological deficits or abnormalities were found on clinical examination or brain computed tomography, respectively. The vertebral blood flows of both patients were also found to be highly increased. Following successful surgery, the postoperative courses were uneventful and patients were discharged from the hospital on the seventh postoperative day.
    Interactive Cardiovascular and Thoracic Surgery 05/2010; 10(5):825-7. · 1.11 Impact Factor
  • Rafet Gunay, Yavuz Sensoz, Ilyas Kayacioglu
    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 02/2010; 37(6):1471. · 2.40 Impact Factor
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    Interactive Cardiovascular and Thoracic Surgery 01/2010; 10(1):52. · 1.11 Impact Factor
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    Rafet Gunay, Yavuz Sensoz, Ilyas Kayacioglu
    Interactive Cardiovascular and Thoracic Surgery 01/2010; 10(1):31. · 1.11 Impact Factor
  • Interactive Cardiovascular and Thoracic Surgery 11/2009; 9(5):846. · 1.11 Impact Factor
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    ABSTRACT: We assessed the effects of aortic valve pathology type on the long-term outcomes of patients who underwent concomitant aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) surgery. We retrospectively reviewed 150 patients who underwent AVR-CABG at our institution between January 1997 and December 2006. We divided patients into aortic stenosis (AS), aortic regurgitation (AR), and mixed-type groups consisting of 98 (65.3%), 20 (13.3%) and 32 (21.3%) patients, respectively. The AS group had more female patients, a higher mean angina class, older mean patient age, increased history of previous myocardial infarction (MI), and smaller valve size compared to other groups. No significant differences were observed among groups in the operative mortality for five or ten-year survival rates. Significant early mortality risk factors included cross-clamp and cardiopulmonary bypass (CBP) time, number of blood transfusion units, chronic obstructive pulmonary disease (COPD), intra-aortic balloon pump (IABP), inotropic drugs, and pacemaker use. Significant late mortality risk factors included intensive care unit (ICU) stay, IABP, stroke, and dialysis. The aortic valve pathology type in patients undergoing concomitant AVR-CABG does not adversely affect survival.
    Interactive Cardiovascular and Thoracic Surgery 08/2009; 9(4):630-4. · 1.11 Impact Factor
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    ABSTRACT: Patients undergoing surgical procedures through median sternotomy have reduced pulmonary function in the postoperative period. Our study was designed to evaluate the effect of pleural integrity in terms of respiratory functions and pain score after coronary bypass procedures. In a randomized, prospective study we evaluated 320 patients in two groups. Group I (n = 160) patients were the patients whose pleural cavity was intact while internal mammary artery (IMA) harvesting, and in group II (n = 160) the pleural cavity of the patients was opened. They matched in terms of postoperative respiratory functions and pain score. FEV1 (%) and FEV1/FVC levels at the postoperative fifth day were significantly lower in group II (I = 71.5 +/- 4.9 vs. II = 63.5 +/- 8.3 and I = 24.1 vs. II = 22.1), respectively (p < 0.05). The rate of postoperative pleural effusions and atelectasis at the postoperative fifth day were significantly higher in group II (I = 35%, 15% vs. II = 48%, 35%), respectively (p < 0.05). The pain score was higher in group II at postoperative fifth day. All patients undergoing cardiac surgery suffer deterioration in pulmonary functions. Pleurotomy seems to compound this with increased rates of atelectasis and pleural effusions. Moreover, preserving pleural integrity provides beneficial effects on pain score after coronary operations especially in the early postoperative period.
    Journal of Cardiac Surgery 10/2008; 24(4):374-8. · 1.35 Impact Factor
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    ABSTRACT: Reactive thrombocytosis has been reported in 20% of patients after coronary artery bypass grafting (CABG), a frequency that might be related to the high incidence of thrombotic complications. The present study was planned to investigate the effect of combined treatment with clopidogrel and acetylsalicylic acid (ASA) on post-CABG reactive thrombocytosis. Included in this prospective, randomized study were 60 patients who underwent CABG operation with a 6-month follow-up. Three study groups were defined: group 1 (n = 20), a control group of patients who have not developed reactive thrombocytosis after CABG surgery; group 2 (n = 20), patients who have developed reactive thrombocytosis and continue taking ASA (300 mg/day); and group 3 (n = 20), patients who have developed reactive thrombocytosis and continue taking ASA (300 mg/day) with the addition of clopidogrel (75 mg/day). The mean ages and sex distributions of the patient groups were similar. There were no significant differences between the groups regarding cardiovascular risk factors, baseline laboratory findings, or intraoperative characteristics. Thrombocytosis disappeared within the first month after the operation in both treatment groups. An evaluation of graft patency in the sixth postoperative month revealed that group 2 had significantly more patients with a "positive" result in the exercise test than group 3 and that group 3 had a lower incidence of graft occlusion than group 2 (P < .01). Combination antiplatelet therapy with ASA and clopidogrel seems to be more effective than ASA alone for maintaining graft patency in patients with reactive thrombocytosis.
    Heart Surgery Forum 01/2008; 11(3):E152-7. · 0.63 Impact Factor
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    ABSTRACT: Problems of wound healing are commonly observed after coronary bypass grafting (CABG) operations. Our aim is to determine the prevalence and the predictors of saphenous vein harvesting complications after coronary artery bypass surgery. One hundred twenty six patients operated in the specified period were included in this prospective study. In an early period 3 patients were excluded because of their mortality. Twenty patients were female and 103 were male. Forty three patients underwent an open procedure with one incision (35%), 61 patients also underwent an open procedure but with multiple incisions (49%), and 19 patients underwent a closed procedure with stripper (16%). Complications related with leg incisions after surgery were investigated. Multiple incision technique has the longest (49.28 +/- 14.7 cm; p < 0.001) total incision length (compare to single incision and stripper technique). As incision length increases, the incidence of drainage (p < 0.01), pain score (p < 0.05), hematoma (p < 0.05) and diffuse ecchymosis (p < 0.05) were increased. Drainage was seen more frequently in female (p < 0.001) and diabetic patients (p < 0.05). Sex (p < 0.001) and incision length (p < 0.05) have been found independent risk factors for drainage complication. Superficial infection (p < 0.05), pain (p < 0.05) and dehiscence (p < 0.05) were significantly higher in female patients. As the incision length of the multiple incision technique became longer, the risk of drainage, pain, hematoma and diffuse ecchymosis were increased. The significantly increased risk for wound complications were also seen in female gender, diabetic and obese patients.
    The Tohoku Journal of Experimental Medicine 04/2007; 211(4):331-7. · 1.37 Impact Factor
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    ABSTRACT: The purpose of this study was to determine the cause of aortic arch calcification and to evaluate its prognostic value as an indicator of cardiovascular disease and its severity. The study was conducted prospectively among 1027 patients who underwent a coronary angiography in our hospital between April 2002 and September 2002 for suspected coronary artery disease. All chest x-rays were reviewed by a radiologist, who categorized aortic arch calcifications by their presence or absence. The patients were stratified according to age (< or =50, 51-64, and > or =65 years) to eliminate the influence of age on aortic arch calcification. Coronary lesions were considered either single-vessel or multivessel disease. Univariate analysis revealed significant correlation with age (r = 0.37; P < .001), presence of hypertension (r = 0.14; P < .001), smoking (r = -0.10; P = .001), presence of coronary artery disease (r = 0.10; P = .001), and the existence of multi-vessel disease (r = 0.09; P = .006). Multivariate analysis disclosed significant association with age and hypertension and no association with smoking, coronary artery disease, and other risk factors. The aortic arch calcifications observed on plain chest x-rays are usually age related, and both aortic arch calcifications and coronary artery disease are strongly associated with age. The presence of aortic calcification on chest x-rays was not an indicator of the presence and extent of coronary artery disease.
    Heart Surgery Forum 01/2007; 10(2):E120-4. · 0.63 Impact Factor
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    ABSTRACT: The purpose of the present study was to investigate retrospectively which aortic clamping technique, the single clamp technique (SCT) or double clamping technique (DCT), is safer in terms of cerebral functions in patients who have undergone coronary bypass surgery. We evaluated 1100 patients who underwent coronary artery bypass graft surgery at our institute from 1998 to 2004. The two groups, SCT (n = 550, 50%) and DCT (n = 550, 50%), were comparable with respect to smoking, hypertension, hypercholesterolemia, diabetes mellitus, chronic obstructive pulmonary disease, peripheral arterial disease, history of neurological events, creatinine levels, and existence of a carotid lesion. No significant differences between the SCT and DCT groups were observed in terms of cardiac and cerebral complications perioperatively and postoperatively. Both single and double clamping techniques have advantages and disadvantages in patients undergoing coronary bypass surgery.
    International Heart Journal 04/2006; 47(2):185-92. · 1.23 Impact Factor
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    ABSTRACT: Femoral pseudoaneurysm (FPA) is one of the common complications of percutaneous catheterization procedures performed via the femoral artery. The aim of this research was to evaluate factors associated with FPA of sufficient clinical significance that they required surgical treatment after diagnostic or interventional cardiac catheterization. We evaluated 41,322 transfemoral catheterization procedures performed in our center within 7 years. Among all procedures, 630 FPAs developed that required surgical repair. Eighty-five cases were managed by compression with duplex guidance. As a case-control group, 1260 patients were selected from the patients who had been catheterized during the same time period but did not develop FPA. Two controls were selected for each study patient, matched according to age, sex, and catheterization day. Body mass index, hypertension, diabetes mellitus, catheter diameter, coronary artery disease, atherosclerosis, and number of cases performed per day in a particular room were evaluated as risk factors by using multivariate techniques. Femoral pseudoaneurysm required operative repair in 1.1% (n = 398) of patients who underwent cardiac catheterization for diagnostic purposes and in 4.7% (n = 232) of patients after cardiac interventional procedures. Factors found to be independently predictive of FPA were hypertension (P = .011; odds ratio, 1.52), diabetes mellitus (P = .035; odds ratio, 1.11), coronary artery disease (P = .022; odds ratio, 1.21), larger (> or = 28 kg/m2) body mass index (P < .001; odds ratio, 2.21), larger number of cases (> or = 18) performed per day in a particular room (P < .001; odds ratio, 2.39), and larger (> or = 7F) catheter diameter (P < .001; odds ratio, 2.82). Due to the development of technology and experience, more and more diagnostic and interventional catheterization procedures are performed on a daily basis. In our study, a high volume of cases in a particular room and use of large catheters were important risk factors for FPA complications. When these situations are combined with other risk factors (such as obesity, diabetes mellitus, hypertension, and arteriosclerosis), giving particular attention to local compression therapy would be more crucial to decrease the FPA rate.
    Journal of Vascular Surgery 03/2006; 43(3):520-4. · 2.88 Impact Factor
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    ABSTRACT: A chest radiograph of a 38-year-old woman, who was diagnosed with rheumatic mitral stenosis, revealed cardiac enlargement due to a giant left atrium that was distorting the cardiac structures. The patient's cardiothoracic ratio was approximately 0.90. A giant left atrium can readily be delineated by echocardiography. Optimal timing of surgery is important in cases of mitral stenosis, because delaying mitral valve replacement can lead to fatal outcomes. To our knowledge, the left atrial diameter of 18.7 cm that we found in our patient is the largest reported to date.
    Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital 02/2006; 33(3):389-91. · 0.67 Impact Factor
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    ABSTRACT: Hydatid cyst in the heart is uncommon, with cardiac involvement occurring in about 0.4-2% of all hydatid infestations. The right ventricle is only rarely involved accounting for 8% of cases. We report a case of a hydatid cyst located in the right ventricle involving the posterior papillary muscle requiring tricuspid valve excision.
    International Journal of Cardiology 06/2005; 101(2):339-41. · 6.18 Impact Factor
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    ABSTRACT: Endocarditis is a rare but life-threatening complication of brucellosis. Its mortality rate has recently been reduced with the use of combined medical and surgical treatment. Between March 2002 and April 2004, 6 patients with Brucella endocarditis underwent surgery at the Siyami Ersek Cardiovascular Center in Istanbul, Turkey. The diagnosis of Brucellosis was based on the presence of clinical signs and symptoms compatible with brucellosis, serology and/or a positive blood culture. All patients with suspected Brucella endocarditis were studied by echocardiography. The diagnosis of Brucella endocarditis was made in accordance with Duke's criteria. The most commonly affected valve was the aortic valve (4 patients). Four patients had prosthetic valves because of a previous history of rheumatic fever. In 5 patients, elective surgery was performed. Five patients underwent valve replacement with prosthetic valves, but 1 patient underwent excision of the abscess cavity without valve replacement. There was no operative mortality. All patients continued antibiotic treatment for at least 3 months postoperatively. The median duration of follow-up after surgery was 12 months. During the follow-up period, 1 patient died, while the others remained alive with no recurrences. Prosthetic valve replacement is a safe procedure in patients with Brucella endocarditis. Surgical interventions combined with triple antibiotic therapy yield good results with no recurrence in the long-term follow-up.
    Heart Surgery Forum 02/2005; 8(4):E262-5. · 0.63 Impact Factor
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    ABSTRACT: We report a single center experience of surgical treatment of 30 cases of left-sided prosthetic valve thrombosis (PVT). In our series, a diagnosis of PVT was established based on clinical and echocardiographic examinations. Thrombosis was the major etiologic factor in 25 patients (83.3%), while 22 of 25 patients (88%) had a subtherapeutic anticoagulation level. The early hospital mortality rate was 7.1% in patients with New York Heart Association (NYHA) functional classes II - III, and 31.3% in NYHA functional class IV. The median interval from the surgical procedure to follow-up for these patients was 29.2 months. No recurrence or deaths were observed during 3 to 73 months following the surgical procedure.
    International Heart Journal 02/2005; 46(1):105-11. · 1.23 Impact Factor
  • International Heart Journal - INT HEART J. 01/2005; 46(1):105-111.
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    ABSTRACT: The aim of this study was to assess the effect of aortic coarctation surgery in adult patients on arterial blood pressure in the early postoperative period. Ninety-three adult patients (61 male, 32 female) aged 15-43 years who had operation since 1962 for aortic coarctation in Siyami Ersek Cardiovascular Surgery Center were retrospectively evaluated. Tube graft interposition was done in 31 patients; resection and end-to-end anastomosis were performed in 32 patients; 24 patients had undergone pathchplasty; and 6 patients by-pass shunting performed. The effect of surgery on the blood pressure was investigated. The mean systolic and diastolic blood pressure significantly reduced after operation (systolic 193.6 +/- 33.7 mmHg vs 147.4 +/- 22.0 mmHg, diastolic 99.8 +/- 17.9 mmHg vs 82.0 +/- 10.8 mmHg). From 93 patients (all with hypertension) 54 (58%) became normotensive after operation according to VIth Joint National Committee classification. The number of normotensive patients after operation was 28 (of 37) for 15-19 years age group, 14 (of 23) for the 20-24 years age group, 4 (of 16) for 25-29 years age group, 6 (of 11) for 30-34 years age group, and 2 (of 6) for the over 35 years old age group. The diastolic and systolic blood pressures reduce significantly in the adult patients operated for aortic coarctation. On the other hand, persistent hypertension seemed to increase in the older age groups in spite of the surgery.
    Journal of Cardiac Surgery 01/2005; 20(4):319-21. · 1.35 Impact Factor
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    ABSTRACT: Carrying out a mitral valve replacement (MVR) while preserving all chordae tendineae in patients with mitral regurgitation has been proven beneficial to the left ventricular performance. To evaluate the effectiveness of this technique in patients with mitral stenosis, a comparison of the echocardiographic data between patients who were operated on using this technique (Group Preservation = GroupP, n = 15), and those operated on using the conventional method of MVR (Group Conventional = GroupC, n = 15) was made. All patients were examined before surgery, 6 months after surgery and 8 years after surgery. The study population was limited to patients who had no evidence of coronary artery disease, aortic stenosis and/or regurgitation and patients who had pure mitral stenosis. Echocardiographic measurements obtained both 6 months and 8 years postoperatively revealed a significant decrease in the left ventricular ejection fraction in GroupC (61.33+/-9.29% preoperatively, 53.2+/-10.3% postoperatively). The difference between the decrease in the left ventricular ejection fraction of the two groups was statistically significant (-0.71+/-6.28% in GroupP, -8.07+/-13.35% in GroupC). There was no evidence of prosthetic valve dysfunction and no operative deaths. Two patients died in GroupP, 3 patients died in GroupC within the 8 year period. The conclusion was reached, that if suitable, mitral valve replacement while preserving the chordae tendineae is expected to have a beneficial effect on postoperative left ventricular performance in patients with mitral stenosis.
    The Tohoku Journal of Experimental Medicine 08/2003; 200(3):119-28. · 1.37 Impact Factor