Mehmet Ali Kaygin

Erzurum Regional Training and Research Hospital, Kalikala, Erzurum, Turkey

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Publications (35)33.43 Total impact

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    ABSTRACT: Background: Leaflet escape of prosthetic valve is rare but potentially life threatening. Early diagnosis is essential on account of avoiding mortality, and emergency surgical correction is compulsory. This complication has previously been reported for both monoleaflet and bileaflet valve models. Methods: A 30-year-old man who had undergone mitral valve replacement with a bileaflet valve 8 years prior at another center was admitted with acute-onset with cardiogenic shock as an emergency case. Transthoracic echocardiograms showed acute-starting severe mitral regurgitation associated with prosthetic mitral valve. There was a suspicious finding of a single prosthetic mitral leaflet. But the problem related with the valve wasn't specifically determined. The patient underwent emergent surgery for replacement of the damaged prosthetic valves immediately. There was no tissue impingement and thrombosis, one of the two leaflets was absent, and there were no signs of endocarditis or pannus formation in the prosthetic valve. The missing leaflet could not be found within the cardiac cavity. The abdominal fluoroscopic study and plain radiography were unable to detect the escaped leaflet during surgery. The damaged valve was removed and a replacement 29 mm bileaflet mechanical valve was inserted by right lateral thoracotomy. Results: After post-operative week one, the abdominal computed tomography scan and the ultrasound showed the escaped leaflet in the left femoral artery. Fifteen days after the surgery the escaped leaflet was removed safely from the left femoral artery and the patient made a complete recovery. Conclusion: The escaped leaflet showed a fracture of one of the pivot systems caused by structural failure. Early cardiac surgery should be applied because of life-threatening problems.
    No preview · Article · Dec 2015 · The Heart Surgery Forum
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    ABSTRACT: The purpose of this study was to evaluate the efficacy and safety of pharmacomechanical thrombectomy performed by using a rotational thrombectomy device for the treatment of deep vein thrombosis. Between April 2012 and November 2014, 17 patients with acute deep vein thrombosis underwent pharmacomechanical thrombolysis. The thrombectomy device was used in a single-session technique for patients with lower-extremity deep vein thrombosis. After the procedure, the effect of thrombolysis was evaluated in 3 grades venographically. Grade I showed lysis of under 50%, and grade III showed complete lysis. Ten patients (58.8%) had an iliofemoral thrombosis and 7 (41.2%) had a femoropopliteal venous thrombosis. At the end of the pharmacomechanical thrombectomy procedure, 12 patients (70%) had complete (grade III) thrombus resolution. Grade I and II lysis were noted in 2 (12%) and 3 (18%) patients, respectively. Additionally, four (23.5%) required an additional lytic infusion as a result of residual thrombi. The overall grade III, II, and I thrombus resolution rates, including the supplemental thrombolysis, were 82.2% (n = 14), 12% (n = 2), and 5.8% (n = 1), respectively. There was no mortality. Based on the present data, use of the Cleaner thrombectomy device may prove to be a safe and feasible single-session pharmacomechanical thrombectomy method for the treatment of acute deep vein thrombosis. To prove the effectiveness of this type treatment, a more extensive large-scale studies are needed.
    No preview · Article · Sep 2015 · Heart Surgery Forum
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    ABSTRACT: Background/aim: The objective of this study is to report our experience with surgical revision of dialysis access-induced ischemia syndrome. Materials and methods: Between January 2005 and July 2013, 1254 patients underwent arteriovenous fistula operation, and 86 of them [53 males, mean age: 55 ± 25 (range: 25 to 75) years; 33 females, mean age: 50 ± 20 (range: 30 to 70) years] subsequently developed steal syndrome. These patients were treated with arterial pressure-controlled polytetrafluoroethylene banding or constriction with polypropylene suturing technique. Patients were followed in the outpatient clinic at regular intervals. Results: Symptoms were not relieved during the first 15 days in 4 patients; therefore, reintervention was performed. Thrombosis occurred in one patient after reintervention. No early or late complications were detected in other patients, and fistulae were suitable for hemodialysis. Patency rates at 6 and 12 months were 96% and 92%, respectively, and thrombosis rates were 7% and 9%. There was no hospital mortality in our study, but one patient died from unrelated causes and two other patients quit follow-up after 6 months. Conclusion: We think that arterial pressure-controlled surgical revision is an effective and safe technique in patients with fistula-related hand ischemia.
    No preview · Article · Jun 2015 · Turkish Journal of Medical Sciences
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    ABSTRACT: Chronic kidney failure can be described as a chronic and progressive disfunction in metabolic-endocrine function and in adjustment of fluid-electrolyte balance of kidney, as a result of reducing of glomerular filtration value. Besides being a medical issue, chronic kidney failure affects social, economic, and psychological conditions of patients. Indwelling catheters can be placed in the right atrium by right mini thoracotomy in kidney patients who depend on dialysis and all central veins are used. In the patients whose central veins were used, were able to do catheterization by this technique, and this is a procedure that must be retentioned.
    No preview · Article · Jan 2015 · Renal Failure
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    ABSTRACT: A 66-year-old male patient was admitted to our clinic because of shortness of breath and chest pain. A grade 4/6 diastolic murmur was heard on auscultation. Physical examination revealed signs of congestive heart failure and poor peripheral perfusion. There was a diagnosis of type II ascending aortic dissection in the history of the patient. He had refused emergency surgical intervention three years earlier. Computed tomography revealed that the ascending aorta was dilated to about 10 cm in diameter, and there was a chronic aortic type II dissection. The patient had second- to third-degree aortic insufficiency and he had a calcified bicuspid aortic valve on echocardiography. Two-vessel disease and a 90-mmHg aortic gradient were detected on angiography. Graft replacement of the ascending aorta, serape aortic valve replacement with a mechanical valve, and coronary arterial bypass grafting were performed successfully under cardiopulmonary bypass with an open aortic technique. The patient was discharged on the 10th postoperative day with no problems.
    No preview · Article · Feb 2014
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    ABSTRACT: We sought to evaluate the effects of on-pump beating-heart versus conventional coronary artery bypass grafting techniques requiring cardioplegic arrest in patients with coronary artery disease with left ventricular dysfunction. We report the early outcomes associated with survival, morbidity and improvement of left ventricular function in patients with low ejection fraction who underwent coronary artery bypass grafting between August 2009 and June 2012. Patients were separated into 2 groups: group I underwent conventional coronary artery bypass grafting and group II underwent an on-pump beating-heart technique without cardioplegic arrest. In all, 131 patients underwent coronary artery bypass grafting: 66 in group I and 65 in group II. Left ventricular ejection fraction was 26.6% ± 3.5% in group I and 27.7% ± 4.7% in group II. Left ventricular end diastolic diameter was 65.6 ± 3.6 mm in group I and 64.1 ± 3.2 mm in group II. There was a significant reduction in mortality in the conventional and on-pump beating-heart groups (p < 0.001). Perioperative myocardial infarction and low cardiac output syndrome were higher in group I than group II (both p < 0.05). Improvement of left ventricular function after the surgical procedure was better in group II than group I. The on-pump beating-heart technique is the preferred method for myocardial revascularization in patients with left ventricular dysfunction. This technique may be an acceptable alternative to the conventional technique owing to lower postoperative mortality and morbidity.
    No preview · Article · Dec 2013 · Canadian journal of surgery. Journal canadien de chirurgie
  • Ozgur Dag · Mehmet Ali Kaygin · Umit Arslan · Adem Kiymaz · Nail Kahraman · Bilgehan Erkut
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    ABSTRACT: We successfully performed coronary artery bypass grafting and mitral valve replacement in a 72-year-old man who had undergone a left pneumonectomy 13 years previously due to a malignant mass. The patient was admitted to our clinic with symptoms of dyspnoea, palpitations, chest pain and fatigue. He was diagnosed with mitral valve disease and two-vessel coronary artery disease, as seen from echocardiography and catheterisation studies. Conventional cardiopulmonary bypass grafting was performed following sternotomy. The patient's heart was completely displaced to the left hemithorax. Saphenous vein grafts were harvested. Distal anastomoses were performed with the use of the on-pump beatingheart technique without cross clamping. Afterwards a cross clamping was placed and a left atriotomy was performed. The mitral valve was severely calcific. A mitral valve replacement was performed using number 27 mechanical valve after the valve had been excised. The patient's postoperative course was uneventful. Cardiac contractility was seen to be normal and the mitral valve was functioning on echocardiography done in the second postoperative month.
    No preview · Article · Oct 2013
  • S. Talay · N. Belgit Talay · M.A. Kaygin · O. Dag · B. Erkut
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    ABSTRACT: We report a case of a rare and asymptomatic vascular ring in an adult patient. A vas cular ring presents a complex of anomalous anatomy of aortic arch and related vascular structures which encircle trachea and esophagus as a nng which presents only less than 100 of all congeni tal cardiac abnormalities. Vascular ring may be with or without concomitant congenital cardiac defects. This defect of vascular ring is free of any geographical predominance and the male to fe male ratio is not distinguishing. Most of cases among vascular ring in a percentage of 85 95°o are double aortic arch as in our case.
    No preview · Article · Oct 2013 · Turkiye Klinikleri Cardiovascular Sciences
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    ABSTRACT: Background: Arteriovenous fistula (AVF) is the most important vascular access method for hemodialysis (HD). In this study, the relationship between AVF success and inflammation in patients who had HD due to end-stage renal failure (ESRF) was investigated. Material and method: In the study, a total of 658 patients, who started HD for ESRF, were evaluated retrospectively. A total of 386 patients were included in this study. The demographic data and C-reactive protein, albumin and fibrinogen levels were investigated in patients with recognized success AVF. Results: In total 311 patients with successful AVF and 75 unsuccessful AVFs were found. In unsuccessful AVF group the average low albumin level, high C-reactive protein and fibrinogen levels were found to be statistically meaningful when compared with successful AVF group (p < 0.001, p < 0.001, p < 0.001). Conclusion: As a result, we think that the evaluation of inflammation before creating AVF in HD patients is very important for increasing the success of AVF.
    No preview · Article · Aug 2013 · Renal Failure
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    ABSTRACT: An atrial septal defect is the most common type of congenital heart disease among adults. Surgical repair or percutaneous closure of the defect is the treatment options. Even though percutaneous closure seems to be less risky than surgical repair, it may result in fatal complications like device embolism, cardiac perforation and tamponade. Herein we report a case of the embolism of a device into the pulmonary artery after one hour of percutaneous closure in which the embolized device was surgically removed and the defect was closed with a pericardial patch.
    Full-text · Article · Apr 2013 · Korean Journal of Thoracic and Cardiovascular Surgery
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    ABSTRACT: Objective: There are various reasons for renal dysfunction after cardiac surgery; however, activation of the renin-angiotensin system has an important role following cardiac surgery. We investigated the effect of preoperative angiotensin-converting enzyme (ACE) inhibitors on renal functions after cardiovascular surgery. Material-methods: Three hundred sixty-six patients awaiting elective cardiac surgery were allocated to two groups, namely the treatment group, comprising the ACE inhibitor group (n = 186), and the control group, which was without ACE inhibitor (n = 180). The renal parameters [blood urea nitrogen, creatinine, creatinine clearance, and glomerular filtration rate (GFR)] and the need for dialysis were evaluated associated with renal functions between the two groups in the postoperative period. Results: After cardiac surgery, renal dysfunction requiring dialysis developed in 11 (3.8%) patients in the control group patients. There was no required dialysis in the treatment group (p < 0.05). As an indicator of renal dysfunction, the increase in creatinine and blood urea nitrogen levels and the decrease in GFR and creatinine clearance were higher in the control group (p < 0.05). The multivariate analysis indicated that therapy with ACE inhibitors was found to decrease the incidence of postoperative renal dysfunction (odds ratio, 1.07; 95% confidence interval, 0.45-2.50; p < 0.05). The other independent predictors were age, preoperative intra-aortic blood pump, hypertension, diabetes mellitus, and a left ventricular ejection fraction below 0.40. Conclusion: Preoperative therapy with ACE inhibitors has an influence on renal functions. This study demonstrates that administration of ACE inhibitors provides better renal protection after cardiac surgery.
    No preview · Article · Mar 2013 · Renal Failure

  • No preview · Article · Mar 2013 · International Journal of Cardiology

  • No preview · Article · Mar 2013 · International Journal of Cardiology
  • U. Halici · M. Misirlioǧlu · M.A. Kaygin · B. Erkut
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    ABSTRACT: Baker cyst is a pathology characterized by swelling behind the knee which causing pain with swelling and compression. Anticoagulant therapy can be started due to the current clinical situation as a false diagnosis of deep vein thrombosis in the patients with Baker cyst. 45-year-old female patient with acute lower extremity pain and swelling was admitted to the emergency department. The deep vein thrombosis is primarily intended to the patient, anticoagulant therapy was started. But Baker cyst was diagnosed as a result of investigations. The clinical signs are completely disappeared with appropriate medical treatment. Baker cyst mimicking thrombophlebitis and deep vein thrombosis clinic should be considered in the differential diagnosis in case of calf pain, swelling, and temperature rise.
    No preview · Article · Dec 2012 · Turkiye Klinikleri Cardiovascular Sciences
  • Mehmet Ali Kaygin · Sureyya Talay · Ozgur Dag · Bilgehan Erkut
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    ABSTRACT: The aim of the study was to evaluated the primary and secondary (after reoperation) patency rates and some effect factors in fistula patency for hemodialysis patients. Over a 10-year period, 1529 arteriovenous fistulas (AVFs) were fashioned in 1003 (611 males, 392 females; median age range 7-72) patients using the native vascular tissue and prosthetic graft material. We also evaluated the effects of various factors in fistula patency and primary and secondary patency rates in AVF patients. The primary patencies of fistulas in this series were 72%, 64%, 51%, 41%, and 26%, and secondary patencies were 79%, 70%, 56%, 46%, and 33% at 6 months, 1, 2, 4, and 6 years, respectively. There was no statistically significant difference between the primary and secondary patencies (p = 0.082) in the 6-year follow-up. Factors affecting the patency of fistulas were diabetes mellitus (p < 0.005), hypertension (p < 0.005), and smoking habits (p < 0.005). Even if shown to be not statistically significant, successful surgical revision after fistula occlusion improves secondary patency with potential benefits in terms of patient morbidity. Besides, the AVF patency was shortened in chronic renal-insufficiency patients with diabetes mellitus, hypertension, and smoking habits.
    No preview · Article · Apr 2012 · Renal Failure

  • No preview · Article · Mar 2012 · International Journal of Cardiology

  • No preview · Article · Jan 2012
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    M Kantarci · M Ali Kaygin · Ü Bayraktutan · C Akgul · B Erkut
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    ABSTRACT: In this report, we describe a patient with a subvalvular membrane on the left ventricular outflow tract. Discrete subvalvular membrane is a cause of left ventricular outflow tract narrowing. Multidetector computerised tomography can demonstrate the anatomical three-dimensional view of this region and guide for surgery.
    Preview · Article · Nov 2011 · Folia morphologica
  • Sureyya Talay · Derih Ay · Mehmet A Kaygin · Bilgehan Erkut · Omer Bayezid
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    ABSTRACT: To compare partial cross clamping and mechanic pulmonary ventilation technique with total cross clamping utilization during cardiopulmonary bypass in coronary artery bypass graft operations in terms of pulmonary healing. Between February and April 2007, isolated coronary artery bypass graft operation was performed for 30 patients in the Cardiovascular Surgery Department, Erzurum Regional Training and Research Hospital, Erzurum, and the Cardiovascular Surgery Department, Medical Faculty, Akdeniz University, Antalya, Turkey. The patients were divided into 2 groups; Group A (n=15) with total cross clamping, and Group B (n= 15) partial cross clamping and mechanic pulmonary ventilation in cardiopulmonary bypass. Postoperative pulmonary functions were studied in 2 main data; 1) the oxygenization rate of artery blood gas, and 2) spirometer results. Additionally, total cardiopulmonary bypass and total cross-clamping times, extubation times, numbers and types of grafts, days of intensive care unit treatment, and hospitalizations were recorded. There was no statistically significant difference between the 2 groups for oxygenization rate, and surgery hospitalization details. We observed a statistically significant difference with advantage in Group B in spirometric results in terms of healing of pulmonary functions. Total cross clamping and circulatory arrest of the lungs are the main sources of postoperative pulmonary complications based on the pulmonary inflammatory response in coronary artery bypass surgery.
    No preview · Article · Oct 2011 · Saudi medical journal
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    ABSTRACT: Artrial fibrillation is the most common arrhythmia that occurs after coronary bypass grafting operation with the rate of 30%. Atrial fibrillation is associated with hemodynamic instability, strokes, and prolonged hospital stay. Pericardial effusion is a risk factor for atrial fibrillation after cardiac surgery, and it occurs commonly in the posterior area during the post-operative period. The aim of this prospective study was to demonstrate the effectiveness of posterior pericardiotomy in reducing the incidence of atrial fibrillation. This prospective randomized study was carried out on 425 patients undergoing a coronary artery bypass grafting in our clinic between August 2009 and February 2011. There were 276 male patients and 149 female patients. These patients were randomly divided into two groups; posterior pericardial incision was performed in 213 patients (pericardiotomy group), while any pericardial incision was not performed in 212 patients (control group). Atrial fibrillation occurred more frequently in control group (62 patients, 14.6%), compared to the pericardiotomy group (14 patients, 3.1%; p < 0.0001). The incidences of early pericardial effusion, late pericardial effusion, and tamponade were also significantly higher in control group. Moreover, posterior pericardiotomy was associated with the decreases in the duration of stay in hospital and intensive care unit. In fact, the total hospital costs were lower in the pericardiotomy group. In conclusion, posterior pericardiotomy is an effective and safe technique that reduces early pericardial effusion, atrial fibrillation, length of stay in hospital, and hospital costs after the coronary artery bypasses grafting.
    No preview · Article · Oct 2011 · The Tohoku Journal of Experimental Medicine