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Öğe Early mortality and long-term survival after repair of post-infarction ventricular septal rupture: An institutional report of experience(Elsevier Ltd, 2016) Yalçınkaya, Adnan; Lafçı, Gökhan; Diken, Adem İlkay; Aksoy, Eray; Çiçek, Ömer Faruk; Lafçı, Ayşe; Korkmaz, Kemal; Çağlı, KerimBackground: To determine predictors of mortality after surgical management of post-infarction ventricular septal rupture repair. Methods: A total of 63 patients (73.2%, mean age 67.22±7.71 years, male:female ratio; 35:28) underwent open heart surgery for post-infarction ventricular septal rupture repair. Patient demographics, operative data and postoperative parameters were analysed to reveal predictors of early mortality and long-term survival. Results: In-hospital mortality was 54.0% (34/63). Time from myocardial infarction to operation ? 14 days (OR: 4.10, 95% CI 1.16-14.46, p=0.02), systolic pulmonary artery pressure > 45 mmHg (OR: 4.14, 95% CI 1.110-15.496, p=0.03) and age (years) (OR: 1.09, 95% CI 1.002-1.194, p=0.04) were found to be independent predictors of in-hospital mortality. In multivariate Cox regression analysis, presence of pulmonary oedema on admission (HR: 4.95, 95% CI 1.58-15.54, p=0.006), age (years) (HR: 1.09, 95% CI 1.009-1.180, p= 0.02) and cross-clamp time <60 min (HR: 3.93, 95% CI 1.13-13.64, p=0.03) were found to be independent predictors of long-term survival. Within a follow-up of a median of 60.0 months, five-year survival rate was 67±9.0%. Conclusion: In line with the previous studies, our study demonstrated the benefits of delaying the repair for post-infarction ventricular septal rupture to allow adequate myocardial healing if haemodynamic status of the patient allows. © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).Öğe Relationship of admission neutrophil-to-lymphocyte ratio with in-hospital mortality in patients with acute type i aortic dissection(2014) Lafçı, Gökhan; Çiçek, Ömer Faruk; Uzun, Hacı Alper; Yalçınkaya, Adnan; Diken, Adem İlkay; Turak, Osman; Çağlı, Kumral; Taşoğlu, İrfan; Gedik, Hikmet Selçuk; Korkmaz, Kemal; Günertem, Orhan Eren; Çağlı, KerimAim: Acute aortic dissection is a life-threatening cardiovascular emergency. Neutrophil-to-lymphocyte ratio is proposed as a prognostic marker and found to be related to worse clinical outcomes in various cardiovascular diseases. Te aim of the present study was to evaluate the relationship between admission neutrophil-to-lymphocyte ratio and in-hospital mortality in acute type I aortic dissection. Materials and methods: We retrospectively evaluated 123 consecutive patients who had undergone emergent surgery for acute type I aortic dissection. Patients were divided into 2 groups as patients dying in the hospital (Group 1) and those discharged alive (Group 2). All parameters, including neutrophil-to-lymphocyte ratio, were compared between the 2 groups and predictors of mortality was estimated by using multivariate analysis. Results: A total of 104 patients (79 males, mean age: 55.2 ± 14 years) were included in the fnal analysis. In multivariate analyses, cross-clamp time, cardiopulmonary bypass time, intensive care unit duration, platelet count, and neutrophil-to-lymphocyte ratio were found to be independent predictors of mortality. Patients with higher neutrophil-to-lymphocyte ratios had a signifcantly higher mortality rate (hazard ratio: 1.05; 95% CI: 1.01-1.10; P = 0.033). Receiver operating characteristic analysis revealed that using a cut-of point of 8, neutrophil-to-lymphocyte ratio predicts mortality with a sensitivity of 70% and specifcity of 53%. Conclusion: Tis study suggests that admission neutrophil-to-lymphocyte ratio is a potential predictive parameter for determining the in-hospital mortality of acute type I aortic dissection. © TÜBİTAK.Öğe Transventricular mitral valve repair in patients with acute forms of ischemic mitral regurgitation(Texas Heart Institute, 2014) Çağlı, Kerim; Gedik, Hikmet Selçuk; Korkmaz, Kemal; Budak, Baran; Yener, Ümit; Lafçı, GökhanTransventricular mitral valve surgery combined with left ventricular restoration avoids atriotomy and provides a larger operative field. We describe a series of 5 patients in whom we performed transventricular mitral valve repair by various techniques, such as band annuloplasty, papillary muscle reattachment, chordal cutting, and edge-to-edge repair. The more acute forms of ischemic mitral regurgitation, as found in our patients, can coexist with post-myocardial infarction contained rupture or post-myocardial infarction ventricular septal rupture. Because these patients already have an indication for ventriculotomy, concomitant transventricular repair of the mitral valve can render a separate atriotomy unnecessary and thereby shorten the duration of cardiopulmonary bypass. Moreover, in patients with acute presentations, the absence of atrial dilation (this last associated with chronic cases) might make transventricular repair a better choice than the more difficult atrial approach. © 2014 by the Texas Heart® Institute, Houston.Öğe Use of a superficial femoral artery autograft as a femoral vein replacement(Elsevier Inc., 2015) Korkmaz, Kemal; Gedik, Hikmet Selçuk; Yalçınkaya, Adnan; Yener, Ali Ümit; Diken, Adem İlkay; Çağlı, KerimPosttraumatic arteriovenous fistulas (AVFs) are common complications of vascular penetrating trauma. Here we present a case of a 59-year-old woman who had a history of gunshot injury 42 years ago causing AVF between superficial femoral artery (SFA) and superficial femoral vein (SFV). SFV was resected. Ipsilateral SFA was used to restore SFV. SFA was reconstituted using a 7-mm polytetrafluorethylene graft. The patient has normal venous and arterial flow at 3- and 15-month follow-up. © 2015 Elsevier Inc.
