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Öğe Cardiac hydatid cyst causing right ventricular outflow tract obstruction: Case report(2013) Acipayam, Mehmet; Uncu, Hasan; Altinay, Levent; Başdo?an, Faruk; Gençaslan, Murat; Özsöyler, IbrahimWe present a case of a hydatid cyst placed on the right ventricular outflow tract and applying compression on the pulmonary valve. Thirty-three years old female patient with complaints of dyspnea, palpitation and fatigue was admitted to the cardiology outpatient department. Transthoracic echocardiography revealed a septated cystic mass with the dimensions of 40X56 mm, accusing gradient on the right ventricle outflow tract, adjacent and on the same plane with the pulmonary valve, representing a hydatid cyst. Cyst resection was performed on cardiopulmonary bypass. Severe tricuspid insufficiency was observed after cyst resection. Tricuspid annuloplasty was performed using an annuloplasty ring. Because of the fatal complications of cyst rupture, in places where epidemic Echinococcus cases are seen, cardiac cysts should also be remembered, its early and correct diagnosis is of vital importance. Copyright © 2013 by Türkiye Klinikleri.Öğe Early postoperative results for females undergoing isolated coronary artery bypass surgery: comparison of the pre- and postmenopausal periods(Springer, 2014) Acipayam, Mehmet; Uncu, Hasan; Altinay, Levent; Zor, Mustafa Hakan; Dogan, Pinar; Ozsoyler, IbrahimIn this retrospective study, we investigated the demographic data and evaluated our early postoperative results of premenopausal and postmenopausal females who underwent coronary artery bypass graft surgery (CABG). A total of 730 female patients who underwent CABG between April 2004 and January 2012 were included in the study. Patients were divided into two groups based on whether they were pre- (group 1) or postmenopausal (group 2). The groups were compared in terms of the demographic and peri-operative parameters. Smoking and the preoperative hematocrit levels were higher in group 1, whereas the incidence of hypertension and obesity and the European system for cardiac operative risk evaluation values were higher in group 2 (p values < 0.01; < 0.01; < 0.01; 0.004 and < 0.01 respectively). The utilization of a left internal mammary artery graft and the postoperative drainage volumes were higher in group 1; however, the number of grafts per patient, cardiopulmonary bypass duration, number of patients who needed inotropic support, blood transfusion volumes, the duration of ventilatory support and the hospital stay were higher in group 2 (p values 0.038; 0.040; 0.026; 0.032; 0.014; 0.001; < 0.01 and < 0.01, respectively). Although the mortality rates were not significantly different, postmenopausal patients require more intensive postoperative care in comparison to premenopausal patients following CABG.Öğe The effect of gender on the early results of coronary artery bypass surgery in the younger patients' group(Soc Brasil Cirurgia Cardiovasc, 2014) Uncu, Hasan; Acipayam, Mehmet; Altinay, Levent; Dogan, Pinar; Davarci, Isil; Ozsoyler, IbrahimIntroduction: In this retrospective study, we aimed to determine the risk factors for coronary artery bypass surgery in patients under 45 years of age, and evaluate the early postoperative results and the effect of gender. Methods: A total of 324 patients under 45 years of age who undergone on-pump coronary artery bypass surgery between April 12, 2004 and January 10, 2012 were included to the study. Patients divided into groups as follows: Group 1 consisted of 269 males (mean age 41.3), Group 2 consisted of 55 females (mean age 41.6). Preoperative risk factors, intraoperative and postoperative data and early mortality rates of the groups were compared. Results: Smoking rate was significantly higher in Group 1. Diabetes mellitus incidence and body mass index were significantly higher in Group 2 (P values P=0.01; P=0.0001; P=0.04 respectively). The aortic cross-clamping and cardiopulmonary bypass time and number of grafts per patient were significantly higher in Group 1 (P values P=0.04; P=0.04; P=0.002 respectively). There were no deaths in either group. Conclusion: We found that gender has no effect on early mortality rates of the coronary bypass surgery patients under 45 years.Öğe The factors affecting the patency of arteriovenous fistulas formed for hemodialysis: evaluation of three-year experience(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Acipayam, Mehmet; Zor, Hakan; Yildiz, Gur Deniz; Uncu, Hasan; Cetinoglu, Mahmut; Halici, Umit; Altinay, LeventBackground: In this study, we assessed surgical techniques used for arteriovenous (AV) fistula formed for hemodialysis and factors affecting the fistula patency in the midterm. Methods: Between April 2007 and July 2010, 530 patients (297 males, 233 females; mean age 57.3 years; range 18 to 86 years) who underwent AV fistula operation were retrospectively analyzed. The patients were divided into two groups including group 1 without AV fistula occlusion (n=411; mean age 57.6 years) and group 2 with AV fistula occlusion (n=119; mean age 56.0 years). Both groups were compared according to following variables: age, sex, diabetes, hypertension, coronary artery disease, cephalic vein and radial artery diameter, postoperative thrill existence on AV fistula and the rate of revision surgery. Results: Distribution of possible risk factors within group 1 and group 2 were as follows respectively: diabetes 82 and 49 patients, hypertension 82 and 29 patients, male sex 243 and 54 patients, coronary artery disease six patients and null, small-diameter radial artery six and four patients, small-diameter cephalic vein 16 and 11 patients, revision surgery eight and five patients, palpable postoperative thrill 377 and 100 patients. We found significant differences in the factors including sex, diabetes, cephalic vein radius and postoperative thrill between the groups (p=0.008, p=0.000, p=0.0019, p=0.0014, respectively). Conclusion: In patients with chronic renal failure, diabetes, female gender and cephalic vein diameter of <2 mm affect the patency of AV fistula adversely, while postoperative trill and male gender affect the patency of AV fistula positively.Öğe Impact of Crowded Restaurant Perception on Affectivity and Behavioral Intentions(Inst Tourism, 2021) Cakici, A. Celil; Iflazoglu, Nurhayat; Altinay, LeventThis research aims to assess the influence of restaurant customers' perceived crowdedness on their behavioral intentions. The data were collected via a questionnaire developed based on the literature. Obtained 459 questionnaires were analyzed using explanatory and confirmatory factor analysis and structural equation modeling methods. It was determined that perception of human crowdedness impacted behavioral intentions in a positive manner, while the perception of spatial crowdedness had a negative influence. Therefore, findings show that perceived human crowdedness does not influence affectivity, whereas spatial crowdedness has a negative effect on it.Öğe Is the risk of isolated coronary artery bypass graft surgery in women aged above 75 years higher compared to men?(Turk Gogus Kalp Damar Cerrahisi Dergisi, 2014) Uncu, Hasan; Acipayam, Mehmet; Altinay, Levent; Gençaslan, Murat; Çakir, Habib; Özsöyler, IbrahimBackground: This study aims to investigate the possible differences of male and female patients aged above 75 years undergoing isolated coronary artery bypass graft surgery (CABG) and to define the risk factors. Methods: Between January 2004 and January 2012, a total of 174 isolated on-pump CABG patients (121 males, 53 females; mean age 77.1 years; range 75 to 97 years) using cardiopulmonary bypass were retrospectively analyzed. The patients were divided into two groups according to their sex: Group 1 consisted of male patients, while group 2 consisted of female patients. Preoperative risk factors, intraoperative and postoperative data and early mortality rates of both groups were compared. Results: The incidence of diabetes mellitus and EuroSCORE values were higher in females, while smoking rates were higher in males (p=0.012; p<0.01; p<0.01, respectively). The number of graft per patient and mediastinal drainage volume were higher in males, whereas the length of intensive care unit stay was longer in females (p=0.039; p=0.041; p<0.01, respectively). The left internal mammary artery graft utilization, need for inotropic support, intra-aortic balloon pump support, neurological complications, the incidence of atrial fibrillation and length of hospital stay were similar in both groups. There was no significant difference in the mortality rates between the groups [group 1, 1.7% (n=2); group 2, 3.8% (n=2)]. Conclusion: Although women aged above 75 years may have a higher incidence of diabetes mellitus, EuroSCORE values and length of intensive care unit stay compared to age-matched men, CABG operations can be done with similar mortality rates.Öğe A novel electrospun nano-fabric graft allows early cannulation access and reduces exposure to central venous catheters(Sage Publications Ltd, 2013) Karatepe, Celalettin; Altinay, Levent; Yetim, Tulin Durgun; Dagli, Celaleftin; Dursun, SuatPurpose: The use of tunneled central venous catheters (CVC) as vascular access for hemodialysis treatment is increasing worldwide. We present a novel polycarbonate urethane nano-fabric graft, produced by electrospinning technology, which has self-sealing features that avoid seroma formation and allow puncturing within 48 hours. The aim of this study was to assess its advantages in a setting where late referral is common. Methods: A retrospective single center study assessed 24 implanted grafts in 24 patients with maximal follow-up of 18 months; patency rates, time to first cannulation and post-operative complications were assessed. Results: Successful access was achieved in all 24 patients within 48 hours. In 50% of the patients cannulation was performed within 24 hours without increasing the complication rate. Twelve month primary and secondary patencies were 50% and 70.8%, respectively. Excluding early failures (within 30 days) because of surgical problems, 12 month primary and secondary patencies were 75% and 81.2% respectively. Complication and infection rates were 10.94 and 0.49/1000 dialysis procedures, respectively. No pseudoaneurysms or seromas were documented at 18 months. Conclusions: Early cannulation was successful in all patients with good 12-month primary and secondary patency rates, compared to data reported by others on polytetrafluoroethylene (PTFE) grafts. The infection rate was substantially lower than in tunneled CVCs. Therefore, the AVflo graft may improve the clinical status of dialysis patients by decreasing the exposure to CVCs.Öğe A RETROSPECTIVE COMPARISON OF EARLY RESULTS OF ISOLATED CORONARY ARTERY BYPASS SURGERY IN YOUNG (<40 YEARS) AND MIDDLE AGED (40-60 YEARS) PATIENTS(Carbone Editore, 2015) Halici, Umit; Acipayam, Mehmet; Uncu, Hasan; Altinay, Levent; Ketenciler, Serkan; Ozsoyler, IbrahimIntroduction: Coronary artery disease is usually seen in middle-aged and older population. Although coronary artery disease in young patients is relatively rare compare to older population, the incidence in young people have been increasing recently. In this retrospective study, we aimed to compare the perioperative characteristics and complications of young aged (<40 years) to midlle aged (40-60 years) patients retrospectively. Materials and methods: A total of 1592 patients who underwent isolated coronary artery bypass grafting operation were included in this retrospective study. Patients were divided into two groups according to age as young aged patients (Group 1; a total of 78 patients; 64 males, 14 females, mean age 36.7 +/- 33 years) and middle-aged patients (Group 2; a total of 1514 patients; 1183 males and 331 females, mean age 51.8+/-5.2 years) and preoperative, intraoperative and postoperative parameters were compared. Results: Smoking rates in Group 1 and low molecular density cholesterol levels in Group 2 were higher but it was not statistically significant. Cardiopulmonary bypass time, cross-clamp time, incidence of reoperation, amount of drainage and number of distal anastomoses were not significantly different between groups. Also development of newly onset atrial fibrillation, use of inotropic agents, intensive care stay time, amount of fresh whole blood used, use of left internal thoracic artery and intraaortic balloon pump seen in groups were not statistically significant. The incidence of delirium and time to discharge were significantly increased in Group 2. Hospital mortality rate of Group 2 was 0.39% (6 patients) whereas there was no hospital mortality in Group 1. Conclusion: The coronary bypass grafting operation can be performed in young aged patients with similar early postoperative results as in middle aged patients group. Thus we think that age has no major effect over the early postoperative results of isolated coronary artery bypass surgery.Öğe A retrospective comparison of early results of isolated coronary artery bypass surgery in young (<40 years) and middle aged (40-60 years) patients(Acta Medica Mediterranea, 2015) Halici, Umit; Acipayam, Mehmet; Uncu, Hasan; Altinay, Levent; Ketenciler, Serkan; Ozsoyler, IbrahimIntroduction: Coronary artery disease is usually seen in middle-aged and older population. Although coronary artery disease in young patients is relatively rare compare to older population, the incidence in young people have been increasing recently. In this retrospective study, we aimed to compare the perioperative characteristics and complications of young aged (<40 years) to midlle aged (40-60 years) patients retrospectively. Materials and methods: A total of 1592 patients who underwent isolated coronary artery bypass grafting operation were included in this retrospective study. Patients were divided into two groups according to age as young aged patients (Group 1; a total of 78 patients; 64 males, 14 females, mean age 36.7±3.3 years) and middle-aged patients (Group 2; a total of 1514 patients; 1183 males and 331 females, mean age 51.8±5.2 years) and preoperative, intraoperative and postoperative parameters were compared. Results: Smoking rates in Group 1 and low molecular density cholesterol levels in Group 2 were higher but it was not statistically significant. Cardiopulmonary bypass time, cross-clamp time, incidence of reoperation, amount of drainage and number of distal anastomoses were not significantly different between groups. Also development of newly onset atrial fibrillation, use of inotropic agents, intensive care stay time, amount of fresh whole blood used, use of left internal thoracic artery and intraaortic balloon pump seen in groups were not statistically significant. The incidence of delirium and time to discharge were significantly increased in Group 2. Hospital mortality rate of Group 2 was 0.39% (6 patients) whereas there was no hospital mortality in Group 1. Conclusion: The coronary bypass grafting operation can be performed in young aged patients with similar early postoperative results as in middle aged patients group. Thus we think that age has no major effect over the early postoperative results of isolated coronary artery bypass surgery.
