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    Coronary Artery Bypass Surgery Beating Heart or Cardiopulmonary Bypass?
    (Int Heart Journal Assoc, 2014) Cakir, Habib; Uncu, Hasan; Gur, Ozcan; Yurekli, Ismail; Acipayam, Mehmet; Ozsoyler, Ibrahim
    In this study, we examined the early results for patients who underwent beating heart coronary bypass surgery and compared these results with those of conventional coronary bypass surgery. A total of 1094 patients who underwent isolated coronary artery bypass surgery between January 2009 and December 2011 in our clinic were included in this study. Seventy-three patients in whom cardiopulmonary bypass was not used (group 1) were compared to 1021 patients in whom cardiopulmonary bypass was used (group 2). The mean age was 60.7 +/- 9.3 in group 1 and 58.9 +/- 9.7 in group 2 (P > 0.05). There was no significant difference between the two groups in terms of gender, or the coexistence of diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), and hypertension (P > 0.05). There was no significant difference between group 1 and group 2 in terms of development of postoperative atrial fibrillation (AF), use of an intra-aortic balloon pump, need for re-operation for bleeding, or duration of hospital stay and intensive care unit stay (P > 0.05). The need for inotropic support and the amount of mediastinal drainage were less in group 1 than in group 2 (P = 0.002, P < 0.001). The incidences of postoperative cerebrovascular accident, development of chronic renal failure, and sternal wound infection did not significantly differ between the groups (P > 0.05). There was no mortality in group 1, whereas it was calculated as 1.8% in group 2 (P = 0.63). Beating heart coronary artery bypass surgery decreases the need for inotropie support and transfusion.
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    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, Ibrahim
    In 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.
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    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, Ibrahim
    Introduction: 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.
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    Our experiences with proximal aortic anastomosis assist device in coronary artery bypass graft surgery
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2016) Pekedis, Mehmet Alaaddin; Acipayam, Mehmet; Uncu, Hasan; Yildiz, Gur Deniz; Cakallioglu, Ahmet; Dogan, Pinar; Ozsoyler, Ibrahim
    Background: This study aims to report our experiences with the proximal aortic anastomosis assist device during coronary artery bypass grafting. Methods: Between January 2006 and May 2010, a total of 26 patients (23 males, 3 females; mean age 72.6 +/- 5.8 years; range 55 to 81 years) who underwent bypass surgery using the proximal aortic anastomosis assist device in our clinic were retrospectively analyzed. The indications for the utilization of the device were the presence of proximal aortic calcifications and atherosclerotic plaques in coronary artery bypass graft surgery and insufficient proximal aortic exploration additionally in redo coronary artery bypass graft surgery. Embolic events, neurological complications, the length of intensive care unit stay, and mortality rate were recorded. Results: Off-pump single-vessel or two-vessel coronary artery bypass grafting without cardiopulmonary bypass was performed in 19 patients, while off-pump three-vessel coronary artery bypass grafting under cardiopulmonary bypass was performed in seven patients. Six patients underwent redo coronary artery bypass grafting. No neurological complications, embolic events or mortality were observed in any patients. Conclusion: Proximal aortic anastomosis assist devices considerably facilitate proximal anastomosis in indicated patients undergoing coronary artery bypass grafting. We believe that the utilization of these devices may also reduce the proximal anastomosis site-related complications which may occur during coronary artery bypass grafting.
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    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, Ibrahim
    Introduction: 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.
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    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, Ibrahim
    Introduction: 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.