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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 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, IbrahimBackground: 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.