Elma, Bekir; Mammadov, Renad; Bilgin, Yasin; Yazici, Gulce Naz; Süleyman, Halis; Çoban, Taha Abdulkadir

Background: This study aims to investigate the possible protective effects of rutin, also called vitamin P1, against pulmonary contusion induced by blunt chest trauma in a rat model. Methods: Thirty male albino Wistar rats were separated into three equal groups as healthy group, trauma group, and trauma+rutin group. After anesthesia provided by intraperitoneal administration of 60 mg/kg ketamine and xylazine by inhalation at appropriate intervals, 200 g weight was dropped from 1 m height to the anterior chest wall of the animals in the trauma group (n=10) and trauma+rutin group (n=10) and pulmonary contusion was created. Thirty min after the trauma, 50 mg/kg of rutin was administered into the stomach of trauma+rutin group animals orally with gavage. The rats received rutin once daily for two days and were sacrificed 48 h later. Their lung tissues were removed and examined biochemically and histopathologically. Results: Nuclear factor-kappa B, cyclooxygenase-2, and malondialdehyde levels increased in the trauma group compared to the healthy group, and rutin administration prevented this increase. Total glutathione levels decreased in the trauma group, and rutin administration also prevented this decrease. The histopathological findings were compatible with the biochemical findings. Conclusion: Our study results suggest that rutin has a protective effect on contused lung tissue in rats.

Elma, Bekir; Mammadov, Renad; Bilgin, Yasin; Yazıcı, Gülce Naz; Süleyman, Halis; Çoban, Taha Abdulkadir

Background: This study aims to investigate the possible protective effects of rutin, also called vitamin P1, against pulmonary contusion induced by blunt chest trauma in a rat model. Methods: T hirty m ale a lbino W istar r ats w ere s eparated into three equal groups as healthy group, trauma group, and trauma+rutin group. After anesthesia provided by intraperitoneal administration of 60 mg/kg ketamine and xylazine by inhalation at appropriate intervals, 200 g weight was dropped from 1 m height to the anterior chest wall of the animals in the trauma group (n=10) and trauma+rutin group (n=10) and pulmonary contusion was created. Thirty min after the trauma, 50 mg/kg of rutin was administered into the stomach of trauma+rutin group animals orally with gavage. The rats received rutin once daily for two days and were sacrificed 48 h later. Their lung tissues were removed and examined biochemically and histopathologically. Results: Nuclear factor-kappa B, cyclooxygenase-2, and malondialdehyde levels increased in the trauma group compared to the healthy group, and rutin administration prevented this increase. Total glutathione levels decreased in the trauma group, and rutin administration also prevented this decrease. The histopathological findings were compatible with the biochemical findings. Conclusion: Our study results suggest that rutin has a protective effect on contused lung tissue in rats.

Polat, Adil; Boyacioglu, Kamil; Erentug, Vedat

Onk, Oruç Alper; Sayar, Ilyas; Onk, Didem; Erentuğ, Vedat; Aksüt, Mehmet; Değirmenci, Hüsnü

In this article, we present a 82-year-old female casewithout any previous history of heart disease diagnosedwith a hyperdense mass originating in left atrial side of theinteratrial septum on echocardiography. The patient wasscheduled for surgery. Left atrium was entered through theinteratrial groove. The tumor was found attached to theinteratrial septum. It was macroscopically creamish-yellowcolored, 20x10 mm in size and solid in texture. It wastotally resected from its attachments to the interatrialseptum. Light microscopy showed polypoid formationswith prominent papillary structures including scatteredhyalinized areas and large areas of calcification. Themass was pathologically diagnosed as cardiac calcifiedamorphous tumor. She was discharged under medicaltreatment on seventh day after surgery.

Vedat, Erentuğ; Polat, Adil; Boyacioglu, Kamil

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Aksüt, Mehmet; Onk, Oruç Alper; Sayar, Ilyas; Değirmenci, Hüsnü; Onk, Didem; Erentuğ, Vedat

In this article, we present a 82-year-old female case without any previous history of heart disease diagnosed with a hyperdense mass originating in left atrial side of the interatrial septum on echocardiography. The patient was scheduled for surgery. Left atrium was entered through the interatrial groove. The tumor was found attached to the interatrial septum. It was macroscopically creamish-yellow colored, 20×10 mm in size and solid in texture. It was totally resected from its attachments to the interatrial septum. Light microscopy showed polypoid formations with prominent papillary structures including scattered hyalinized areas and large areas of calcification. The mass was pathologically diagnosed as cardiac calcified amorphous tumor. She was discharged under medical treatment on seventh day after surgery.

Polat, Adil; Ketenciler, Serkan; Yücel, Cihan; Boyacioğlu, Kamil; Akdemir, Ilknur; Kük, Zeynep Gülben; Yildizhan, Ibrahim; Erentuğ, Vedat

Background: This study aims to retrospectively analyze the early and mid-term results of ultrasound accelerated catheter-directed thrombolytic treatment (EKOS) performed in our clinic in patients with iliofemoral deep venous thrombosis (DVT). Methods: In our clinic, EKOS was performed in 16 patients (12 males, 4 females; mean age 50.2±18.2 years; range 20 to 86 years). Deep venous thrombosis was present on the left lower extremity in nine and right lower extremity in seven patients. Mean duration of treatment from the onset of symptoms was 8.2±5.2 days. Additional to standard EKOS, six patients were administered additional thrombolytic via an angiocath placed in dorsal vein of ipsilateral foot in 1/3 dosage. Patients' fibrinogen levels were monitored periodically and thrombolytic treatment was stopped under critical levels with continuation of heparin infusion. Mean duration of thrombolytic infusion was 18.4±9.8 hours (range, 6-48 hours) and mean dose of thrombolytic was 38.2±18.1 mg (range, 13-90 mg). Results: Complete patency was obtained in seven patients (43.8%). One patient (6.3%) developed post-procedural retroperitoneal hematoma. No mortality occurred during follow-up. Mean and total durations of follow-up were 9.3±8.3 months (range, 0.9-24.3 months) and 148.7 patient/months, respectively. In the final controls, 10 patients (62.5%) were asymptomatic or mildly symptomatic, and two patients (12.5%) had post-thrombotic syndrome. Recurrence of DVT was observed in three patients (18.8%). Recurrence-free average and total durations of follow-up were 7.6±7.3 months and 122.0 patient/months, respectively. No patients had pulmonary emboli during follow-up. Conclusion: Incidence of post-thrombotic syndrome after DVT with EKOS treatment was lower than the reported 25%-50% incidence in the literature compared to only anticoagulant usage. However, rate of asymptomatic or mildly symptomatic patients was not as high as expected. Larger scale studies and comparisons with other pharmacomechanical treatments are required to evaluate treatment efficiency.

Onk, Oruç Alper; Yıldırım, Özgür; Erentuğ, Vedat; Yakut, Cevat; Kayalar, Nihan; Aksüt, Mehmet; Ömeroğlu, Suat Nail; Özkaynak, Berk

Background: This study aims to evaluate the long-term results of angiography in patients undergoing off-pump coronary artery bypass grafting (CABG). Methods: Between September 1993 and December 1995, a total of 162 patients who underwent off-pump CABG by the same two surgeons at a single center, followed by angiography were retrospectively analyzed. Results: The mean time from surgery to angiography was 9.8±1.2 years (range, 7.1 to 12.6 years). The overall patency rate of the left internal mammary artery graft was 95.57% and 46.03% in saphenous vein grafts (SVG). During follow-up, 27 patients (16.67%) underwent percutaneous coronary intervention. The procedure was performed due to severe stenosis in the SVG in eight of them and due to severe lesion formation in native coronary artery in the others. Five patients underwent repeated CABG. There was no significant association between pre-, intra-, and postoperative variables and graft patency. Conclusion: Off-pump CABG technique, in contrast to the conventional bypass, has well-known advantages such as lower transfusion of blood and blood products, shortened length of intensive care unit and hospital stay, reduced cost, and lower morbidity and mortality. Our very long-term angiographic follow-up study showed that off-pump CABG is as reliable as conventional bypass procedure with excellent outcome and patency particularly in the left anterior descending coronary artery. Therefore, off-pump CABG technique should be the primary procedure of choice in selected patients.

Özkaynak, Berk; Yildirim, özgür; Aksüt, Mehmet; Onk, Oruç Alper; Kayalar, Nihan; Ömeroglu, Suat Nail; Erentug, Vedat; Yakut, Cevat

Background: This study aims to evaluate the long-term results of angiography in patients undergoing off-pump coronary artery bypass grafting (CABG). Methods: Between September 1993 and December 1995, a total of 162 patients who underwent off-pump CABG by the same two surgeons at a single center, followed by angiography were retrospectively analyzed. Results: The mean time from surgery to angiography was 9.8±1.2 years (range, 7.1 to 12.6 years). The overall patency rate of the left internal mammary artery graft was 95.57% and 46.03% in saphenous vein grafts (SVG). During follow-up, 27 patients (16.67%) underwent percutaneous coronary intervention. The procedure was performed due to severe stenosis in the SVG in eight of them and due to severe lesion formation in native coronary artery in the others. Five patients underwent repeated CABG. There was no significant association between pre-, intra-, and postoperative variables and graft patency. Conclusion: Off-pump CABG technique, in contrast to the conventional bypass, has well-known advantages such as lower transfusion of blood and blood products, shortened length of intensive care unit and hospital stay, reduced cost, and lower morbidity and mortality. Our very long-term angiographic follow-up study showed that off-pump CABG is as reliable as conventional bypass procedure with excellent outcome and patency particularly in the left anterior descending coronary artery. Therefore, off-pump CABG technique should be the primary procedure of choice in selected patients.

Dinçkal, Mustafa Hakan; Erentuğ, Vedat; Polat, Adil; Sahin, Irfan; Yücel, Cihan; Onur, İmran

Background: This study aims to investigate the results of coronary artery bypass graft (CABG) surgeries in terms of the relation of postoperative atrial fibrillation, coronary vasculature, and the nature and extent of coronary artery disease.Methods: Between January 2011 and May 2011, 94 consecutive CABG patients (68 males, 26 females; mean age 61.4±10.9 years; range 38 to 87 years) who were operated in our clinic were enrolled in this prospective observational study. Logistic regression analysis was performed for the factors influencing the occurrence of postoperative atrial fibrillation. The perioperative parameters (Gensini score, Rentrop score, number of revascularized vessels, dominant coronary artery system, revascularization of the dominant coronary artery system, left main coronary artery disease, clinical status on admission, left ventricular dysfunction, and left atrium diameter) were analyzed as independent variables.Results: Twenty-three patients (24.5%) developed perioperative atrial fibrillation. Twenty patients returned to normal sinus rhythm with amiodarone therapy. In-hospital mortality was observed in three patients (3.2%). There was no statistically significant difference in mortality rates among the patients with and without atrial fibrillation. Left ventricular dysfunction (p=0.034) and left main coronary artery disease (p=0.019) were found to be significantly associated with the occurrence of postoperative atrial fibrillation. The rate of renal complications (p=0.030) and the need for sternal revision surgery (p=0.003) were not significantly different between both groups.Conclusion: Postoperative atrial fibrillation is a frequently encountered complication of cardiac surgery. The left ventricular dysfunction is a significant risk factor for postoperative occurrence of atrial fibrillation. Although no significant association between coronary vasculature and atrial fibrillation, the left main coronary artery disease is a serious risk factor for postoperative atrial fibrillation.