ANKARA ÜNİVERSİTESİ TIP FAKÜLTESİ
KALP VE DAMAR CERRAHİSİ ANABİLİM DALI
1. Akalin, H., E. T. Corapcioglu, U. Ozyurda, K. Ucanok, A. Uysalel, B.
Kaya, N. T. Eren, and C. Erol. Clinical evaluation of the Omniscience
cardiac valve prosthesis. Follow- up of up to 6 years. J Thorac
Cardiovasc Surg 103: 259-266, 1992.
Abstract: From January 1984 to June 1989, 259 Omniscience valve
prostheses were implanted in 225 patients. Of the 225 patients; 143
(63.6%) received mitral, 48 (21.3%) aortic, and 34 (15.1%) double valve
replacements. The early mortality rate was 8.9%; 97.6% of the patients
were included in this study. These patients represent a cumulative follow-
up of 407.9 patient-years, with a mean follow-up of 2.03 +/- 0.1
(standard error) years. The late mortality rate was 4.03% overall, which
corresponds to 2.0% +/- 0.7%/pt-yr (SE). The annual rate of valve
endocarditis was 1.0% +/- 0.5%/pt-yr (SE). The linearized rate of
thromboembolism was 1.2% +/- 0.5%/pt-yr (SE). Anticoagulant-related
hemorrhage occurred in 15 patients with an annual rate of 3.7% +/-
0.9%/pt-yr (SE). The linearized rate of valve thrombosis was 0.2% +/-
0.2%/pt-yr (SE). By echocardiography the mean mitral valve opening was
75.9 +/- 3.1 degrees (standard deviation) for 27 patients. During follow-
up study, 136 (70.8%) patients were in New York Heart Association class
I, 44 (22.9%) were in class II, and 12 (6.3%) were in class III; there were
25 (11.1%) patient
2. Akalin, H., C. Erol, D. Oral, T. Corapcioglu, K. Ucanok, U. Ozyurda,
and V. Ulusoy. Aortico-left ventricular tunnel: successful diagnostic
and surgical approach to the oldest patient in the literature. J
Thorac Cardiovasc Surg 97: 804-805, 1989.
Abstract: Publication Types: Letter PMID: 2709873 [PubMed - indexed for
3. Akalin, H., U. Ozyurda, T. Corapcioglu, A. Uysalel, and A. Sonel.
Successful nonsurgical therapy of mural thrombosis of the left
atrium after mitral valve replacement. J Thorac Cardiovasc Surg
95: 733-734, 1988.
Abstract: Mural thrombosis of the left atrium is a complication of mitral
valve replacement. In this report we present a case of mural thrombosis of
the left atrium after mitral valve replacement treated successfully without
surgical intervention. PMID: 3352309 [PubMed - indexed for MEDLINE]
4. Akalin, H., A. Uysalel, U. Ozyurda, T. Corapcioglu, N. T. Eren, N.
Emirogullari, C. Erol, and A. Sonel. The triad of persistent left
superior vena cava connected to the coronary sinus, right superior
vena cava draining into the left atrium, and atrial septal defect:
report of a successful operation for a rare anomaly. J Thorac
Cardiovasc Surg 94: 151-153, 1987.
Abstract: The triad of right superior vena cava connecting to the left
atrium, persistent left superior vena cava draining into the right atrium
(coronary sinus), and atrial septal defect is a rare malformation. Recently,
we successfully corrected this anomaly in a 47-year-old man
5. Alp, M., R. Dogan, K. Ucanok, S. Kaya, M. Unlu, B. Moldibi, and G.
Cetin. Surgical treatment of childhood pleural empyema. Thorac
Cardiovasc Surg 36: 361-364, 1988.
Abstract: From June 1977 to January 1987, 175 patients underwent
surgical treatment of childhood pleural empyema. The surgical treatment
consisted of tube drainage in 159 (90%) cases, decortication in 31 (17%)
cases, pleuropneumonectomy in 2, lobectomy in 1, and partial
thoracoplasty in one cases. There were 2 hospital deaths (14 and 26 days
after admission). Late recurrences didn't occur, except in one case where
a partial thoracoplasty was necessary. During the follow-up of 11 to 120
months (mean 32 months) examinations were done by chest radiographs.
We believe that, children with loculated empyema can be treated
successfully with antibiotics and chest tube drainage in early stage. The
tube drainage is a more effective method than the other surgical
procedures. Few patients require open drainage, and further surgery is
rarely required. PMID: 3232136 [PubMed - indexed for MEDLINE]
6. Aral, A., M. Oguz, H. Ozberrak, Y. Batislam, T. Corapcioglu, N. T.
Eren, R. Tasoz, and H. Akalin. Hemodynamic advantages of left
atrial epinephrine administration in open heart operations. Ann
Thorac Surg 64: 1046-1049, 1997.
Abstract: BACKGROUND: It is often necessary to administer a
catecholamine to patients who have undergone cardiac operations.
However, there are some potential disadvantages to using the central
venous circulation, a routine route for catecholamine infusion. The
advantages of the left atrial infusion of epinephrine were investigated in
21 patients. METHODS: The first group received epinephrine through the
central venous route (central venous group), and the second group
received adrenaline through the left atrial route (left atrial group).
Hemodynamic studies were performed in all patients before and after the
infusions. Blood samples were also taken from the radial and pulmonary
arteries to determine the epinephrine concentrations. RESULTS: The
average pulmonary arterial pressure and pulmonary vascular resistance
were higher in the central venous group, whereas higher cardiac indices
and average blood pressures were noted in the left atrial group (p <
0.05). There was a statistically significant difference in the epinephrine
concentrations in the pulmonary arterial and radial arterial samples
between the two groups. CONCLUSIONS: We conclude that epinephrine
infusion through the left atrial route is associated with greater
hemodynamic advantages than infusion through the central venous route.
Publication Types: Clinical Trial Randomized Controlled Trial PMID:
9354525 [PubMed - indexed for MEDLINE]
7. Candan, I., C. Erol, A. Sonel, and H. Akalin. Behcet's disease:
cardiac and pulmonary involvement. Eur Heart J 7: 999-1002,
Abstract: A patient with Behcet's disease who had pulmonary and cardiac
involvement is described. The cardiac lesion was endocarditis in the right
ventricle and a thrombus on this lesion which caused pulmonary emboli.
The thrombus was excised completely and hemoptysis stopped. Pulmonary
defects shown by pulmonary scintigraphy did not disappear with the
therapies given to the patient. These abnormalities in Behcet's disease are
very rare, echocardiographic examination can be useful in detecting them.
PMID: 3792359 [PubMed - indexed for MEDLINE]
8. Eren, N. T. and A. R. Akar. Primary pericardial mesothelioma. Curr
Treat.Options.Oncol. 3: 369-373, 2002.
Abstract: Pericardial mesothelioma is a rare cancer for which treatment
options are limited. Operative intervention in pericardial mesothelioma is
primarily for effusion control, for cytoreduction before multimodal therapy,
or to deliver and monitor innovative intrapericardial therapies.
Misdiagnosis is common. Early detection of the disease is the only hope for
survival. Echocardiography, pathologic examination of pericardial fluid and
pericardial biopsy, Gallium-67 scintigraph, Ber-EP4 antibody, and
immunohistochemical procedures can be used. Magnetic resonance
imaging is emerging as the best modality for demonstrating the nature
and extent of the constrictive process, and the infiltration to the cardiac
wall and great vessels. Failure of surgical techniques is usually associated
with mesothelioma with entrapped heart, a large solid tumor mass, and a
long history of pericardial effusion. If the tumor is localized, resection is
the only hope for this rare, but lethal, entity. No single treatment modality
is efficient by itself. The exact role of intracavitary chemotherapy or
irradiation remains to be defined. Preliminary clinical application of
photodynamic therapy and attempts at inhibiting the effects of growth
factors, such as vascular endothelial growth factor and platelet-derived
growth factor, and vaccine treatments are being explored. Adenoviral
molecular chemotherapy recently completed phase I testing. Clinical trials
for pleural mesothelioma remain important as clinicians seek to improve
the outcome for patients with pericardial mesothelioma. Early diagnosis
and multidisciplinary patient care is essential for improved surgical
outcome. In the future, combined therapeutic strategies involving radical
surgery, radiotherapy, adjuvant chemotherapy, and immunomodulation
may have a role in the treatment of pericardial mesotheliomas. Publication
Types: Review Review, Tutorial PMID: 12194802 [PubMed - indexed for
9. Eren, N. T., S. Eryilmaz, M. Sirlak, M. B. Inan, T. Corapcioglu, and H.
Akalin. Treatment of iatrogenic acute mitral regurgitation. J Thorac
Cardiovasc Surg 123: 362-363, 2002.
Abstract: [PubMed - indexed for MEDLINE]
10. Erol, C., I. Candan, H. Akalin, A. Sonel, and C. Kervancioglu.
Cardiac hydatid cyst simulating tricuspid stenosis. Am J Cardiol 56:
Abstract: PMID: 4061322 [PubMed - indexed for MEDLINE]
11. Eryilmaz, S., T. Corapcioglu, N. T. Eren, L. Yazicioglu, K. Kaya, and
H. Akalin. Off-pump coronary artery bypass surgery in the left
ventricular dysfunction. Eur J Cardiothorac Surg 21: 36-40, 2002.
Abstract: OBJECTIVE: The purpose of this study is to report our
experience in off- pump coronary artery surgery in patients who have left
ventricular dysfunction. METHODS: Off-pump coronary artery surgery was
performed to 48 patients who were chosen randomly among 265 patients
having two or more coronary artery disease and whose ejectio
12. Eryilmaz, S., M. B. Inan, N. T. Eren, L. Yazicioglu, T. Corapcioglu,
and H. Akalin. Coronary endarterectomy with off-pump coronary
artery bypass surgery. Ann Thorac Surg 75: 865-869, 2003.
Abstract: BACKGROUND: The aim of this study is to review our experience
in coronary artery endarterectomy performed without cardiopulmonary
bypass. METHODS: Between May 1998 and June 2000 off-pump coronary
endarterectomy was performed on 11 patients who had unstable angina
pectoris. The mean ejection fraction (EF) was 26.3 +/- 4.4, and all of the
patients were New York Heart Association (NYHA) III or IV. Off-pump open
left anterior descending (LAD) endarterectomy was performed on 7
patients, and closed endarterectomy of the right coronary artery (RCA)
was done on the remaining 4. RESULTS: There were no deaths. None of
the procedures was converted to on-pump operation; all the
endarterectomies and bypasses were performed on the beating heart. All
patients were completely revascularized, the left internal mammary artery
was bypassed to the LAD in all operations, and all other grafts were of
saphenous vein. At the end of the first year all bypasses to the
endarterectomized arteries were patent. The overall patency rate was
95.6%. The mean postoperative EF was 34.7 +/- 9.1, which was
significantly higher than the preoperative one (p < 0.05). At the end of the
first year 9 patients were NYHA I or II and all were angina free in
Canadian Cardiovascular Society class 0 or I. CONCLUSIONS:
Endarterectomy without cardiopulmonary bypass can be performed in
patients with severe left ventricular dysfunction who are expected to
benefit from the complete revascularization.
13. Eryilmaz, S., M. Sirlak, M. B. Inan, E. Erden, N. T. Eren, T.
Corapcioglu, and H. Akalin. Primary pericardial mesothelioma.
Cardiovasc Pathol 10: 147-149, 2001.
Abstract: Primary pericardial mesothelioma is an extremely rare tumor.
This case illustrates the typical late presentation of primary pericardial
mesothelioma with symptoms and signs of constrictive pericarditis. An
unusual feature was the complete encasement of the heart by the tumor.
No satisfactory treatment was available. PMID: 11485860 [PubMed -
indexed for MEDLINE]
14. Guldal, M., R. Karaoguz, H. Akalin, M. Bayar, and T. Akyol. Is there
an effect of amiodarone on the defibrillation threshold? Jpn Heart J
34: 221-226, 1993.
Abstract: The interaction between amiodarone and the defibrillation
threshold (DFT) is still controversial. We present a case with dilated
cardiomyopathy and recurrent sustained monomorphic ventricular
tachycardia who received an automatic implantable cardioverter
defibrillator (AICD) while under long-term amiodarone treatment. AICD
implantation was performed without thoracotomy. The transvenous lead
was inserted via a left subclavian vein puncture and the patch was placed
on the lateral chest wall, submuscularly. At the time of implantation a 35J
shock was not successful in converting ventricular fibrillation to sinus
rhythm, but a 40J rescue shock was successful. After discontinuation of
amiodarone, DFT measurements were repeated. Sixteen days later DFT
was still higher than 34J, but 71 days later it decreased to 20J. PMID:
8315819 [PubMed - indexed for MEDLINE]
15. Gurlek, A., Z. Dagalp, and U. Ozyurda. A case of multiple
pericardial hydatid cysts. Int J Cardiol 36: 366-368, 1992.
Abstract: Pericardial cysts are rare developmental benign intrathoracic
lesions and constitute 7% of all mediastinal tumors. As many as 70% of
the cysts are found in the right cardiophrenic angle. Unusual locations
include the left costophrenic angle, the hilum and the superior
mediastinum at the level of the aortic arch. Cysts arising inside the
pericardial cavity and attached to the heart are exceedingly rare. We
describe a case of multiple pericardial hydatid cysts
16. Imamoglu, A., H. Akalin, T. Corapcioglu, N. Girgin, K. Mengubas,
and C. Erol. Hepatoma with right atrial extension. Pediatr Cardiol
10: 236-237, 1989.
Abstract: The case is described of a 14-year-old boy who had a hepatoma
with a right atrial extension. He presented with edema, abdominal pain,
and ascites. Two-dimensional echocardiography showed a right atrial
tumor that had invaded from the inferior vena cava as an extension into
the right atrium of the hepatoma. PMID: 2556690 [PubMed - indexed for
17. Kaya, B., K. Ucanok, R. Tasoz, K. Ozisik, O. Peker, O. Tatlican, and
I. Gelisen. Repair of a ruptured posterior left ventricular
pseudoaneurysm. Minerva Cardioangiol. 50: 389-391, 2002.
Abstract: A 51 year old man with a large ruptured posterior left ventricular
(LV) pseudoaneurysm (PsAn) was successfully surgically treated. Complete
repair was performed by excision of the PsAn, leaving a cuff of fibrous
tissue suitable to hold sutures and a Dacron patch reconstruction of the
LV. On the 7th postoperative day, echocardiographic examination
confirmed pericardial effusion (swinging heart). Media-stinal drainage tube
was performed and the patient was discharged with a good recovery. The
patient's preoperative LV ejection fraction (EF) increased from 42.7 to
52% after operation. We consider endoventricular circular patch plasty of
ruptured posterior LV PsAn excellent because of the avoidance of
thrombus and the effectiveness for improvement of LV function
18. Kiziltepe, U., Z. B. Eyileten, A. Uysalel, and H. Akalin. Prolonged
pleural effusion following Fontan operation: effective pleurodesis
with talc slurry. Int J Cardiol 85: 297-299, 2002.
Abstract: Prolonged pleural effusions following a Fontan operation are a
difficult problem. Although fenestrations and embolizations of systemic-
pulmonary artery collaterals were suggested to treat and to decrease the
risk of this complication, talc slurry pleurodesis may successfully augment
and accelerate the beneficial effects of those techniques against the
19. Kiziltepe, U., Z. B. Eyileten, A. Uysalel, and H. Akalin. Acute
pulmonary hypertensive crisis after TAPVC repair treated with
atrial septectomy with inflow occlusion. Int J Cardiol 87: 107-109,
Abstract: Acute pulmonary hypertensive crisis is a fatal complication after
obstructive TAPVC repair. An atrial septectomy or enlargement of a small
ASD could be a lifesaving procedure in order to maintain cardiac output in
severe cases. This
procedure can be accomplished with inflow occlusion in patients with
20. Kiziltepe, U., A. Uysalel, T. Corapcioglu, K. Dalva, H. Akan, and H.
Akalin. Effects of combined conventional and modified
ultrafiltration in adult patients. Ann Thorac Surg 71: 684-693,
Abstract: BACKGROUND: Modified ultrafiltration (MUF) improves
hemodynamics and postoperative recovery in children. Ultrafiltration (UF)
may have similar benefits in adults. The purpose of this study was to
investigate the effects of UF in adult patients. METHODS: A total of 40
adult patients undergoing cardiac surgery were randomized into a study
group of conventional UF during bypass + venovenous MUF after bypass
and a control group with no UF. Perioperative clinical variables, cytokines,
and endothelin-1 levels were compared between groups. RESULTS: There
was no mortality in either group. The patients in the study group had a
greater rise in hematocrit (5.7% +/- 2.4% vs 1.2% +/- 1.9%, p < 0.001),
hemoglobin (1.7 +/- 0.8 mg/mL vs 0.5 +/- 0.6 mg/mL, p < 0.0005), and
platelet levels (27,800 +/- 29,200 vs -9,000 +/- 30,970, p < 0.001).
Mean arterial blood pressure and CI increased after MUF (from 64.2 +/-
16.9 mm Hg to 72.3 +/- 14.1 mm Hg, p = 0.05, and from 2.4 +/- 0.7 to
2.8 +/- 0.6, p < 0.03, respectively). Postoperative oxygenation was better
in the study group (alveolo-arterial PO2 tension gradient 74.6 +/- 43.9
mm Hg vs 107.2 +/- 27.8 mm Hg, p = 0.03). Ultrafiltration reduced
postoperative bleeding (522.2 +/- 233.4 mL vs 740 +/- 198.4 mL, p <
0.003). CONCLUSIONS: A combination of conventional and modified UF is
effective and safe in adult patients undergoing cardiac surgery.
Ultrafiltration improved hemodynamics, hemostatic, and pulmonary
functions. We recommend the use of combined UF in high-risk adult
patients. Publication Types: Clinical Trial Randomized Controlled Trial
PMID: 11235728 [PubMed - indexed for MEDLINE]
21. Kiziltepe, U., A. Uysalel, E. Tutar, and H. Akalin. Brucella melitensis
endocarditis of ventricular septal defect patch: successful surgical
treatment without replacement. J Thorac Cardiovasc Surg 125:
22. Kocak, G., S. Atalay, E. Tutar, A. Imamoglu, A. Uysalel, and M.
Guldal. Congenital complete atrioventricular block in an infant with
long QT syndrome. Acta Cardiol 53: 153-155, 1998.
Abstract: A three months old patient with congenital complete
atrioventricular block and prolonged QT interval syndrome is presented.
Before admission she had had two syncopal attacks. During hospitalization
she had an episode of torsade de pointes which was followed by
ventricular fibrillation. After a successful cardiopulmonary resuscitation, a
permanent epicardial ventricular pacemaker was implanted and she was
discharged on propranolol therapy. She is now free of symptoms and
doing well, 16 months after discharge. PMID: 9793568 [PubMed - indexed
23. Sayin, M. M., O. Ozatamer, R. Tasoz, K. Kilinc, and N. Unal. Propofol
attenuates myocardial lipid peroxidation during coronary artery
bypass grafting surgery. Br J Anaesth. 89: 242-246, 2002.
Abstract: BACKGROUND: Propofol can scavenge free radicals because it
has a chemical structure similar to antioxidants. METHODS: We examined
if free radical scavenging occurs with propofol during CABG operations. We
studied 24 patients undergoing CABG surgery for triple vessel disease,
randomized into two groups. After induction of anaesthesia with fentanyl
10 micrograms kg-1 and midazolam 0.1 mg kg-1, patients in the fentanyl
group (n = 14) received fentanyl infusion 10-30 micrograms kg- 1 h-1 and
patients in the propofol group (n = 10) received propofol infusion 3-6 mg
kg-1 h-1 for maintenance of anaesthesia. Atrial tissue biopsies were taken
during cannulation for bypass, 45 min after cross- clamp insertion, 5 min
after unclamping, and in the decannulation period. Lipid peroxidation was
assessed by measurement of thiobarbituric acid reactive substances
(TBARS) in the atrial tissue samples. RESULTS: Lipid peroxidation in the
propofol group was less than in the fentanyl group (P < 0.05) in all
sampling periods. Lipid peroxidation in the fentanyl group increased
significantly during cardiopulmonary bypass (CPB) (P < 0.05), but no
increase was found in the propofol group (P > 0.05). CONCLUSION: In
clinical doses, propofol strongly attenuates lipid peroxidation during CABG
24. Tulunay, M., S. Demiralp, S. Tastan, H. Akalin, U. Ozyurda, T.
Corapcioglu, and E. S. Akarsu. Complement (C3, C4) and C-reactive
protein responses to cardiopulmonary bypass and protamine
administration. Anaesth.Intensive Care 21: 50-55, 1993.
Abstract: Complement activation has been deemed responsible for the
damaging effects of cardiopulmonary bypass (CPB) in patients undergoing
open heart surgery. We studied C3, C4 and C-reactive protein (CRP) in 22
patients undergoing CPB. In Group 1 (11 patients), protamine was given
intravenously and in Group 2 (11 patients), via the aortic root after CPB.
Significant decreases were observed in C3 and C4 during CPB in both
groups indicating complement activation primarily by the classic pathway.
Protamine did not lead to further activation of the complement system. In
both groups, C3 levels gradually returned toward baseline within 24 hours
but C4 levels were still lower than baseline 24 hours postoperatively. CPB
and protamine administration did not cause any significant changes in CRP
levels, but CRP increased abruptly 24 hours after operation. Although
activation of complement system during CPB is expected to invoke an
acute phase response, we conclude that this period is not long enough to
induce an increased production of CRP in response to tissue injury or
25. Tutar, H. E., S. Atalay, A. Uysalel, H. Ozberrak, and G. Kocak.
Recurrent pericardial effusion due to gunshot wound of the heart
in a hemodynamically stable child--a case report. Angiology 50:
Abstract: A 12-year-old girl presented with recurrent pericardial effusion
due to firearm pellet injury to the left ventricle. The pellet was localized by
two-dimensional echocardiography within the left ventricular apical wall.
Since the patient was asymptomatic, left ventriculotomy was avoided to
extract the pellet and only pericardial tube drainage was carried out. A
slightly elevated blood lead level of the patient was alarming for potential
subsequent lead poisoning due to retained pellets. Publication Types:
Review Review of Reported Cases PMID: 10225471 [PubMed - indexed for
26. Tutar, H. E., E. Yilmaz, S. Atalay, T. Ucar, A. Uysalel, U. Kiziltepe,
and H. Gumus. The changing aetiological spectrum of pericarditis
in children. Ann Trop Paediatr 22: 251-256, 2002.
Abstract: The aetiologies, clinical features and follow-up data of 62
pericarditis admitted to a university hospital during a 6-year period were
retrospectively assessed. Uraemic pericarditis was the most frequent and
infections the second most frequent cause. In this series, the proportion of
children with purulent pericarditis is less than in previous reports from
developing countries. Familial Mediterranean fever, neoplasias, acute
fever and post-pericardiotomy syndrome were other important causes of
27. Uysalel, A., A. Aral, S. Atalay, and H. Akalin. Cardiac echinococcsis
with multivisceral involvement. Pediatr Cardiol 17: 268-270, 1996.
Abstract: Cardiac hydatid cyst is an uncommon lesion. The infection, often
acquired by children during play with infected dogs, is most common in
sheep-raising areas of the world. We report our clinical and surgical
experience in the treatment of one of the youngest reported cardiac
hydatidosis patients with multivisceral involvement
28. Uysalel, A., L. Yazicioglu, A. Aral, and H. Akalin. A multivesicular
cardiac hydatid cyst with hepatic involvement. Eur J Cardiothorac
Surg 14: 335-337, 1998.
Abstract: Cardiac hydatid cyst is an uncommon lesion, mostly caused by
Echinococcus granulosus. Occurrence of the disease in man appears to be
limited geographically to areas where close and continuous contact exists
between domesticated carnivores such as dogs and ungulates such as
cattle and sheep. Generally cardiac hydatid cysts are univesicular. Here we
report our clinical and surgical experience of treatment in a case of a
multivesicular cardiac hydatid cyst with hepatic involvement. PMID:
9761448 [PubMed - indexed for MEDLINE]
29. Yazicioglu, L., S. Eryilmaz, M. Sirlak, M. B. Inan, A. Aral, R. Tasoz,
and H. Akalin. The effect of preoperative digitalis and atenolol
combination on postoperative atrial fibrillation incidence. Eur J
Cardiothorac Surg 22: 397-401, 2002.
Abstract: PURPOSE: The most frequent arrhythmia after coronary artery
bypass surgery is atrial fibrillation (AF). The prevention and treatment of
this type of arrhythmia is subobtimal. Digitalis, beta-blockers, diltiazem
and amiodarone are the preferred drugs for the treatment. This study was
designed to compare the effects of preoperatively started digitalis and
atenolol in combination and separately, on the incidence of AF that occurs
within 7 days following the operation. MATERIALS AND METHOD: One-
hundred and sixty patients who had similar demographic properties were
randomly grouped as group I, that preoperatively received combined drug
therapy (n=40), group II preoperatively used digitalis (n=40), group III
atenolol (n=40), and group IV was the control group (n=40). RESULTS:
Postoperative AF incidence was 25, 15,4, and 17,9% in groups IV, III, and
II, respectively, whereas it was 5% in group I which was lower than all
other groups, but the difference was only significant between groups I and
IV (P=0.012). CONCLUSION: The combined use of atenolol and digitalis
preoperatively was considered as an efficient treatment for lowering the
incidence of AF following coronary artery bypass surgery
30. Yazicioglu, L., S. Eryilmaz, M. Sirlak, M. B. Inan, A. Aral, R. Tasoz,
N. T. Eren, B. Kaya, and H. Akalin. Recombinant human
erythropoietin administration in cardiac surgery. J Thorac
Cardiovasc Surg 122: 741-745, 2001.
Abstract: OBJECTIVE: Postoperative anemia and multiple blood
transfusions are still important problems in cardiac surgery. During the
past few years, there have been some reports indicating that multiple
recombinant human erythropoietin infusions starting at least 2 weeks
before the operation induced erythropoiesis. We aimed to reduce the risk
of adverse reactions of high doses of recombinant human erythropoietin
and reduce the period of hospitalization by using it only once, 4 days
before the operation. METHODS: Twenty-five patients received
recombinant human erythropoietin 4 days before the operation, and 28
patients comprised the control group. All the hematologic parameters of
the patients are measured on the day of admission, the day before the
operation (fourth day), the first day after the operation, and 1 week later.
RESULTS: In the recombinant human erythropoietin group the mean
hemoglobin concentration increased on the morning of the operation (14.5
+/- 0.52 g/dL in the recombinant human erythropoietin group and 12.4
+/- 0.65 in the control group, P <.05). To maintain hemoglobin levels at
greater than 8.5 g/dL, 330 +/- 33 mL of homologous transfusion was
required in the recombinant human erythropoietin group, whereas 680 +/-
75 mL was required in the control group (P <.01). CONCLUSION:
Recombinant human erythropoietin induces erythropoiesis rapidly, even
when it is used with a low single dose just 4 days before the operation. No
adverse reactions were seen with this kind of recombinant human
erythropoietin treatment. Publication Types: Clinical Trial Randomized
Controlled Trial PMID: 11581607 [PubMed - indexed for MEDLINE]