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Prisciandaro E, Bertolaccini L, Fieuws S, Cara A, Spaggiari L, Huang L, Petersen RH, Ambrogi MC, Sicolo E, Barbarossa A, De Leyn P, Sporici D, Balsamo L, Donlagic A, Gonzalez M, Fuentes-Gago MG, Forcada-Barreda C, Congedo MT, Margaritora S, Belaroussi Y, Thumerel M, Tricard J, Felix P, Lebeda N, Opitz I, De Palma A, Marulli G, Braggio C, Thomas PA, Mbadinga F, Baste JM, Sayan B, Yildizeli B, Van Raemdonck DE, Weder W, Ceulemans LJ. Multicentre retrospective analysis on pulmonary metastasectomy: an European perspective. Eur J Cardiothorac Surg 2024; 65:ezae141. [PMID: 38579246 DOI: 10.1093/ejcts/ezae141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 03/27/2024] [Accepted: 04/03/2024] [Indexed: 04/07/2024] Open
Abstract
OBJECTIVES To assess the current practice of pulmonary metastasectomy at 15 European Centres. Short- and long-term outcomes were analysed. METHODS Retrospective analysis on patients ≥18 years who underwent curative-intent pulmonary metastasectomy (January 2010 to December 2018). Data were collected on a purpose-built database (REDCap). Exclusion criteria were: previous lung/extrapulmonary metastasectomy, pneumonectomy, non-curative intent and evidence of extrapulmonary recurrence at the time of lung surgery. RESULTS A total of 1647 patients [mean age 59.5 (standard deviation; SD = 13.1) years; 56.8% males] were included. The most common primary tumour was colorectal adenocarcinoma. The mean disease-free interval was 3.4 (SD = 3.9) years. Relevant comorbidities were observed in 53.8% patients, with a higher prevalence of metabolic disorders (32.3%). Video-assisted thoracic surgery was the chosen approach in 54.9% cases. Wedge resections were the most common operation (67.1%). Lymph node dissection was carried out in 41.4% cases. The median number of resected lesions was 1 (interquartile range 25-75% = 1-2), ranging from 1 to 57. The mean size of the metastases was 18.2 (SD = 14.1) mm, with a mean negative resection margin of 8.9 (SD = 9.4) mm. A R0 resection of all lung metastases was achieved in 95.7% cases. Thirty-day postoperative morbidity was 14.5%, with the most frequent complication being respiratory failure (5.6%). Thirty-day mortality was 0.4%. Five-year overall survival and recurrence-free survival were 62.0% and 29.6%, respectively. CONCLUSIONS Pulmonary metastasectomy is a low-risk procedure that provides satisfactory oncological outcomes and patient survival. Further research should aim at clarifying the many controversial aspects of its daily clinical practice.
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Affiliation(s)
- Elena Prisciandaro
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Leuven Intestinal Failure and Transplantation Centre (LIFT), University Hospitals Leuven, Leuven, Belgium
| | - Luca Bertolaccini
- Department of Thoracic Surgery, IEO European Institute of Oncology IRCCS, Milano, Italy
| | - Steffen Fieuws
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KU Leuven-University of Leuven, Leuven, Belgium
| | - Andrea Cara
- Department of Thoracic Surgery, IEO European Institute of Oncology IRCCS, Milano, Italy
| | - Lorenzo Spaggiari
- Department of Thoracic Surgery, IEO European Institute of Oncology IRCCS, Milano, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | - Lin Huang
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - René H Petersen
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Marcello C Ambrogi
- Division of Thoracic Surgery, Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - Elisa Sicolo
- Division of Thoracic Surgery, Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - Annalisa Barbarossa
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Leuven Intestinal Failure and Transplantation Centre (LIFT), University Hospitals Leuven, Leuven, Belgium
| | - Paul De Leyn
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Leuven Intestinal Failure and Transplantation Centre (LIFT), University Hospitals Leuven, Leuven, Belgium
| | - Diana Sporici
- Unit of Thoracic Surgery, Department of Surgical Sciences, University of Torino, Torino, Italy
| | - Ludovica Balsamo
- Unit of Thoracic Surgery, Department of Surgical Sciences, University of Torino, Torino, Italy
| | - Abid Donlagic
- Service of Thoracic Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Michel Gonzalez
- Service of Thoracic Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | | | | | - Maria T Congedo
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Stefano Margaritora
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Yaniss Belaroussi
- Department of Thoracic Surgery, University Hospital Bordeaux, Pessac, France
| | - Matthieu Thumerel
- Department of Thoracic Surgery, University Hospital Bordeaux, Pessac, France
| | - Jérémy Tricard
- Department of Cardiac and Thoracic Surgery, University Hospital Limoges, Limoges, France
| | - Pierre Felix
- Department of Cardiac and Thoracic Surgery, University Hospital Limoges, Limoges, France
| | - Nina Lebeda
- Department of Thoracic Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Isabelle Opitz
- Department of Thoracic Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Angela De Palma
- Section of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Bari, Italy
| | - Giuseppe Marulli
- Section of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Bari, Italy
| | - Cesare Braggio
- Department of Thoracic Surgery, Lung Transplantation and Oesophageal Diseases, North Hospital, Marseille, France
| | - Pascal A Thomas
- Department of Thoracic Surgery, Lung Transplantation and Oesophageal Diseases, North Hospital, Marseille, France
| | - Frankie Mbadinga
- Department of General and Cardiothoracic Surgery, University Hospital Rouen, Rouen, France
| | - Jean-Marc Baste
- Department of General and Cardiothoracic Surgery, University Hospital Rouen, Rouen, France
| | - Bihter Sayan
- Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Bedrettin Yildizeli
- Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Dirk E Van Raemdonck
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Leuven Intestinal Failure and Transplantation Centre (LIFT), University Hospitals Leuven, Leuven, Belgium
| | - Walter Weder
- Department of Thoracic Surgery, Bethanien Klinik, Zürich, Switzerland
| | - Laurens J Ceulemans
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Leuven Intestinal Failure and Transplantation Centre (LIFT), University Hospitals Leuven, Leuven, Belgium
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Unaldi E, Firlatan B, Duzgun SA, Koca SS, Yildizeli B, Akdogan A. Case report: Pulmonary endarterectomy in Takayasu arteritis patient with group IV pulmonary hypertension: A rare clinical scenario. Int J Rheum Dis 2024; 27:e15119. [PMID: 38488384 DOI: 10.1111/1756-185x.15119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/22/2024] [Accepted: 02/28/2024] [Indexed: 03/19/2024]
Affiliation(s)
- Erdinc Unaldi
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Busra Firlatan
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Selin Ardali Duzgun
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Suleyman Serdar Koca
- Division of Rheumatology, Department of Internal Medicine, Firat University School of Medicine, Elazig, Turkey
| | - Bedrettin Yildizeli
- Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Ali Akdogan
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
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Ermerak NO, Uprak KT, Emran M, Lacin T, Yildizeli B, Yegen C. Esophageal Perforation During Intragastric Balloon Therapy: Management of a Patient with Late Referral. Obes Surg 2024; 34:272-273. [PMID: 37952060 DOI: 10.1007/s11695-023-06929-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 06/30/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023]
Affiliation(s)
- Nezih Onur Ermerak
- Department of Thoracic Surgery, Marmara University School of Medicine, Fevzi Çakmak Mah. Mimar Sinan Cad. No: 41, Üst Kaynarca, 34899, Pendik, Istanbul, Turkey.
| | - Kivilcim Tevfik Uprak
- Department of General Surgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Miray Emran
- Department of Thoracic Surgery, Marmara University School of Medicine, Fevzi Çakmak Mah. Mimar Sinan Cad. No: 41, Üst Kaynarca, 34899, Pendik, Istanbul, Turkey
| | - Tunc Lacin
- Department of Thoracic Surgery, Marmara University School of Medicine, Fevzi Çakmak Mah. Mimar Sinan Cad. No: 41, Üst Kaynarca, 34899, Pendik, Istanbul, Turkey
| | - Bedrettin Yildizeli
- Department of Thoracic Surgery, Marmara University School of Medicine, Fevzi Çakmak Mah. Mimar Sinan Cad. No: 41, Üst Kaynarca, 34899, Pendik, Istanbul, Turkey
| | - Cumhur Yegen
- Department of General Surgery, Marmara University School of Medicine, Istanbul, Turkey
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Aksoy A, Kocakaya D, Demircioglu O, Cimsit NC, Yildizeli B, Karakurt S, Direskeneli H, Alibaz-Oner F. Angiographic findings of pulmonary arterial involvement in Behcet's Disease: Do they correlate with symptoms and acute phase response? Respir Med 2024; 221:107481. [PMID: 38035945 DOI: 10.1016/j.rmed.2023.107481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/08/2023] [Accepted: 11/24/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION Behcet's disease (BD) is a chronic inflammatory disorder with arterial vasculitis. Although, pulmonary artery aneurysm (PAA) is accepted as the prototypic arterial disorder, an increasing presence of pulmonary artery thrombosis (PAT) with or without aneurysms was also reported in recent studies. In this study, we aimed to describe computed tomography pulmonary angiography (CTPA) findings of pulmonary involvement and its correlation with symptoms and acute phase response in BD. METHOD In this retrospective study, 153 CTPA of BD patients were assessed by two radiologists. Clinical and laboratory data were collected from the patient files. Pulmonary artery involvement (PAI) was defined as thrombus or aneurysm in CT angiography. RESULTS Most of (85.6 %) our patients were male and median age was 33.7 ± 10 years during angiographic assessments. Sixty-two (40.5 %) angiographies presented a thrombus: 14 subsegmental, 29 segmental, 13 lobar and 6 main branches. Among these, 82.3 % (n = 51) had bilateral involvement. Isolated PAT was present in 58 (93.5 %) angiographies with only 4 (2.6 %) angiographies displaying an aneurysm together with a thrombus. Pulmonary infarction was detected in 9 angiographies. Forty-four (29.3 %) patients, almost all of them under immunosuppressive treatments for other indications, were screened for asymptomatic pulmonary involvement (without any symptoms or increased acute-phase response (APR)), and one fourth of these were diagnosed as having a segmental or subsegmental PAT. CONCLUSION Our results show that isolated pulmonary thrombosis is the main form of PAI, and isolated pulmonary aneurysm formation is rare in our BD cases. In the presence of pulmonary symptoms with or without increased APRs, involvement of segmental or more proximal parts of pulmonary arteries is most commonly detected. We also observed that PAI may be seen in about one fourth of especially male BD patients without symptoms or increased APR. Our results suggest that BD patients with pulmonary symptoms should be screened by CTPA for PAI, however, further research is needed to clarify the role of routine CTPA screening in asymptomatic BD patients.
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Affiliation(s)
- Aysun Aksoy
- Department of Internal Medicine Division of Rheumatology, Faculty of Medicine, Marmara University, İstanbul, Turkey.
| | - Derya Kocakaya
- Department of Pulmonary Medicine and Critical Care, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Ozlem Demircioglu
- Department of Radiology, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Nuri Cagatay Cimsit
- Department of Radiology, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Bedrettin Yildizeli
- Department of Chest Surgery, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Sait Karakurt
- Department of Pulmonary Medicine and Critical Care, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Haner Direskeneli
- Department of Internal Medicine Division of Rheumatology, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Fatma Alibaz-Oner
- Department of Internal Medicine Division of Rheumatology, Faculty of Medicine, Marmara University, İstanbul, Turkey
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Ermerak NO, Yildizeli SO, Kocakaya D, Mutlu B, Ak K, Tas S, Yildizeli B. Surgical Treatment of Another Sequalae of COVID-19: Post-COVID CTEPH. Thorac Cardiovasc Surg 2023; 71:413-417. [PMID: 36944361 DOI: 10.1055/a-2059-4513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is still an ongoing entity and every day we face new sequalae of the disease. We hereby present surgical results of patients who are treated for post-COVID chronic thromboembolic pulmonary hypertension. METHODS Data were collected among patients who underwent pulmonary endarterectomy and had a diagnosis of post-COVID chronic thromboembolic pulmonary hypertension. All data were retrospectively reviewed from a prospectively conducted database. Operative mortality was described as death in hospital or within 30 days of surgery. RESULTS Eleven patients (seven males, four females; median age, 52 [22-63] years) were identified. Pulmonary vascular resistance improved significantly from 572 dyn/s/cm-5 (240-1,192) to 240 (195-377) dyn/s/cm-5 (p < 0.005). Significant difference was also detected in median mPAP, as it decreased from 40 mm Hg (24-54) to 24 mm Hg (15-36) following surgery (p < 0.005). Mortality was observed in one patient due to sepsis on the fifth postoperative day. Median time from COVID-19 disease to surgery was 12 months (6-24). Median length of hospital stay of the survivors was 10 days (8-14). CONCLUSION In the new era of chronic thromboembolic pulmonary hypertension, hybrid approach including surgery, balloon pulmonary angioplasty, and medical treatment has been recommended. pulmonary endarterectomy is still the only curative treatment when the disease is surgically accessible. We hereby report the first publication of post-COVID chronic thromboembolic pulmonary hypertension patients who were surgically treated. As we see a lot of long-term symptoms and clinical manifestations in patients who had COVID-19, we should always remember chronic thromboembolic pulmonary hypertension in the differential diagnosis.
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Affiliation(s)
- Nezih Onur Ermerak
- Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
| | | | - Derya Kocakaya
- Department of Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Bulent Mutlu
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Koray Ak
- Department of Cardiovascular Surgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Serpil Tas
- Department of Cardiovascular Surgery, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Bedrettin Yildizeli
- Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
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Zengin A, Kalkan R, Aydin KY, Olgun Yildizeli Ş, Mutlu B, Karakoç AZ, Taş S, Sunar H, Kiliç Ü, Yanartaş M, Yildizeli B. Extracellular Matrix Collagen Biomarker Levels in Patients who Underwent Pulmonary Endarterectomy. Eur J Cardiothorac Surg 2023; 63:7083438. [PMID: 36946285 DOI: 10.1093/ejcts/ezad106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/23/2023] [Accepted: 03/21/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVE The role of extracellular matrix collagen biomarkers in chronic thromboembolic pulmonary hypertension is not well known. Our aim is to investigate the matrix metalloproteinase-2 and -9 protein levels in patients with chronic thromboembolic pulmonary hypertension. MATERIALS AND METHODS This is a prospective and cross-sectional study. Patients with chronic thromboembolic pulmonary hypertension who underwent pulmonary endarterectomy (Group 1) and the control group included patients who underwent lung surgery without pulmonary hypertension (Group 2) between March 2020 and March 2021. In addition to serum levels of matrix metalloproteinase-9, the pulmonary endarterectomy and control pulmonary artery tissue samples were measured by ELISA 4pl, cubic, quadratic and western blot techniques. Levels of matrix metalloproteinase-2 which consist of pro matrix metalloproteinase-2/ß-actin and active matrix metalloproteinase-2/ß-actin and matrix metalloproteinase-9/ß-actin were measured only in the tissue samples. RESULTS Forty eight patients were enrolled consecutively in Group 1 (n: 24) and Group 2 (n: 24). The serum concentrations of matrix metalloproteinase-9 were similar in both groups. Similarly, in comparison of tissue sample levels of pro matrix metalloproteinase-2/ß-actin (p: 0.496) and active matrix metalloproteinase-2/ß-actin (p: 0.216) no significant difference was found between the groups. Chronic thromboembolic pulmonary hypertension patients had significantly lower tissue samples of matrix metalloproteinase-9/ß-actin compared to the control group (p: 0.001). CONCLUSION This study indicates that serum levels of extracellular matrix collagen biomarkers were similar in patients with chronic thromboembolic pulmonary hypertension who candidates for surgery and non-pulmonary hypertension patients are who undergo lung surgery. Differences in levels of matrix metalloproteinase-9/ß-actin in tissue samples may play a role in pulmonary vascular remodeling in operable patients. CLINICAL TRIAL REGISTRATION NUMBER NCT04773028.
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Affiliation(s)
- Ahmet Zengin
- Department of Cardiovascular Surgery, University of Health Sciences, Kartal Koşuyolu Teaching and Education Hospital, Istanbul, Turkey
| | - Rabia Kalkan
- Department of Medical Biology, University of Health Sciences, School of Medicine, Istanbul, Turkey
| | - Kübra Yildiz Aydin
- Public Health Sciences, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Şehnaz Olgun Yildizeli
- Department of Pulmonology and Intensive Care, Marmara University School of Medicine, Istanbul, Turkey
| | - Bülent Mutlu
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Ayşe Zehra Karakoç
- Department of Cardiovascular Surgery, University of Health Sciences, Kartal Koşuyolu Teaching and Education Hospital, Istanbul, Turkey
| | - Serpil Taş
- Department of Cardiovascular Surgery, University of Health Sciences, Kartal Koşuyolu Teaching and Education Hospital, Istanbul, Turkey
| | - Hasan Sunar
- Department of Cardiovascular Surgery, University of Health Sciences, Kartal Koşuyolu Teaching and Education Hospital, Istanbul, Turkey
| | - Ülkan Kiliç
- Department of Medical Biology, University of Health Sciences, School of Medicine, Istanbul, Turkey
| | - Mehmed Yanartaş
- Department of Cardiovascular Surgery, University of Health Sciences, Kartal Koşuyolu Teaching and Education Hospital, Istanbul, Turkey
| | - Bedrettin Yildizeli
- Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
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Ermerak NO, Yilmaz B, Batirel S, Olgun Yildizeli S, Kocakaya D, Mutlu B, Tas S, Yildizeli B. The angiogenic gene profile of pulmonary endarterectomy specimens: Initial study. JTCVS Open 2023; 13:423-434. [PMID: 37063122 PMCID: PMC10091285 DOI: 10.1016/j.xjon.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/03/2022] [Accepted: 12/19/2022] [Indexed: 04/18/2023]
Abstract
Objectives The underlying mechanisms for the development of chronic thromboembolic pulmonary hypertension and prognostic biomarkers are not clear yet. Thus, our aim is to assess and identify new biomarkers for the expression of 84 key genes linked to angiogenesis. Methods Patients who had levels more than 1000 dynes·sec·cm-5 were included in the test group, and the other patients were included in the control group. Twelve specimens were taken from the patients. RT2 Profiler PCR Array (Qiagen) was used to quantify the expression of the 84 key genes. Results Eight patients (6 male, 2 female, median age 54.4 ± 13.1 years) who underwent pulmonary endarterectomy were included. Pulmonary vascular resistance improved significantly from 811 ± 390 dyn/s/cm-5 to 413.3 ± 144.9 dyn/s/cm-5 (P < .005). A difference was also detected in median mean pulmonary arterial pressure, which decreased from 49.8 ± 9 mm Hg to 32.62 ± 2.50 mm Hg (P > .005) after surgery. Median length of hospital stay was 11.62 ± 2.97 days. The test group had a distinct pattern of impaired angiogenic and antiangiogenic genes. The expression levels of TGFA, TGFB1, THBS2, THBS1, TGFBR1, SERPINE1, SERPINF1, TGFB2, TIMP2, VEGFC, IFNA1, TNF, CXCL10, NOS3, IGF1, and MMP14 were downregulated in the specimens from the patients who had higher pulmonary vascular resistance values, whereas some genes, including PDGFA, showed upregulation that was statistically nonsignificant in the same group. Conclusions These results can lead to the development of new markers that could predict adverse outcomes of patients with CTEPH. Identification of new markers that are related to worse outcomes would enable screening patients for early diagnosis and treatment.
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Affiliation(s)
- Nezih Onur Ermerak
- Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
- Address for reprints: Nezih Onur Ermerak, MD, Department of Thoracic Surgery, Marmara University School of Medicine, Fevzi Cakmak Mah. Mimar Sinan Cad. No: 41, Ust Kaynarca, Pendik, İstanbul, 34899, Turkey.
| | - Betul Yilmaz
- Department of Biochemistry, Marmara University School of Medicine, Istanbul, Turkey
| | - Saime Batirel
- Department of Biochemistry, Marmara University School of Medicine, Istanbul, Turkey
| | - Sehnaz Olgun Yildizeli
- Department of Biochemistry, Marmara University School of Medicine/Genetic and Metabolic Diseases Research and Investigation Center (GEMHAM), Marmara University, Istanbul, Turkey
| | - Derya Kocakaya
- Department of Biochemistry, Marmara University School of Medicine/Genetic and Metabolic Diseases Research and Investigation Center (GEMHAM), Marmara University, Istanbul, Turkey
| | - Bulent Mutlu
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Serpil Tas
- Department of Cardiovascular Surgery, Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Bedrettin Yildizeli
- Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
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Akaslan D, Aslanger E, Atas H, Gonenc Kanar B, Kocakaya D, Yildizeli B, Mutlu B. The Effects of Iron Replacement on Functional Capacity in Patients with Group 1 and Group 4 Pulmonary Hypertension. Turk Kardiyol Dern Ars 2022; 50:492-497. [DOI: 10.5543/tkda.2022.22343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Erkilinç A, Ermerak NO, Zengin A, Olgun Yildizeli Ş, Mutlu BL, Karakoç AZ, Yanartaş M, Taş S, Bozkurtlar E, Sunar H, Yildizeli B. Is There Any Role of Pulmonary Endarterectomy in Pulmonary Arterial Hydatidosis? Ann Thorac Surg 2021; 114:2093-2099. [PMID: 34843694 DOI: 10.1016/j.athoracsur.2021.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/04/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Hydatid Cyst is a zoonosis caused by Echinococcus granulosis. Pulmonary artery involvement is a rare condition. The aim of this study was to review our experience in the surgical treatment of pulmonary arterial hydatidosis. METHODS Data were collected prospectively for consecutive patients who underwent pulmonary endarterectomy and had a diagnosis of hydatidosis at or after surgery. RESULTS Eight patients (two male, six female, mean age, 31.25±13.68 years) with hydatidosis were defined. Only one patient presented with hemoptysis, while the rest of the patients reported exertional dyspnea as their main symptom. Cardiac hydatidosis associated with pulmonary arterial involvement was noted in one patient. The mean time interval for duration of disease was 12±24.29 months before PEA. Mortality was observed in two patients due to massive hemoptysis in one and right heart failure in one. No anaphylactic reaction was observed. Significant difference was detected in mean pulmonary vascular resistance as decline from 442.38±474.20 to 357.25±285.34 dyn/s/cm-5 following surgery (p: 0.011). Two patients had recurrence of the disease following a median follow-up of 9.1 months All survivors improved to New York Heart Association functional class I and II. CONCLUSIONS Pulmonary arterial hydatidosis may mimic chronic thromboembolic pulmonary hypertension and these patients can be diagnosed with pulmonary endarterectomy. Surgery may be a therapeutic option for patients who do not respond to medical therapy if the cystic lesions are surgically accessible. Pulmonary endarterectomy should be performed only in expert centers because of the high risk of perioperative morbidity, mortality, and postoperative recurrence.
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Affiliation(s)
- Atakan Erkilinç
- University of Health Sciences, Kartal Koşuyolu Teaching and Education Hospital, Department of Anesthesia, Istanbul, Turkey
| | - Nezih Onur Ermerak
- Marmara University School of Medicine, Department of Thoracic Surgery, Istanbul, Turkey
| | - Ahmet Zengin
- University of Health Sciences, Kartal Koşuyolu Teaching and Education Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey
| | - Şehnaz Olgun Yildizeli
- Marmara University School of Medicine, Department of Department of Pulmonology and Intensive Care, Istanbul, Turkey
| | - Bu Lent Mutlu
- Marmara University School of Medicine, Department of Cardiology, Istanbul, Turkey
| | - Ayşe Zehra Karakoç
- University of Health Sciences, Kartal Koşuyolu Teaching and Education Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey
| | - Mehmed Yanartaş
- University of Health Sciences, Kartal Koşuyolu Teaching and Education Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey
| | - Serpil Taş
- University of Health Sciences, Kartal Koşuyolu Teaching and Education Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey
| | - Emine Bozkurtlar
- Marmara University School of Medicine, Department of Pathology, Istanbul, Turkey
| | - Hasan Sunar
- University of Health Sciences, Kartal Koşuyolu Teaching and Education Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey
| | - Bedrettin Yildizeli
- Marmara University School of Medicine, Department of Thoracic Surgery, Istanbul, Turkey.
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Atas H, Mutlu B, Akaslan D, Kocakaya D, Kanar B, Inanc N, Karakurt S, Cimsit C, Yildizeli B. Balloon Pulmonary Angioplasty in Patients With Inoperable or Recurrent/Residual Chronic Thromboembolic Pulmonary Hypertension: A Single-Centre Initial Experience. Heart Lung Circ 2021; 31:520-529. [PMID: 34838454 DOI: 10.1016/j.hlc.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 05/31/2021] [Accepted: 10/16/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) are often treated with pulmonary arterial hypertension-specific drugs. However, most of these patients remain symptomatic, despite medical treatment. Balloon pulmonary angioplasty (BPA) is an emerging therapeutic intervention for patients with inoperable CTEPH. This study aimed to report the initial experience of BPA in a tertiary referral centre for CTEPH. METHODS A total of 26 consecutive patients, who underwent 91 BPA sessions, were included in the study. All patients underwent a detailed examination, including 6-minute walking distance (6MWD), and right heart catheterisation at baseline and 3 months after the last BPA session. RESULTS The mean age of the patients was 51±17 years. Fifteen (15) patients had inoperable CTEPH and 11 patients had residual or recurrent CTEPH post pulmonary endarterectomy (PEA). Functional class improved in 17 of 26 (65%) patients. The 6MWD increased from a mean 315±129 to 411±140 m (p<0.001), and NT pro-BNP reduced from a median 456 to 189 pg/mL (p=0.001). The number of patients who required supplemental oxygen decreased from 11 (42.3%) to five (19%) (p=0.031) after BPA treatment. The mean pulmonary artery pressure decreased from a mean 47.5±13.4 to 38±10.9 mmHg (p<0.001), the pulmonary vascular resistance decreased from a mean 9.3±4.7 to 5.8±2.8 Wood units (p<0.001), and the cardiac index increased from a mean 2.4±0.7 to 2.9±0.6 L/min/m2 (p=0.008). CONCLUSIONS Balloon pulmonary angioplasty improved haemodynamics, 6MWD, and functional class, and reduced the requirement for supplemental oxygen, with an acceptable risk-benefit ratio in patients with inoperable CTEPH and with residual/recurrent CTEPH.
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Affiliation(s)
- Halil Atas
- Marmara University, School of Medicine, Department of Cardiology.
| | - Bulent Mutlu
- Marmara University, School of Medicine, Department of Cardiology
| | - Dursun Akaslan
- Marmara University, School of Medicine, Department of Cardiology
| | - Derya Kocakaya
- Marmara University, School of Medicine, Department of Pulmonology
| | - Batur Kanar
- Marmara University, School of Medicine, Department of Cardiology
| | - Nevsun Inanc
- Marmara University, School of Medicine, Department of Internal Medicine, Division of Rheumatology
| | - Sait Karakurt
- Marmara University, School of Medicine, Department of Pulmonology
| | - Cagatay Cimsit
- Marmara University, School of Medicine, Department of Radiology
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11
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Yanartaş M, Karakoç AZ, Zengin A, Taş S, Olgun Yildizeli Ş, Mutlu BL, Ataş H, Alibaz-Öner F, Inanç N, Direskeneli H, Bozkurtlar E, Erkilinç A, Çimşit Ç, Bekiroğlu GN, Yildizeli B. Multimodal Approach of Isolated Pulmonary Vasculitis: A Single-Institution Experience. Ann Thorac Surg 2021; 114:1253-1261. [PMID: 34506746 DOI: 10.1016/j.athoracsur.2021.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 07/11/2021] [Accepted: 08/02/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Isolated pulmonary vasculitis (IPV) is a single-organ vasculitis of unknown etiology and may mimic chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to review our clinical experience with pulmonary endarterectomy in patients with CTEPH secondary to IPV. METHODS Data were collected prospectively for consecutive patients who underwent pulmonary endarterectomy and had a diagnosis of IPV at or after surgery. RESULTS We identified nine patients (six female, median age 48 (23-55) years) with IPV. The diagnosis was confirmed after histopathological examination of all surgical materials. The mean duration of disease before surgery was 88.0 ±70.2 months. Exercise-induced dyspnea was the presenting symptom in all patients. Pulmonary endarterectomy was bilateral in six patients and unilateral in three. No mortality was observed, however, one patient had pulmonary artery stenosis and stent implantation was performed. All patients received immunosuppressive therapies after surgery. Mean pulmonary artery pressure decreased significantly from 30(19-67) mm Hg to 21(15-49) mm Hg after surgery (p <0.05). Pulmonary vascular resistance also improved significantly from 270 (160-1600) to 153 (94-548) dyn/s/cm-5 (p<0.05). After a median follow-up of 41 months, all but one patient had improved to the New York Heart Association functional class I. CONCLUSIONS Isolated pulmonary vasculitis can mimic CTEPH, and these patients can be diagnosed with pulmonary endarterectomy. Furthermore, surgery has not only diagnostic but also therapeutic value for IPV when stenotic and/or thrombotic lesions are surgically accessible. A multidisciplinary experienced CTEPH team is critical for management of these unique patients.
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Affiliation(s)
- Mehmed Yanartaş
- University of Health Sciences,Kartal Koşuyolu Teaching and Education Hospital,Department of Cardiovascular Surgery, Istanbul.
| | - Ayşe Zehra Karakoç
- University of Health Sciences,Kartal Koşuyolu Teaching and Education Hospital,Department of Cardiovascular Surgery, Istanbul
| | - Ahmet Zengin
- University of Health Sciences,Kartal Koşuyolu Teaching and Education Hospital,Department of Cardiovascular Surgery, Istanbul
| | - Serpil Taş
- University of Health Sciences,Kartal Koşuyolu Teaching and Education Hospital,Department of Cardiovascular Surgery, Istanbul
| | - Şehnaz Olgun Yildizeli
- Marmara University School of Medicine,Department of Department of Pulmonology and Intensive Care, Istanbul
| | - Bu Lent Mutlu
- Marmara University School of Medicine,Department of Cardiology, Istanbul
| | - Halil Ataş
- Marmara University School of Medicine,Department of Cardiology, Istanbul
| | - Fatma Alibaz-Öner
- Marmara University School of Medicine,Department of Internal Medicine,Division of Rheumatology, Istanbul
| | - Nevsun Inanç
- Marmara University School of Medicine,Department of Internal Medicine,Division of Rheumatology, Istanbul
| | - Haner Direskeneli
- Marmara University School of Medicine,Department of Internal Medicine,Division of Rheumatology, Istanbul
| | - Emine Bozkurtlar
- Marmara University School of Medicine,Department of Pathology, Istanbul
| | - Atakan Erkilinç
- University of Health Sciences,Kartal Koşuyolu Teaching and Education Hospital,Department of Anesthesia, Istanbul
| | - Çagatay Çimşit
- Marmara University School of Medicine,Department of Radiology, Istanbul
| | - G Nural Bekiroğlu
- Marmara University School of Medicine, Department of Biostatistics, Istanbul, Turkey
| | - Bedrettin Yildizeli
- Marmara University School of Medicine,Department of Thoracic Surgery, Istanbul
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12
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Guth S, D'Armini AM, Delcroix M, Nakayama K, Fadel E, Hoole SP, Jenkins DP, Kiely DG, Kim NH, Lang IM, Madani MM, Matsubara H, Ogawa A, Ota-Arakaki JS, Quarck R, Sadushi-Kolici R, Simonneau G, Wiedenroth CB, Yildizeli B, Mayer E, Pepke-Zaba J. Current strategies for managing chronic thromboembolic pulmonary hypertension: results of the worldwide prospective CTEPH Registry. ERJ Open Res 2021; 7:00850-2020. [PMID: 34409094 PMCID: PMC8365143 DOI: 10.1183/23120541.00850-2020] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 06/12/2021] [Indexed: 12/03/2022] Open
Abstract
Background Pulmonary endarterectomy (PEA), pulmonary arterial hypertension (PAH) therapy and balloon pulmonary angioplasty (BPA) are currently accepted therapies for chronic thromboembolic pulmonary hypertension (CTEPH). This international CTEPH Registry identifies clinical characteristics of patients, diagnostic algorithms and treatment decisions in a global context. Methods 1010 newly diagnosed consecutive patients were included in the registry between February 2015 and September 2016. Diagnosis was confirmed by right heart catheterisation, ventilation–perfusion lung scan, computerised pulmonary angiography and/or invasive pulmonary angiography after at least 3 months on anticoagulation. Results Overall, 649 patients (64.3%) were considered for PEA, 193 (19.1%) for BPA, 20 (2.0%) for both PEA and BPA, and 148 (14.7%) for PAH therapy only. Reasons for PEA inoperability were technical inaccessibility (n=235), comorbidities (n=63) and patient refusal (n=44). In Europe and America and other countries (AAO), 72% of patients were deemed suitable for PEA, whereas in Japan, 70% of patients were offered BPA as first choice. Sex was evenly balanced, except in Japan where 75% of patients were female. A history of acute pulmonary embolism was reported for 65.6% of patients. At least one PAH therapy was initiated in 35.8% of patients (26.2% of PEA candidates, 54.5% of BPA candidates and 54.1% of those not eligible for either PEA or BPA). At the time of analysis, 39 patients (3.9%) had died of pulmonary hypertension-related causes (3.5% after PEA and 1.8% after BPA). Conclusions The registry revealed noticeable differences in patient characteristics (rates of pulmonary embolism and sex) and therapeutic approaches in Japan compared with Europe and AAO. There are distinct regional differences in the management of CTEPH patients but globally, the proportion of patients managed by PEA remains stable, independently of the new established treatment options of PAH therapies and BPAhttps://bit.ly/3zEXxkv
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Affiliation(s)
- Stefan Guth
- Dept of Thoracic Surgery, Kerckhoff Heart and Lung Center, Bad Nauheim, Germany
| | - Andrea M D'Armini
- Cardiac Surgery, Heart-Lung Transplantation and CTEPH, University of Pavia, School of Medicine, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marion Delcroix
- Clinical Dept of Respiratory Diseases, University Hospitals of Leuven and Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Dept of Chronic Diseases and Metabolism (CHROMETA), KU Leuven - University of Leuven, Leuven, Belgium
| | - Kazuhiko Nakayama
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Elie Fadel
- Research and Innovation Unit, INSERM UMR-S 999, Marie Lannelongue Hospital, Univ Paris Sud, Paris-Saclay University, Le Plessis Robinson, France; Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, Univ Paris Sud, Paris-Saclay University, Le Plessis Robinson, France; Paris-Sud University and Paris-Saclay University, School of Medicine, Kremlin-Bicêtre, France
| | | | | | - David G Kiely
- Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Nick H Kim
- Division of Pulmonary and Critical Care Medicine, University of California San Diego, La Jolla, CA, USA
| | - Irene M Lang
- Dept of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Michael M Madani
- Cardiovascular and Thoracic Surgery, University of California, San Diego, La Jolla, CA, USA
| | - Hiromi Matsubara
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Aiko Ogawa
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Jaquelina S Ota-Arakaki
- Pulmonary Circulation Group and Pulmonary Function and Exercise Physiology Unit, Division of Respiratory Diseases, Department of Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
| | - Rozenn Quarck
- Clinical Dept of Respiratory Diseases, University Hospitals of Leuven and Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Dept of Chronic Diseases and Metabolism (CHROMETA), KU Leuven - University of Leuven, Leuven, Belgium
| | - Roela Sadushi-Kolici
- Dept of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Gérald Simonneau
- Assistance Publique-Hôpitaux de Paris, Service de Pneumologie, Hôpital Bicêtre, Université Paris-Sud, Laboratoire d'Excellence en Recherche sur le Médicament et Innovation Thérapeutique, and Institut National de la Santé et de la Recherche Médicale Unité 999, Le Kremlin-Bicêtre, France
| | | | - Bedrettin Yildizeli
- Dept of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Eckhard Mayer
- Dept of Thoracic Surgery, Kerckhoff Heart and Lung Center, Bad Nauheim, Germany
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13
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Sayan B, Yamansavci Sirzai E, Yildizeli B. A Word of Caution for Gossypiboma. Thorac Cardiovasc Surg 2021; 70:579-582. [PMID: 34376001 DOI: 10.1055/s-0041-1731779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Gossypiboma, a retained nonabsorbable surgical sponge, is a major safety issue despite being infrequent, causing serious malpractice debates. In addition to this, it may mimic a range different disease within the thorax and even have unpleasant clinical presentations even after years.In this article, we report four gossypiboma cases with nonspecific clinical presentations to emphasize the importance of keeping this diagnosis in mind with all patients who have had a previous operation.
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Affiliation(s)
- Bihter Sayan
- Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
| | | | - Bedrettin Yildizeli
- Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
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14
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Ak N, Ozkan B, Yenigun MB, Yilmazbayhan D, Toker A, Ferhatoglu F, Yasar A, Dizbay Sak S, Tanju S, Dilege S, Erus S, Bulutay P, Firat P, Molinas Mandel N, Kilickap S, Onder S, Dikmen E, Alan O, Yumuk PF, Bozkurtlar E, Lacin T, Yildizeli B, Ozturk A, Kocaturk C, Karapinar K, Urer N, Oyan B, Aydiner A, Demirkazik A, Eralp Y. The role of adjuvant chemotherapy in resected stage I non - small cell lung cancer: A Turkish Oncology Group Study. J BUON 2021; 26:819-829. [PMID: 34268941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The benefit of adjuvant chemotherapy for tumors smaller than 4 cm is not clear. We aimed to evaluate the prognostic impact of adjuvant platin-based chemotherapy in high-risk stage I patients with non-small cell lung cancer (NSCLC). METHODS This cooperative group study included 232 NSCLC patients who underwent curative surgery for stage I disease with tumor size 2-4 cm. Re ults: Median age at presentation was 63 years (range 18-90). The mean tumor size was 29.6 ± 7.3 mm. The frequency of patients with specified risk factors were: visceral pleural effusion (VPI): n: 82 (36.6%); lymphovascular invasion (LVI): n: 86 (39.1%); Grade 3: n: 48 (32.7%); Solid micropapillary pattern (SMP): n: 70 (48.3%). Adjuvant platin-based chemotherapy was administered to 51 patients. During a median follow-up period of 50.5 months 68 patients (29.3%) developed recurrence, 54 (23.3%) died from any cause and 38 (16.4%) of them died of lung cancer. Patients who received chemotherapy compared with the non-chemotherapy group had a longer 5-years relapse-free survival (RFS) (84.5 vs 61.1%). Also on multivariate analysis, adjuvant chemotherapy was a significant independent prognostic factor for RFS. CONCLUSION Adjuvant platin-based chemotherapy should be considered for patients with small tumors with adverse risk factors. Key words: adjuvant chemotherapy, lung cancer, oncology, lymphovascular invasion, solid-micropapillary pattern, platinum-based therapy.
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Affiliation(s)
- Naziye Ak
- Istanbul University, Institute of Oncology, Department of Medical Oncology, Istanbul, Turkey
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15
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Erdem H, Korun O, Yanartaş M, Taş S, Erden B, Yerlikhan O, Erkilinç A, Kaymaz C, Sunar H, Yildizeli B. Outcomes of Pulmonary Endarterectomy Operation Concomitant with Cardiac Procedures. Thorac Cardiovasc Surg 2020; 69:279-283. [PMID: 32738809 DOI: 10.1055/s-0040-1710580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim of this study was to analyze the results of pulmonary endarterectomy (PEA) performed simultaneously with additional cardiac procedures in a single tertiary-level center. METHODS Data of patients who underwent PEA with additional cardiac procedures for chronic thromboembolic pulmonary hypertension (CTEPH) in our clinic were retrospectively reviewed using patient records. RESULTS Between March 2011 and April 2019, 56 patients underwent PEA with additional cardiac surgery. The most common additional procedure was coronary artery bypass grafting (21 patients; 38%). The median intensive care unit and hospital stays were 4 (3-6) days and 10 (8-14) days. Mortality was recorded in six patients (11%). In multivariate analysis, only preoperative pulmonary vascular resistance (PVR) (p = 0.02; odds ratio [OR]: 1.003) and cardiopulmonary bypass duration (p = 0.02; OR: 1.028) were associated with mortality. When the cutoff value of 1000 dyn.s.cm-5 was taken in the receiver operating characteristic curve analysis, preoperative PVR predicted mortality with 83% sensitivity and 94% specificity (area under curve = 0.89; p < 0.01). CONCLUSION PEA for CTEPH may be performed safely with other cardiac operations. This type of surgery is a complex procedure that should be performed only in expert centers. Patients with high preoperative PVR are at increased risk of perioperative complications.
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Affiliation(s)
- Hasan Erdem
- Department of Cardiovascular Surgery, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
| | - Oktay Korun
- Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Mehmed Yanartaş
- Department of Cardiovascular Surgery, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
| | - Serpil Taş
- Department of Cardiovascular Surgery, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
| | - Benay Erden
- Department of Cardiovascular Surgery, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
| | - Onur Yerlikhan
- Department of Cardiovascular Surgery, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
| | - Atakan Erkilinç
- Department of Anesthesia, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
| | - Cihangir Kaymaz
- Department of Cardiology, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
| | - Hasan Sunar
- Department of Cardiovascular Surgery, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
| | - Bedrettin Yildizeli
- Department of Thoracic Surgery, Marmara University School of Medicine, İstanbul, Turkey
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16
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Kilinc M, Yaylali YT, Yildizeli B, Tas S. Chronic Thromboembolic Pulmonary Hypertension Secondary to Thrombophilia and Incidentally Diagnosed Atrial Septal Defect. JACC Case Rep 2020; 2:658-661. [PMID: 34317315 PMCID: PMC8298561 DOI: 10.1016/j.jaccas.2020.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/10/2020] [Accepted: 01/16/2020] [Indexed: 11/16/2022]
Abstract
A 46-year-old man developed chronic thromboembolic pulmonary hypertension and atrial fibrillation after acute pulmonary embolism. He was found incidentally to have an isolated secundum atrial septal defect, as well as a homozygous mutation for the plasminogen activator inhibitor-1 gene. He was successfully treated with pulmonary endarterectomy and atrial septal defect repair. He has continued to do well on a regimen of dabigatran. (Level of Difficulty: Beginner.)
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Key Words
- AF, atrial fibrillation
- ASD, atrial septal defect
- CTEPH, chronic thromboembolic pulmonary hypertension
- DOAC, direct oral anticoagulant agent
- HF, heart failure
- PAI, plasminogen activator inhibitor
- PAP, pulmonary arterial pressure
- PE, pulmonary embolism
- PEA, pulmonary endarterectomy
- PH, pulmonary hypertension
- PVR, pulmonary vascular resistance
- RA, right atrial
- RHC, right-sided heart catheterization
- RV, right ventricular
- TAPSE, tricuspid annular excursion
- VTE, venous thromboembolism
- dabigatran
- plasminogen activator inhibitor-1 (PAI-1) mutation
- pulmonary endarterectomy
- t-PA, tissue-type plasminogen activator
- u-PA, urokinase-type plasminogen activator
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Affiliation(s)
- Mehmet Kilinc
- Department of Cardiology, Ceylanpinar State Hospital, Sanliurfa, Turkey
| | - Yalin Tolga Yaylali
- Department of Cardiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Bedrettin Yildizeli
- Department of Thoracic Surgery, School of Medicine, Marmara University, Istanbul, Turkey
| | - Serpil Tas
- Department of Cardiovascular Surgery, Kartal Kosuyolu Hospital, University of Health Sciences, Istanbul, Turkey
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Saracoglu A, Ermerak O, Sirzai EYS, Yuksel M, Aykac Z, Yildizeli B. Anesthesia Management for a Patient Undergoing Pulmonary Endarterctomy without Cardiopulmonary Bypass. Braz J Cardiovasc Surg 2019; 34:783-787. [PMID: 31793258 PMCID: PMC6894026 DOI: 10.21470/1678-9741-2018-0245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Pulmonary endarterectomy is a curative procedure for chronic thromboembolic Pulmonary Hypertension. As usual, cardiopulmonary bypass circuit is required. However, there are several complications attributed to extracorporeal circulation. Hemodilution, systemic inflammatory response syndrome and leukocyte sequestration are circulation related complications. The severe forms include Acute Respiratory Distress Syndrome, Acute Lung Injury, myocardial stunning, dysfunction of the right ventricle, coagulopathy, postoperative stroke or renal dysfunction. In this case report, we aimed to give information about perioperative anesthesia and surgical management of pulmonary endarterectomy which was successfully managed without Cardiopulmonary Bypass.
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Affiliation(s)
- Ayten Saracoglu
- Marmara University Medical School Department of Anesthesiology and Intensive Care Istanbul Turkey Department of Anesthesiology and Intensive Care, Marmara University Medical School, Istanbul, Turkey
| | - Onur Ermerak
- Marmara University Medical School Department of Thoracic Surgery Istanbul Turkey Department of Thoracic Surgery, Marmara University Medical School, Istanbul, Turkey
| | - Esra Yaman Savci Sirzai
- Marmara University Medical School Department of Thoracic Surgery Istanbul Turkey Department of Thoracic Surgery, Marmara University Medical School, Istanbul, Turkey
| | - Mustafa Yuksel
- Marmara University Medical School Department of Thoracic Surgery Istanbul Turkey Department of Thoracic Surgery, Marmara University Medical School, Istanbul, Turkey
| | - Zuhal Aykac
- Marmara University Medical School Department of Anesthesiology and Intensive Care Istanbul Turkey Department of Anesthesiology and Intensive Care, Marmara University Medical School, Istanbul, Turkey
| | - Bedrettin Yildizeli
- Marmara University Medical School Department of Thoracic Surgery Istanbul Turkey Department of Thoracic Surgery, Marmara University Medical School, Istanbul, Turkey
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Alpay-Kanitez N, Çelik S, Baltacioğlu F, Içaçan OC, Bes C, Yildizeli B. Endovascular embolisation with Amplatzer vascular plug of ruptured pulmonary artery aneurism in Behçet's disease. Clin Exp Rheumatol 2019; 37 Suppl 121:152-153. [PMID: 30873949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/08/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Nilüfer Alpay-Kanitez
- Division of Rheumatology, Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey.
| | - Selda Çelik
- Division of Rheumatology, Department of Internal Medicine, Health Science University, Bakırköy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Feyyaz Baltacioğlu
- Department of Radiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Ozan Cemal Içaçan
- Division of Rheumatology, Department of Internal Medicine, Health Science University, Bakırköy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Cemal Bes
- Division of Rheumatology, Department of Internal Medicine, Health Science University, Bakırköy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Bedrettin Yildizeli
- Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
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Cinar C, Olgun Yildizeli S, Peker Y, Yildizeli B, Balcan B. Prevelance of Sleep Related Breathing Disorders in CTEPH patients. Turk Thorac J 2019. [DOI: 10.5152/turkthoracj.2019.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Kivrak T, Oguz M, Sunbul M, Dede F, Yildizeli B, Mutlu B. Diagnostic modality for evaluation of right ventricle in chronic thromboembolic pulmonary hypertension patients. Int J Cardiovasc Acad 2019. [DOI: 10.4103/ijca.ijca_35_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Hydatid disease is the most common mediterranean parasitic infection; it commonly affects the liver and lungs and rarely involves multiple organs. A 14-year-old girl presented with a 1-year history of dyspnoea and fatigue. She was found to have pulmonary hypertension owing to hydatid cysts in the right ventricle and both pulmonary arteries. After administration of albendazole she underwent pulmonary endarterectomy and a calcified hydatid cyst was removed from the right ventricle. She made a complete recovery and remained on albendazole for 6 months.
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Affiliation(s)
- Mecnun Çetin
- a Department of Pediatric Cardiology , Yuzuncu Yil University , Van , Turkey
| | - Kamuran Karaman
- b Pediatric Hematology , Yuzuncu Yil University , Van , Turkey
| | | | - Hadi Geylan
- b Pediatric Hematology , Yuzuncu Yil University , Van , Turkey
| | - Bedrettin Yildizeli
- d Department of Thoracic Surgery , Marmara University Hospital , Istanbul , Turkey
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Batirel HF, Metintas M, Caglar HB, Ak G, Yumuk PF, Ahiskali R, Bozkurtlar E, Bekiroglu N, Lacin T, Yildizeli B, Yuksel M. Macroscopic complete resection is not associated with improved survival in patients with malignant pleural mesothelioma. J Thorac Cardiovasc Surg 2018; 155:2724-2733. [DOI: 10.1016/j.jtcvs.2017.12.131] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 11/15/2017] [Accepted: 12/23/2017] [Indexed: 01/10/2023]
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Abstract
Purpose Although prolonged venous access devices (PVADs) are used in case prolonged intravenous therapy is required, implantation and use of these devices is associated with complications. The purpose of this study was to evaluate perioperative and long-term complications associated with PVADs and the management of these complications. Methods A retrospective review was undertaken of 225 PVADs implanted in 217 patients from February 1993 to June 2004. This included 144 single-lumen port infusion systems, 49 single-lumen Hickman® catheters and 32 double-lumen Groshong® catheters. The PVADs were inserted using either the percutaneous Seldinger method (n=183) or cutdown access to the subclavian vein (n=42). Indications for placement were as follows: chemotherapy in 66.2% of patients, drug-infusion treatment in 31.6% of patients and total parenteral nutrition in 2.2% of patients. Results Perioperative complications occurred in 13 patients (5.7%): catheter malposition in seven patients (3.1%), pneumothorax in three patients (1.3%), hemorrhage in two patients (0.9%) and catheter embolization in one patient (0.4%). Long-term complications appeared in 15 patients (6.6%): infection in five patients (2.2%), thrombosis in three patients (1.3%), extravasation in three patients (1.3%), and catheter fracture in four patients (1.8%). The fractured fragments were removed by the Amplatz® snare device. In 10 patients (4.4%) only were PVADs removed prior to completion of the intended therapy. Indications for removal were catheter infection in five patients (2.2%) and catheter fracture in five patients (2.2%). Conclusions PVAD implantation is associated with some risk of serious perioperative and long-term complications. Care of the catheter and the patient should be maintained with the proper and immediate evaluation of the perioperative and long-term complications.
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Affiliation(s)
- B Yildizeli
- Department of Thoracic Surgery, Faculty of Medicine, Marmara University Hospital, Acibadem, Istanbul, Turkey
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Kivrak T, Ata Bolayir H, Gönenc Kanar B, Akaslan D, Kepez A, Mutlu B, Yildizeli B. Prevelance of Pulmonary Atherosclerosis in Patients With Chronic Thromboembolic Pulmonary Hypertension. ACTA ACUST UNITED AC 2017. [DOI: 10.15226/2573-864x/2/4/00125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
Prolonged venous access devices are needed in cancer patients for central venous access. Catheter fragmentation leading to catheter malfunction represents a rare problem. Herein we present our experience in the management of fragmented catheters. Between 2001 and 2003, 183 catheters were placed via the subclavian vein, and five cases of fragmented catheters were observed. Fragments were removed by an Amplatz gooseneck snare (Microvena, St. Paul, MN) with angiographic intervention. The diagnosis of the breakage was made by chest radiography. The incidence of catheter rupture was 2.7%. All fragments were removed by the snare, without any complications. Catheter narrowing and breakage owing to its medial positioning in the subclavian vein were the main causes of catheter malfunction. In any case of catheter malfunction, radiologic evaluation of the catheter must be done to rule out its rupture. Removal of the fragments using the Amplatz snare is a safe and easily applied procedure.
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Affiliation(s)
- Bedrettin Yildizeli
- Department of Thoracic Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey
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Kepez A, Mutlu B, Paudel A, Ileri C, Atas H, Yildizeli B. Prevalence of Coronary Artery to Pulmonary Artery Collaterals in Patients with Chronic Thromboembolic Pulmonary Hypertension: Retrospective Analysis from a Single Center. Thorac Cardiovasc Surg 2016; 66:180-186. [PMID: 27326914 DOI: 10.1055/s-0036-1584572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Our aim was to determine the prevalence of coronary artery - pulmonary artery collaterals in patients with chronic thromboembolic pulmonary hypertension (CTEPH) by retrospectively evaluating coronary angiograms of eligible consecutive patients who had undergone pulmonary endarterectomy (PEA). We also aimed to evaluate predictors and potential clinical associates of these collaterals. METHODS Coronary angiograms of 83 consecutive CTEPH patients who had undergone coronary angiography before PEA operation between January 1, 2012 and June 1, 2015 were retrospectively evaluated for presence of coronary artery - pulmonary artery collaterals. Medical records of all patients were also retrospectively reviewed for demographic information, cardiovascular risk factors, preoperative right heart catheterization reports, operation reports, and follow-up data. Data of CTEPH patients with coronary artery - pulmonary artery collaterals were compared with data of CTEPH patients without such collaterals. RESULTS There were 15 patients (18.1%) with definite and 4 patients (4.8%) with probable coronary artery - pulmonary artery collaterals among the study population. CTEPH patients with collaterals had higher preoperative pulmonary artery pressures, higher pulmonary vascular resistance (PVR) and lower cardiac index values compared with CTEPH patients without collaterals. However, CTEPH patients with collaterals displayed higher amount of reduction in PVR after PEA compared with patients without collaterals. There were no significant differences between groups regarding incidence of reperfusion injury or mortality. CONCLUSION Prevalence of coronary artery - pulmonary artery collaterals seems to be increased in our CTEPH patients compared with the general population. The presence of coronary artery - pulmonary artery collaterals is often combined with proximal disease with the possibility of increased reduction of PVR after PEA operation.
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Affiliation(s)
- Alper Kepez
- Cardiology Clinic, Marmara University Training and Research Hospital, Istanbul, Turkey
| | - Bulent Mutlu
- Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Ashok Paudel
- Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Cigdem Ileri
- Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Halil Atas
- Cardiology Clinic, Marmara University Training and Research Hospital, Istanbul, Turkey
| | - Bedrettin Yildizeli
- Department of Thoracic Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey
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Batirel HF, Metintas M, Caglar HB, Ak G, Yumuk PF, Yildizeli B, Yuksel M. Adoption of pleurectomy and decortication for malignant mesothelioma leads to similar survival as extrapleural pneumonectomy. J Thorac Cardiovasc Surg 2015; 151:478-84. [PMID: 26611742 DOI: 10.1016/j.jtcvs.2015.09.121] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 09/03/2015] [Accepted: 09/28/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE We changed our surgical approach to malignant pleural mesothelioma (MPM) in August 2011 and adopted pleurectomy and decortication (PD) instead of extrapleural pneumonectomy (EPP). In this study, we analyzed our perioperative and survival results during the 2 periods. METHODS All patients who underwent surgical intervention for MPM during 2003-2014 were included. Data were retrospectively analyzed from a prospective database. Before August 2011, patients underwent evaluation for EPP and adjuvant chemoradiation (group 1). After August 2011, patients were evaluated for PD and adjuvant chemotherapy and/or radiation (group 2). Demographic characteristics, surgical technique, histology, side, completeness of resection, and types of treatments were recorded. Statistics was performed using Student t test, χ(2) tests, uni- and multivariate regression, and Kaplan-Meier survival analysis. RESULTS The same surgical team operated on 130 patients. Median age was 55.7 years (range, 26-80 years) and 76 were men. EPP and extended PD was performed in 72 patients. Ninety-day mortality was 10%. Median survival was 17.8 months with a 5-year survival rate of 14%. Uni- and multivariate analyses showed that epithelioid histology, stage N0, and trimodality treatment were associated with better survival (P = .039, P = .012, and P < .001, respectively). Demographic variables and overall survival (15.6 vs 19.6 months, respectively) were similar between the groups, whereas nonepithelioid histology, use of preoperative chemotherapy, and incomplete resections were more frequent in group 2 (P < .001, P < .001, and P = .006, respectively). Follow-up was shorter in group 2 (22.5 ± 20.6 vs 16.4 ± 10.9 months; P < .001). CONCLUSIONS Adoption of PD as the main surgical approach is not associated with survival disadvantage in the surgical treatment of MPM.
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Affiliation(s)
- Hasan Fevzi Batirel
- Department of Thoracic Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey.
| | - Muzaffer Metintas
- Lung and Pleural Cancers Research and Clinical Center, Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Hale Basak Caglar
- Department of Radiation Oncology, Medipol University, Istanbul, Turkey
| | - Guntulu Ak
- Lung and Pleural Cancers Research and Clinical Center, Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Perran Fulden Yumuk
- Division of Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Bedrettin Yildizeli
- Department of Thoracic Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Mustafa Yuksel
- Department of Thoracic Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey
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Batirel HF, Ermerak N, Lacin T, Metintas M, Ak G, Yumuk F, Caglar H, Ahiskali R, Yildizeli B, Yuksel M. P-261EPITHELIOID MALIGNANT PLEURAL MESOTHELIOMA: IMPORTANCE OF EXTRAPLEURAL LYMPH NODE METASTASIS AND TRIMODALITY TREATMENT. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yanartas M, Kalkan ME, Arslan A, Tas SG, Koksal C, Bekiroglu N, Yildizeli B. Neutrophil/Lymphocyte Ratio Can Predict Postoperative Mortality in Patients with Chronic Thromboembolic Pulmonary Hypertension. Ann Thorac Cardiovasc Surg 2015; 21:229-35. [PMID: 25753325 PMCID: PMC4989968 DOI: 10.5761/atcs.oa.14-00190] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 09/30/2014] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of our study was to investigate clinical importance of neutrophil/ lymphocyte ratio in patients with Chronic thromboembolic pulmonary hypertension. METHODS 125 consecutive patients with a diagnosis of Chronic thromboembolic pulmonary hypertension were operated pulmonary thromboendarterectomy in our center between February 2011 and August 2013. 106 patients included into the study due to limitations. The patients were classified into two groups as patients discharged alive (Group 1) and those dying in the hospital (Group 2). Baseline neutrophil/lymphocyte ratio level was measured by dividing neutrophil count to lymphocyte count. RESULTS 84 patients (79%) were in Group 1, 22 patients (21%) were in Group 2. Patients with higher neutrophil/lymphocyte ratio in admission have a significantly higher mortality rate and postoperative pulmonary vascular resistance was found statistically significant variable to predict the mortality. Receiver operator characteristic (ROC) analysis revealed that using a cut-off point of 2.54, admission neutrophil/lymphocyte ratio predicts mortality. Also, correlation analysis showed a significant correlation between preoperative pulmonary vascular resistance and neutrophil/lymphocyte ratio. CONCLUSION The neutrophil/lymphocyte ratio level may be a useful and noninvasive biomarker for operative risk stratification for mortality after pulmonary thromboendarterectomy.
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Affiliation(s)
- Mehmed Yanartas
- Department of Cardiovascular Surgery, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
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Orii M, Tanimoto T, Yokoyama M, Ota S, Kubo T, Hirata K, Tanaka A, Imanishi T, Akasaka T, Michelsen M, Pena A, Mygind N, Hoest N, Prescott E, Abd El Dayem S, Battah A, Abd El Azzez F, Ahmed A, Fattoh A, Ismail R, Andjelkovic K, Kalimanovska Ostric D, Nedeljkovic I, Andjelkovic I, Rashid H, Abuel Enien H, Ibraheem M, Vago H, Toth A, Csecs I, Czimbalmos C, Suhai FI, Kecskes K, Becker D, Simor T, Merkely B, D'ascenzi F, Pelliccia A, Natali B, Cameli M, Lisi M, Focardi M, Corrado D, Bonifazi M, Mondillo S, Zaha V, Kim G, Su K, Zhang J, Mikush N, Ross J, Palmeri M, Young L, Tadic M, Ilic S, Celic V, Jaimes C, Gonzalez Mirelis J, Gallego M, Goirigolzarri J, Pellegrinet M, Poli S, Prati G, Vriz O, Di Bello V, Carerj S, Zito C, Mateescu A, Popescu B, Antonini-Canterin F, Chatzistamatiou E, Moustakas G, Memo G, Konstantinidis D, Mpampatzeva Vagena I, Manakos K, Traxanas K, Vergi N, Feretou A, Kallikazaros I, Hewing B, Theres L, Dreger H, Spethmann S, Stangl K, Baumann G, Knebel F, Uejima T, Itatani K, Nakatani S, Lancellotti P, Seo Y, Zamorano J, Ohte N, Takenaka K, Naar J, Mortensen L, Johnson J, Winter R, Shahgaldi K, Manouras A, Braunschweig F, Stahlberg M, Coisne D, Al Arnaout AM, Tchepkou C, Raud Raynier P, Diakov C, Degand B, Christiaens L, Barbier P, Mirea O, Cefalu C, Savioli G, Guglielmo M, Maltagliati A, O'neill L, Walsh K, Hogan J, Manzoor T, Ahern B, Owens P, Savioli G, Guglielmo M, Mirea O, Cefalu C, Barbier P, Marta L, Abecasis J, Reis C, Ribeiras R, Andrade M, Mendes M, D'andrea A, Stanziola A, Di Palma E, Martino M, Lanza M, Betancourt V, Maglione M, Calabro' R, Russo M, Bossone E, Vogt MO, Meierhofer C, Rutz T, Fratz S, Ewert P, Roehlig C, Kuehn A, Storsten P, Eriksen M, Remme E, Boe E, Smiseth O, Skulstad H, Ereminiene E, Ordiene R, Ivanauskas V, Vaskelyte J, Stoskute N, Kazakauskaite E, Benetis R, Marketou M, Parthenakis F, Kontaraki J, Zacharis E, Maragkoudakis S, Logakis J, Roufas K, Vougia D, Vardas P, Dado E, Dado E, Knuti G, Djamandi J, Shota E, Sharka I, Saka J, Halmai L, Nemes A, Kardos A, Neubauer S, Kurnicka K, Domienik-Karlowicz J, Lichodziejewska B, Goliszek S, Grudzka K, Krupa M, Dzikowska-Diduch O, Ciurzynski M, Pruszczyk P, Chung H, Kim J, Yoon Y, Min P, Lee B, Hong B, Rim S, Kwon H, Choi E, Soya O, Kuryata O, Kakihara R, Naruse C, Inayoshi A, El Sebaie M, Frer A, Abdelsamie M, Eldamanhory A, Ciampi Q, Cortigiani L, Simioniuc A, Manicardi C, Villari B, Picano E, Sicari R, Ferferieva V, Deluyker D, Lambrichts I, Rigo J, Bito V, Kuznetsov V, Yaroslavskaya E, Krinochkin D, Pushkarev G, Gorbatenko E, Trzcinski P, Michalski B, Lipiec P, Szymczyk E, Peczek L, Nawrot B, Chrzanowski L, Kasprzak J, Todaro M, Zito C, Khandheria B, Cusma-Piccione M, La Carrubba S, Antonini-Canterin F, Di Bello V, Oreto G, Di Bella G, Carerj S, Gunyeli E, Oliveira Da Silva C, Sahlen A, Manouras A, Winter R, Shahgaldi K, Spampinato R, Tasca M, Roche E Silva J, Strotdrees E, Schloma V, Dmitrieva Y, Dobrovie M, Borger M, Mohr F, Calin A, Rosca M, Beladan C, Mirescu Craciun A, Gurzun M, Mateescu A, Enache R, Ginghina C, Popescu B, Antova E, Georgievska Ismail L, Srbinovska E, Andova V, Peovska I, Davceva J, Otljanska M, Vavulkis M, Tsuruta H, Kohsaka S, Murata M, Yasuda R, Dan M, Yashima F, Inohara T, Maekawa Y, Hayashida K, Fukuda K, Migliore R, Adaniya M, Barranco M, Miramont G, Gonzalez S, Tamagusuku H, Abid L, Ben Kahla S, Charfeddine S, Abid D, Kammoun S, Amano M, Izumi C, Miyake M, Tamura T, Kondo H, Kaitani K, Nakagawa Y, Ghulam Ali S, Fusini L, Tamborini G, Muratori M, Gripari P, Bottari V, Celeste F, Cefalu' C, Alamanni F, Pepi M, Teixeira R, Monteiro R, Garcia J, Ribeiro M, Cardim N, Goncalves L, Miglioranza M, Muraru D, Cavalli G, Addetia K, Cucchini U, Mihaila S, Tadic M, Veronesi F, Lang R, Badano L, Galian Gay L, Gonzalez Alujas M, Teixido Tura G, Gutierrez Garcia L, Rodriguez-Palomares J, Evangelista Masip A, Conte L, Fabiani I, Giannini C, La Carruba S, De Carlo M, Barletta V, Petronio A, Di Bello V, Mahmoud H, Al-Ghamdi M, Ghabashi A, Salaun E, Zenses A, Evin M, Collart F, Pibarot P, Habib G, Rieu R, Fabregat Andres O, Estornell Erill J, Cubillos-Arango A, Bochard-Villanueva B, Chacon-Hernandez N, Higueras-Ortega L, Perez-Bosca L, Paya-Serrano R, Ridocci-Soriano F, Cortijo-Gimeno J, Mzoughi K, Zairi I, Jabeur M, Ben Moussa F, Mrabet K, Kamoun S, Fennira S, Ben Chaabene A, Kraiem S, Schnell F, Betancur J, Daudin M, Simon A, Lentz P, Tavard F, Hernandes A, Carre F, Garreau M, Donal E, Abduch M, Vieira M, Antunes M, Mathias W, Mady C, Arteaga E, Alencar A, Tesic M, Djordjevic-Dikic A, Beleslin B, Giga V, Trifunovic D, Petrovic O, Jovanovic I, Petrovic M, Stepanovic J, Vujisic-Tesic B, Choi E, Cha J, Chung H, Kim K, Yoon Y, Kim J, Lee B, Hong B, Rim S, Kwon H, Bergler-Klein J, Geier C, Maurer G, Gyongyosi M, Cortes Garcia M, Oliva M, Navas M, Orejas M, Rabago R, Martinez M, Briongos S, Romero A, Rey M, Farre J, Ruisanchez Villar C, Ruiz Guerrero L, Rubio Ruiz S, Lerena Saenz P, Gonzalez Vilchez F, Hernandez Hernandez J, Armesto Alonso S, Blanco Alonso R, Martin Duran R, Gonzalez-Gay M, Novo G, Marturana I, Bonomo V, Arvigo L, Evola V, Karfakis G, Lo Presti M, Verga S, Novo S, Petroni R, Acitelli A, Bencivenga S, Cicconetti M, Di Mauro M, Petroni A, Romano S, Penco M, Park S, Kim S, Kim M, Shim W, Tadic M, Majstorovic A, Ivanovic B, Celic V, Driessen MMP, Meijboom F, Mertens L, Dragulescu A, Friedberg M, De Stefano F, Santoro C, Buonauro A, Muscariello R, Lo Iudice F, Ierano P, Esposito R, Galderisi M, Sunbul M, Kivrak T, Durmus E, Yildizeli B, Mutlu B, Rodrigues A, Daminello E, Echenique L, Cordovil A, Oliveira W, Monaco C, Lira E, Fischer C, Vieira M, Morhy S, Mignot A, Jaussaud J, Chevalier L, Lafitte S, D'ascenzi F, Cameli M, Curci V, Alvino F, Lisi M, Focardi M, Corrado D, Bonifazi M, Mondillo S, Ikonomidis I, Pavlidis G, Lambadiari V, Kousathana F, Triantafyllidi H, Varoudi M, Dimitriadis G, Lekakis J, Cho JS, Cho E, Yoon H, Ihm S, Lee J, Molnar AA, Kovacs A, Apor A, Tarnoki A, Tarnoki D, Horvath T, Maurovich-Horvat P, Jermendy G, Kiss R, Merkely B, Petrovic-Nagorni S, Ciric-Zdravkovic S, Stanojevic D, Jankovic-Tomasevic R, Atanaskovic V, Mitic V, Todorovic L, Dakic S, Coppola C, Piscopo G, Galletta F, Maurea C, Esposito E, Barbieri A, Maurea N, Kaldararova M, Tittel P, Kantorova A, Vrsanska V, Kollarova E, Hraska V, Nosal M, Ondriska M, Masura J, Simkova I, Tadeu I, Azevedo O, Lourenco M, Luis F, Lourenco A, Planinc I, Bagadur G, Bijnens B, Ljubas J, Baricevic Z, Skoric B, Velagic V, Milicic D, Cikes M, Campanale CM, Di Maria S, Mega S, Nusca A, Marullo F, Di Sciascio G, El Tahlawi M, Abdallah M, Gouda M, Gad M, Elawady M, Igual Munoz B, Maceira Gonzalez Alicia A, Estornell Erill J, Donate Betolin L, Vazquez Sanchez Alejandro A, Valera Martinez F, Sepulveda- Sanchez P, Cervera Zamora A, Piquer Gil Marina M, Montero- Argudo A, Naka K, Evangelou D, Lakkas L, Kalaitzidis R, Bechlioulis A, Gkirdis I, Tzeltzes G, Nakas G, Pappas K, Michalis L, Mansencal N, Bagate F, Arslan M, Siam-Tsieu V, Deblaise J, El Mahmoud R, Dubourg O, Wierzbowska-Drabik K, Plewka M, Kasprzak J, Bandera F, Generati G, Pellegrino M, Alfonzetti E, Labate V, Villani S, Gaeta M, Guazzi M, Bandera F, Generati G, Pellegrino M, Labate V, Alfonzetti E, Guazzi M, Generati G, Bandera F, Pellegrino M, Labate V, Alfonzetti E, Guazzi M, Grycewicz T, Szymanska K, Grabowicz W, Lubinski A, Sotaquira M, Pepi M, Tamborini G, Caiani E, Bochard Villanueva B, Chacon-Hernandez N, Fabregat-Andres O, Garcia-Gonzalez P, Cubillos-Arango A, De La Espriella-Juan R, Albiach-Montanana C, Berenguer-Jofresa A, Perez-Bosca J, Paya-Serrano R, Cheng HL, Huang CH, Wang YC, Chou WH, Kuznetsov V, Melnikov N, Krinochkin D, Kolunin G, Enina T, Sierraalta W, Le Bihan D, Barretto R, Assef J, Gospos M, Buffon M, Ramos A, Garcia A, Pinto I, Souza A, Mueller H, Reverdin S, Ehret G, Conti L, Dos Santos S, Abdel Moneim SS, Nhola LF, Huang R, Kohli M, Longenbach S, Green M, Villarraga HR, Bordun KA, Jassal DS, Mulvagh SL, Evangelista A, Madeo A, Piras P, Giordano F, Giura G, Teresi L, Gabriele S, Re F, Puddu P, Torromeo C, Suwannaphong S, Vathesatogkit P, See O, Yamwong S, Katekao W, Sritara P, Iliuta L, Szulik M, Streb W, Wozniak A, Lenarczyk R, Sliwinska A, Kalarus Z, Kukulski T, Weng KP, Lin CC, Hein S, Lehmann L, Kossack M, Juergensen L, Katus H, Hassel D, Turrini F, Scarlini S, Giovanardi P, Messora R, Mannucci C, Bondi M, Olander R, Sundholm J, Ojala T, Andersson S, Sarkola T, Karolyi M, Kocsmar I, Raaijmakers R, Kitslaar P, Horvath T, Szilveszter B, Merkely B, Maurovich-Horvat P. Poster session 4: Friday 5 December 2014, 08:30-12:30 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lacin T, Bilgi Z, Yildizeli B, Bati rel HF. 334-I * VIDEO-ASSISTED THORACOSCOPIC SURGERY LEFT LOWER LOBE BASILAR SEGMENTECTOMY FOR INTRAPULMONARY SEQUESTRATION. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Coskun U, Sinan UY, Calpar I, Yildizeli B, Yanartas M, Filinte D, Kucukoglu MS. Pulmonary artery sarcoma masquerading as chronic pulmonary thromboembolism. Tex Heart Inst J 2014; 41:518-22. [PMID: 25425987 DOI: 10.14503/thij-13-3598] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We describe the case of a 60-year-old woman who presented with pulmonary artery sarcoma, a very rare tumor of the cardiovascular system. Her tumor was initially misdiagnosed as chronic pulmonary thromboembolism, and she underwent pulmonary endarterectomy. Early diagnosis of primary pulmonary artery sarcoma is crucial. That alternative should always be considered before settling on a diagnosis of pulmonary embolism. Suspicion should be aroused by the failure of anticoagulant treatment to alleviate pulmonary perfusion abnormalities and systemic symptoms. Surgical resection of the tumor-preferably by pulmonary endarterectomy, followed by reconstruction as needed-is currently the most promising treatment for pulmonary artery sarcoma.
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Arslantas M, Batirel H, Bilgili B, Kara H, Yildizeli B, Yuksel M, Bostanci K, Kararmaz A, Cinel I. Effects of the restrictive fluid strategy on postoperative pulmonary and renal function following pulmonary resection surgery. Crit Care 2014. [PMCID: PMC4068357 DOI: 10.1186/cc13334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Issaka A, Yildizeli B, Yuksel M. Accidental superior vena cava access to central venous system lately disclosed by thoracotomy. Ann Vasc Surg 2013; 28:1045-7. [PMID: 24368184 DOI: 10.1016/j.avsg.2013.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 05/12/2013] [Accepted: 05/16/2013] [Indexed: 11/28/2022]
Abstract
We report the case of a 51-year-old woman who underwent hemicolectomy for colon cancer and subsequent hepatic metastasectomy for liver metastases. Right percutaneous infraclavicular subclavian venous port catheterization was performed during the initial operation for chemotherapy. She received chemotherapy after each operation with no reported complications. During a right thoracotomy for lung metastases 2 years after the catheter placement, we noticed the catheter perforating the right subclavian vein and directly entering the superior vena cava. To prevent hemorrhaging during catheter removal, we initially performed the lung metastasectomy, after which we decided to intrathoracically remove the catheter. No complication was observed. To the best of our knowledge, this case is the first of its kind to be reported in the published literature.
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Affiliation(s)
- Adamu Issaka
- Department of Thoracic Surgery, Faculty of Medicine, Marmara University, Istanbul, Turkey.
| | - Bedrettin Yildizeli
- Department of Thoracic Surgery, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Mustafa Yuksel
- Department of Thoracic Surgery, Faculty of Medicine, Marmara University, Istanbul, Turkey
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Abdovic E, Abdovic S, Hristova K, Hristova K, Katova T, Katova T, Gocheva N, Gocheva N, Pavlova M, Pavlova M, Gurzun MM, Ionescu A, Canpolat U, Yorgun H, Sunman H, Sahiner L, Kaya E, Ozer N, Tokgozoglu L, Kabakci G, Aytemir K, Oto A, Gonella A, D'ascenzo F, Casasso F, Conte E, Margaria F, Grosso Marra W, Frea S, Morello M, Bobbio M, Gaita F, Seo H, Lee S, Lee J, Yoon Y, Park E, Kim H, Park S, Lee H, Kim Y, Sohn D, Nemes A, Domsik P, Kalapos A, Orosz A, Lengyel C, Forster T, Enache R, Muraru D, Popescu B, Calin A, Nastase O, Botezatu D, Purcarea F, Rosca M, Beladan C, Ginghina C, Canpolat U, Aytemir K, Ozer N, Yorgun H, Sahiner L, Kaya E, Oto A, Muraru D, Piasentini E, Mihaila S, Padayattil Jose' S, Peluso D, Ucci L, Naso P, Puma L, Iliceto S, Badano L, Cikes M, Jakus N, Sutherland G, Haemers P, D'hooge J, Claus P, Yurdakul S, Oner F, Direskeneli H, Sahin T, Cengiz B, Ercan G, Bozkurt A, Aytekin S, Osa Saez AM, Rodriguez-Serrano M, Lopez-Vilella R, Buendia-Fuentes F, Domingo-Valero D, Quesada-Carmona A, Miro-Palau V, Arnau-Vives M, Palencia-Perez M, Rueda-Soriano J, Lipczynska M, Piotr Szymanski P, Anna Klisiewicz A, Lukasz Mazurkiewicz L, Piotr Hoffman P, Kim K, Cho S, Ahn Y, Jeong M, Cho J, Park J, Chinali M, Franceschini A, Matteucci M, Doyon A, Esposito C, Del Pasqua A, Rinelli G, Schaefer F, Kowalik E, Klisiewicz A, Rybicka J, Szymanski P, Biernacka E, Hoffman P, Lee S, Kim W, Yun H, Jung L, Kim E, Ko J, Ruddox V, Norum I, Edvardsen T, Baekkevar M, Otterstad J, Erdei T, Edwards J, Braim D, Yousef Z, Fraser A, Melcher A, Reiner B, Hansen A, Strandberg L, Caidahl K, Wellnhofer E, Kriatselis C, Gerd-Li H, Furundzija V, Thnabalasingam U, Fleck E, Graefe M, Park Y, Moon J, Ahn T, Baydar O, Kadriye Kilickesmez K, Ugur Coskun U, Polat Canbolat P, Veysel Oktay V, Umit Yasar Sinan U, Okay Abaci O, Cuneyt Kocas C, Sinan Uner S, Serdar Kucukoglu S, Ferferieva V, Claus P, Rademakers F, D'hooge J, Le TT, Wong P, Tee N, Huang F, Tan R, Altman M, Logeart D, Bergerot C, Gellen B, Pare C, Gerard S, Sirol M, Vicaut E, Mercadier J, Derumeaux GA, Park TH, Park JI, Shin SW, Yun SH, Lee JE, Makavos G, Kouris N, Keramida K, Dagre A, Ntarladimas I, Kostopoulos V, Damaskos D, Olympios C, Leong D, Piers S, Hoogslag G, Hoke U, Thijssen J, Ajmone Marsan N, Schalij M, Bax J, Zeppenfeld K, Delgado V, Rio P, Branco L, Galrinho A, Cacela D, Abreu J, Timoteo A, Teixeira P, Pereira-Da-Silva T, Selas M, Cruz Ferreira R, Popa BA, Zamfir L, Novelli E, Lanzillo G, Karazanishvili L, Musica G, Stelian E, Benea D, Diena M, Cerin G, Fusini L, Mirea O, Tamborini G, Muratori M, Gripari P, Ghulam Ali S, Cefalu' C, Maffessanti F, Andreini D, Pepi M, Mamdoo F, Goncalves A, Peters F, Matioda H, Govender S, Dos Santos C, Essop M, Kuznetsov VA, Yaroslavskaya EI, Pushkarev GS, Krinochkin DV, Kolunin GV, Bennadji A, Hascoet S, Dulac Y, Hadeed K, Peyre M, Ricco L, Clement L, Acar P, Ding W, Zhao Y, Lindqvist P, Nilson J, Winter R, Holmgren A, Ruck A, Henein M, Illatopa V, Cordova F, Espinoza D, Ortega J, Cavalcante J, Patel M, Katz W, Schindler J, Crock F, Khanna M, Khandhar S, Tsuruta H, Kohsaka S, Murata M, Yasuda R, Tokuda H, Kawamura A, Maekawa Y, Hayashida K, Fukuda K, Le Tourneau T, Kyndt F, Lecointe S, Duval D, Rimbert A, Merot J, Trochu J, Probst V, Le Marec H, Schott J, Veronesi F, Addetia K, Corsi C, Lamberti C, Lang R, Mor-Avi V, Gjerdalen GF, Hisdal J, Solberg E, Andersen T, Radunovic Z, Steine K, Maffessanti F, Gripari P, Tamborini G, Muratori M, Fusini L, Ferrari C, Caiani E, Alamanni F, Bartorelli A, Pepi M, D'ascenzi F, Cameli M, Iadanza A, Lisi M, Reccia R, Curci V, Sinicropi G, Henein M, Pierli C, Mondillo S, Rekhraj S, Hoole S, Mcnab D, Densem C, Boyd J, Parker K, Shapiro L, Rana B, Kotrc M, Vandendriessche T, Bartunek J, Claeys M, Vanderheyden M, Paelinck B, De Bock D, De Maeyer C, Vrints C, Penicka M, Silveira C, Albuquerque E, Lamprea D, Larangeiras V, Moreira C, Victor Filho M, Alencar B, Silveira A, Castillo J, Zambon E, Iorio A, Carriere C, Pantano A, Barbati G, Bobbo M, Abate E, Pinamonti B, Di Lenarda A, Sinagra G, Salemi VMC, Tavares L, Ferreira Filho J, Oliveira A, Pessoa F, Ramires F, Fernandes F, Mady C, Cavarretta E, Lotrionte M, Abbate A, Mezzaroma E, De Marco E, Peruzzi M, Loperfido F, Biondi-Zoccai G, Frati G, Palazzoni G, Park TH, Lee JE, Lee DH, Park JS, Park K, Kim MH, Kim YD, Van 'T Sant J, Gathier W, Leenders G, Meine M, Doevendans P, Cramer M, Poyhonen P, Kivisto S, Holmstrom M, Hanninen H, Schnell F, Betancur J, Daudin M, Simon A, Carre F, Tavard F, Hernandez A, Garreau M, Donal E, Calore C, Muraru D, Badano L, Melacini P, Mihaila S, Denas G, Naso P, Casablanca S, Santi F, Iliceto S, Aggeli C, Venieri E, Felekos I, Anastasakis A, Ritsatos K, Kakiouzi V, Kastellanos S, Cutajar I, Stefanadis C, Palecek T, Honzikova J, Poupetova H, Vlaskova H, Kuchynka P, Linhart A, Elmasry O, Mohamed M, Elguindy W, Bishara P, Garcia-Gonzalez P, Cozar-Santiago P, Bochard-Villanueva B, Fabregat-Andres O, Cubillos-Arango A, Valle-Munoz A, Ferrer-Rebolleda J, Paya-Serrano R, Estornell-Erill J, Ridocci-Soriano F, Jensen M, Havndrup O, Christiansen M, Andersen P, Axelsson A, Kober L, Bundgaard H, Karapinar H, Kaya A, Uysal E, Guven A, Kucukdurmaz Z, Oflaz M, Deveci K, Sancakdar E, Gul I, Yilmaz A, Tigen MK, Karaahmet T, Dundar C, Yalcinsoy M, Tasar O, Bulut M, Takir M, Akkaya E, Jedrzejewska I, Braksator W, Krol W, Swiatowiec A, Dluzniewski M, Lipari P, Bonapace S, Zenari L, Valbusa F, Rossi A, Lanzoni L, Molon G, Canali G, Campopiano E, Barbieri E, Rueda Calle E, Alfaro Rubio F, Gomez Gonzalez J, Gonzalez Santos P, Cameli M, Lisi M, Focardi M, D'ascenzi F, Solari M, Galderisi M, Mondillo S, Pratali L, Bruno RM, Corciu A, Comassi M, Passera M, Gastaldelli A, Mrakic-Sposta S, Vezzoli A, Picano E, Perry R, Penhall A, De Pasquale C, Selvanayagam J, Joseph M, Simova II, Katova TM, Kostova V, Hristova K, Lalov I, D'ascenzi F, Pelliccia A, Natali B, Cameli M, Alvino F, Zorzi A, Corrado D, Bonifazi M, Mondillo S, Rees E, Rakebrandt F, Rees D, Halcox J, Fraser A, O'driscoll J, Lau N, Perez-Lopez M, Sharma R, Lichodziejewska B, Goliszek S, Kurnicka K, Kostrubiec M, Dzikowska Diduch O, Krupa M, Grudzka K, Ciurzynski M, Palczewski P, Pruszczyk P, Gheorghe L, Castillo Ortiz J, Del Pozo Contreras R, Calle Perez G, Sancho Jaldon M, Cabeza Lainez P, Vazquez Garcia R, Fernandez Garcia P, Chueca Gonzalez E, Arana Granados R, Zhao X, Xu X, Bai Y, Qin Y, Leren I, Hasselberg N, Saberniak J, Leren T, Edvardsen T, Haugaa K, Daraban AM, Sutherland G, Claus P, Werner B, Gewillig M, Voigt J, Santoro A, Ierano P, De Stefano F, Esposito R, De Palma D, Ippolito R, Tufano A, Galderisi M, Costa R, Fischer C, Rodrigues A, Monaco C, Lira Filho E, Vieira M, Cordovil A, Oliveira E, Mohry S, Gaudron P, Niemann M, Herrmann S, Strotmann J, Beer M, Hu K, Bijnens B, Ertl G, Weidemann F, Baktir A, Sarli B, Cicek M, Karakas M, Saglam H, Arinc H, Akil M, Kaya H, Ertas F, Bilik M, Yildiz A, Oylumlu M, Acet H, Aydin M, Yuksel M, Alan S, O'driscoll J, Gravina A, Di Fino S, Thompson M, Karthigelasingham A, Ray K, Sharma R, De Chiara B, Russo C, Alloni M, Belli O, Spano' F, Botta L, Palmieri B, Martinelli L, Giannattasio C, Moreo A, Mateescu A, La Carrubba S, Vriz O, Di Bello V, Carerj S, Zito C, Ginghina C, Popescu B, Nicolosi G, Antonini-Canterin F, Malev E, Omelchenko M, Vasina L, Luneva E, Zemtsovsky E, Cikes M, Velagic V, Gasparovic H, Kopjar T, Colak Z, Hlupic L, Biocina B, Milicic D, Tomaszewski A, Kutarski A, Poterala M, Tomaszewski M, Brzozowski W, Kijima Y, Akagi T, Nakagawa K, Ikeda M, Watanabe N, Ueoka A, Takaya Y, Oe H, Toh N, Ito H, Bochard Villanueva B, Paya-Serrano R, Fabregat-Andres O, Garcia-Gonzalez P, Perez-Bosca J, Cubillos-Arango A, Chacon-Hernandez N, Higueras-Ortega L, De La Espriella-Juan R, Ridocci-Soriano F, Noack T, Mukherjee C, Ionasec R, Voigt I, Kiefer P, Hoebartner M, Misfeld M, Mohr FW, Seeburger J, Daraban AM, Baltussen L, Amzulescu M, Bogaert J, Jassens S, Voigt J, Duchateau N, Giraldeau G, Gabrielli L, Penela D, Evertz R, Mont L, Brugada J, Berruezo A, Bijnens B, Sitges M, Yoshikawa H, Suzuki M, Hashimoto G, Kusunose Y, Otsuka T, Nakamura M, Sugi K, Ruiz Ortiz M, Mesa D, Romo E, Delgado M, Seoane T, Martin M, Carrasco F, Lopez Granados A, Arizon J, Suarez De Lezo J, Magalhaes A, Cortez-Dias N, Silva D, Menezes M, Saraiva M, Santos L, Costa A, Costa L, Nunes Diogo A, Fiuza M, Ren B, De Groot-De Laat L, Mcghie J, Vletter W, Geleijnse M, Toda H, Oe H, Osawa K, Miyoshi T, Ugawa S, Toh N, Nakamura K, Kohno K, Morita H, Ito H, El Ghannudi S, Germain P, Samet H, Jeung M, Roy C, Gangi A, Orii M, Hirata K, Yamano T, Tanimoto T, Ino Y, Yamaguchi T, Kubo T, Imanishi T, Akasaka T, Sunbul M, Kivrak T, Oguz M, Ozguven S, Gungor S, Dede F, Turoglu H, Yildizeli B, Mutlu B, Mihaila S, Muraru D, Piasentini E, Peluso D, Cucchini U, Casablanca S, Naso P, Iliceto S, Vinereanu D, Badano L, Rodriguez Munoz D, Moya Mur J, Becker Filho D, Gonzalez A, Casas Rojo E, Garcia Martin A, Recio Vazquez M, Rincon L, Fernandez Golfin C, Zamorano Gomez J, Ledakowicz-Polak A, Polak L, Zielinska M, Kamiyama T, Nakade T, Nakamura Y, Ando T, Kirimura M, Inoue Y, Sasaki O, Nishioka T, Farouk H, Sakr B, Elchilali K, Said K, Sorour K, Salah H, Mahmoud G, Casanova Rodriguez C, Cano Carrizal R, Iglesias Del Valle D, Martin Penato Molina A, Garcia Garcia A, Prieto Moriche E, Alvarez Rubio J, De Juan Bagua J, Tejero Romero C, Plaza Perez I, Korlou P, Stefanidis A, Mpikakis N, Ikonomidis I, Anastasiadis S, Komninos K, Nikoloudi P, Margos P, Pentzeridis P. Poster session Thursday 12 December - AM: 12/12/2013, 08:30-12:30 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sunbul M, Kivrak T, Oguz M, Ozguven S, Gungor S, Dede F, Turoglu HT, Yildizeli B, Mutlu B. Evaluation of Association Between Fluoro-D-Glucose Positron Emission Tomography Uptake with Right Ventricular Functions in Patients with Chronic Thromboembolic Pulmonary Hypertension. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kara HV, Bilgi Z, Issaka A, Yildizeli B, Bekiroğlu N, Batirel H. P-193PRIOR ENDOSCOPIC TREATMENT HAS NO IMPACT ON SURGICAL OUTCOMES OF ACHALASIA PATIENTS. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Yüksel M, Özalper MH, Bostanci K, Ermerak NO, Cimşit Ç, Tasali N, Yildizeli B, Fevzi Batirel H. Do Nuss bars compromise the blood flow of the internal mammary arteries? Interact Cardiovasc Thorac Surg 2013; 17:571-5. [PMID: 23788198 DOI: 10.1093/icvts/ivt255] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Minimally invasive repair of pectus excavatum, the so-called Nuss procedure, has become a popular technique in recent years. The internal mammary arteries (IMAs) lie on the posterolateral surface of the sternum, and the Nuss bar is likely to obstruct the blood flow in these arteries. This obstruction could become important in the later stages of the lives of these young people if they were to require coronary artery bypass grafting. The goal of this study is to investigate the extent of obstruction of the IMAs caused by Nuss bars. METHODS Data were collected prospectively on all patients who underwent the Nuss procedure between October 2011 and May 2012. Patients with a history of pectus excavatum repair by open surgery and those who were younger than 16 years of age were excluded. Computed tomography-angiography (CTA) was performed for the detection of IMA blood flow preoperatively and on the 10th postoperative day. Blood flow in the IMAs was evaluated blindly by two radiologists and classified as blood flow unaffected (group I) or affected (group II) by comparing the assessment of preoperative and postoperative CTAs. The patients in group II were also categorized as having blood flow obstructed bilaterally, blood flow obstructed unilaterally and others (diminished unilaterally/diminished on one side or obstructed on the other side). RESULTS Thirty-four patients (31 male and three female; mean age 20.7 ± 4.2 years) underwent surgery. Blood flow was affected in 15 patients (44%), with bilateral obstruction in five, unilateral obstruction in seven, and unilateral diminished flow in two patients. In one patient, blood flow was diminished on one side and obstructed on the other. There was no significant difference between unaffected group I patients and affected group II patients in terms of sex, age, type of deformity, Haller index and the number of bars placed. CONCLUSIONS Nuss bars cause pressure on the IMAs, but a risk factor for this effect could not be identified. This is a relatively common clinical consequence of minimally invasive repair of pectus excavatum, and the long-term effects will be apparent following bar removal.
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Affiliation(s)
- Mustafa Yüksel
- Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey.
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Sunbul M, Kepez A, Kivrak T, Eroglu E, Ozben B, Yildizeli B, Mutlu B. Right ventricular longitudinal deformation parameters and exercise capacity : prognosis of patients with chronic thromboembolic pulmonary hypertension. Herz 2013; 39:470-5. [PMID: 23740084 DOI: 10.1007/s00059-013-3842-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 04/26/2013] [Accepted: 04/28/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Chronic thromboembolic pulmonary hypertension (CTEPH) is a progressive disease characterized by increased pulmonary vascular resistance resulting in pulmonary hypertension and right heart failure. The six-minute walk test (6MWT) distance is associated with the prognosis of CTEPH patients. Speckle tracking echocardiography (STE) is a reliable method for determining ventricular function. The aim of this study was to assess and compare the right ventricular (RV) function of CTEPH patients according to their 6MWT distances. METHODS Forty-nine consecutive CTEPH patients (mean age, 50 ± 16 years; 22 male) who were referred to our center for pulmonary thromboendarterectomy (PTE) were included in the study. All patients underwent the 6MWT and right heart catheterization (RHC). Standard echocardiography and STE were performed on all patients before PTE. Patients were divided into two groups based on their 6MWT distance being less or more than 300 m. RESULTS Patients with a shorter 6MWT distance had a significantly larger RV, while they had a significantly lower RV fractional area change and higher myocardial performance index suggesting impaired RV function. Both RV basal-lateral strain and strain rate measures were significantly lower in patients with shorter 6MWT distances than those with longer 6MWT distances. Similarly, they had lower RV basal-septal, mid-lateral, and global strain measures. 6MWT distances were correlated with RV basal-lateral and mid-lateral strain measures (r = 0.349, p = 0.025 and r = 0.415, p = 0.008, respectively). CONCLUSION Our data suggest that RV myocardial deformation parameters are associated with 6MWT distances. Determination of RV dysfunction by STE may be helpful in identifying patients with a poor prognosis.
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Affiliation(s)
- M Sunbul
- Department of Cardiology, Cardiology Clinic, Marmara University Faculty of Medicine, Marmara University Research and Training Hospital, Fevzi Cakmak Mahallesi No. 41, Ustkaynarca/Pendik, Istanbul, Turkey,
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Abaci O, Cetinkal G, Kocas C, Evren E, Yildiz M, Yildizeli B, Yanartaş M. Pulmonary embolism: a late complication of pectus excavatum repair. CONGENIT HEART DIS 2013; 9:E113-5. [PMID: 23721082 DOI: 10.1111/chd.12094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/06/2013] [Indexed: 11/30/2022]
Abstract
The Ravitch operation is frequently performed to correct pectus excavatum with few and minor complications. We present a case of pulmonary embolism with pulmonary endarterectomy in a patient undergoing Ravitch repair for pectus excavatum 2 years ago.
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Affiliation(s)
- Okay Abaci
- Department of Cardiology, Istanbul University Cardiology Institute
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Sunbul M, Kivrak T, Eroglu E, Ozben B, Yildizeli B, Mutlu B, Kepez A. Evaluation of Improvement in Exercise Capacity after Pulmonary Endarterectomy in Patients with Chronic Thromboembolic Pulmonary Hypertension: Correlation with Echocardiographic Parameters. Thorac Cardiovasc Surg 2013; 62:60-5. [DOI: 10.1055/s-0033-1336012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Murat Sunbul
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Tarik Kivrak
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Elif Eroglu
- Department of Cardiology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
| | - Beste Ozben
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Bedrettin Yildizeli
- Department of Thoracic Surgery, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Bulent Mutlu
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Alper Kepez
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
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Evman S, Bostanci K, Ediz K, Yildizeli B, Batirel H, Yuksel M. Assistance of Patient's Knowledge and Consciousness on Surgeon's Decision. Chest 2012. [DOI: 10.1378/chest.1389951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Asicioglu E, Gonenli G, Kahveci A, Yildizeli B, Deyneli O, Yavuz D, Yuksel M, Akalin S. Thymic neuroendocrine carcinoma presenting as cushing's syndrome: treatment with octreotide combined with surgery and radiotherapy. ACTA ACUST UNITED AC 2011; 34:46-9. [PMID: 21346385 DOI: 10.1159/000323348] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Ebru Asicioglu
- Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey
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Yildizeli B, Isbir S. [Pulmonary thromboendarterectomy]. Anadolu Kardiyol Derg 2010; 10 Suppl 2:31-38. [PMID: 20819754 DOI: 10.5152/akd.2010.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease characterized by the persistence of thromboemboli obstructing the pulmonary arteries as an organized tissue. The consequence is an increase in pulmonary vascular resistance resulting in pulmonary hypertension (PH) and progressive right heart failure. Pulmonary thromboendarterectomy (PTE) is the treatment of choice of chronic thromboembolic pulmonary disease. Pulmonary thromboendarterectomy is performed under hypothermia and total circulatory arrest. This procedure is associated with a low mortality rate in experienced centers and results in a dramatic improvement of hemodynamic parameters, functional status and survival rate. This surgery should be performed as early as possible in the history of this disease, preferentially before development of arteriolitis in the non obstructed territories. Because of the absence of clinically evident acute pulmonary embolism history in >50% of patients, the diagnosis of CTEPH can be difficult. Lung scintigraphic scan showing segmentary mismatched perfusion defects is the best diagnostic tool to detect CTEPH. Pulmonary angiography and high-resolution computerized tomography scan are required to establish the diagnosis and to assess the operability. A diagnostic right heart catheterization is required to confirm the diagnosis of PH and to determine the degree of hemodynamic impairment. If there is a good correlation between the pulmonary vascular resistance and the anatomical obstruction, pulmonary thromboendarterectomy should be proposed. Pulmonary or cardiopulmonary transplantation is indicated in this setting only when the lesions are too distal and thus inaccessible to endarterectomy.
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Affiliation(s)
- Bedrettin Yildizeli
- Marmara Universitesi Tip Fakültesi, Göğüs Cerrahisi Anabilim Dali, Istanbul, Türkiye.
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Ozyurtkan MO, Yildizeli B, Kuşçu K, Bekiroğlu N, Bostanci K, Batirel HF, Yüksel M. Postoperative psychiatric disorders in general thoracic surgery: incidence, risk factors and outcomes. Eur J Cardiothorac Surg 2010; 37:1152-7. [PMID: 20117012 DOI: 10.1016/j.ejcts.2009.11.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Revised: 11/08/2009] [Accepted: 11/30/2009] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Postoperative psychiatric disorders (PPDs) may complicate the post-surgical outcome. We analysed the types, incidences, risk factors and outcomes of the PPDs in non-cardiac thoracic surgery patients. METHODS All patients (n=100) undergoing major non-cardiac thoracic surgery from January 2004 to March 2005 were investigated prospectively. The diagnosis of PPD was made based on the Diagnosis and Statistical Manual of Mental Disorders. The patients were grouped into two according to the presence (group I) or absence (group II) of PPD. Data on pre-, per- and postoperative factors, and the adverse outcomes were analysed. RESULTS Eighteen patients (18%) developed PPD, including delirium in 44%, adjustment disorders in 22%, panic attack in 17%, minor depression in 11% and psychosis in 6%. The patients who developed PPD were older (58+/-17 vs 50+/-15 years, p=0.05), had a longer operation time (6+/-1 vs 5+/-2h, p=0.015) and hospital stay (13+/-9 vs 8+/-5 days, p=0.019). The morbidity and mortality rates were not significantly different between the groups (67% vs 46%; 11% vs 1%, respectively). The causative factors in the development of PPD were older age, longer operation time, abnormal serum chemistry values of sodium, potassium, calcium and glucose, hypoalbuminaemia, the presence of the postoperative respiratory distress and infection and blood transfusion (p<0.05). CONCLUSIONS PPDs are associated with adverse outcomes including a longer hospital stay, and increased morbidity and mortality rates. The identification, detection and elimination of these risk factors are recommended.
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Chataigner O, Fadel E, Yildizeli B, Achir A, Mussot S, Fabre D, Mercier O, Dartevelle PG. Factors affecting early and long-term outcomes after completion pneumonectomy☆. Eur J Cardiothorac Surg 2008; 33:837-43. [DOI: 10.1016/j.ejcts.2008.02.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2007] [Revised: 01/29/2008] [Accepted: 02/01/2008] [Indexed: 10/22/2022] Open
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Dartevelle PG, Yildizeli B, Mussot S. Extended Resections for Lung Cancer. Lung Cancer 2008. [DOI: 10.1002/9780470696330.ch13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Dartevelle PG, Yildizeli B, Fadel E, Mussot S. MTP19-01: T4 N0/N1 nonsmall cell lung cancer can be cured as a first line treatment with an expected five year survival rate as high as 43% provided a radical resection is performed. J Thorac Oncol 2007. [DOI: 10.1097/01.jto.0000283060.34074.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Epithelioid hemangioendothelioma is a rare vascular neoplasm of uncertain malignant potential. Various reports document metastatic or concurrent epithelioid hemangioendothelioma in several sites, most commonly with combined lung and liver involvement. The concurrent involvement of multiple sites at presentation may cause diagnostic problems because epithelioid hemangioendothelioma can mimic other neoplastic processes. Although it is a chemo-resistant disease, chemotherapy is usually advised for patients with metastatic or concurrent involvement. Here we document the presentation, treatment, and outcome of two cases with concurrent involvement of the lung and liver.
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Affiliation(s)
- Cigdem Celikel
- Department of Pathology, Marmara University School of Medicine, Istanbul, Turkey
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