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    Impact of Single versus Double Clamp Technique on Blood Lactate Levels and Postoperative Complications in Coronary Artery Bypass Surgery
    (Soc Brasil Cirurgia Cardiovasc, 2022) Ozmen, Rifat; Bozguney, Muhammet; Tekin, Ali Ihsan; Eroglu, Tamer; Tuncay, Aydin
    Introduction: Cardiopulmonary bypass (CPB) is associated with hyperlactatemia, which leads to adverse clinical outcomes. No study has examined the effect of different clamping techniques on postoperative hyperlactatemia (PHL). Thus, we aimed to evaluate the impact of two different techniques on PHL and the clinical outcomes in patients undergoing isolated coronary artery bypass surgery. Methods: This retrospective study included 100 patients who underwent isolated CPB either with single clamp technique (SCT, n=47) or double clamp technique (DCT, n=53). Demographic and preoperative laboratory data, as well as operative features and arterial blood lactate levels at the onset and at the end of CPB, were collected from patient charts. Results: Blood lactate levels collected at the end of CPB did not differ significantly between groups whereas intraoperative lactate increased significantly in both groups (P<0.005). PHL developed in 16 patients (32%). There was no meaningful difference in SCT and DCT in this regard. Left internal mammary artery was used more frequently in the DCT group than in the SCT group. While the cross-clamp time was significantly longer in the SCT group, there was no difference regarding CPB time. Among postoperative complications, only the incidence of stroke was significantly higher in the DCT group than in the SCT group (10.6% vs. 0%, P=0.020). CPB time, cross-clamp time and numbers of proximal saphenous graft and distal anastomosis showed a significant positive correlation with the postoperative lactate level. In the regression analysis, CPB time emerged as the only independent predictor of PHL (OR 1.04, CI 95% 1.01-1.07, P=0.011). Conclusion: There was no difference in postoperative blood lactate levels between SCT and DCT groups.
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    Overview of Treatment Methods in Peripheral Major Vascular Injuries: A Retrospective Study
    (Erciyes Univ Sch Medicine, 2020) Ozmen, Rifat; Bozguney, Muhammet; Eroglu, Tamer; Tekin, Ali Ihsan; Tuncay, Aydin; Elcik, Deniz
    Objective: Vascular injuries are observed in 0.2-4% of all traumas and can be life-threatening or difficult when not properly treated. In this study, we aimed to present our experience in the treated vascular injury cases. Materials and Methods: This retrospective and descriptive study covered the period between May 2014 and December 2018. Medical records of patients with vascular injuries were evaluated concerning demographic and trauma-related parameters. Results: In this study, 73.1% of 93 patients were male, and the average age was 27.44 +/- 6.70 years. In the majority of the patients, it was observed that vascular injuries occurred as a result of penetrating traumas, and mainly radial and superficial femoral arteries were affected. Nerve injuries were found to be accompanied in 16.1% of the patients. The concomitant nerve injuries were also present in 16.1% of the patients. End-to-end anastomosis was used in 73.3% of the injuries. Mortality and amputation rates were 1.1% and 3.2%, respectively. Conclusion: Demographic and clinical parameters in vascular injury cases were found to be compatible with the previous studies. By collecting the correct data obtained from this study and the other studies, the medical needs of patients with vascular injuries could be better evaluated and clinical services could be planned in advance by conducting a medical approach accordingly.
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    The Systemic Immune-Inflammation Index Predicts In-Hospital Mortality in Patients Who Underwent On-Pump Cardiac Surgery
    (Arquivos Brasileiros Cardiologia, 2024) Gunturk, Inayet; Ozmen, Rifat; Ozocak, Okan; Gunturk, Ertugrul Emre; Dagli, Fatma; Yazici, Cevat
    Background: Systemic immune-inflammation index (SII), a new inflammatory index calculated using platelet, neutrophil, and lymphocyte counts, has been demonstrated to be an independent risk factor for the identification of high-risk coronary artery disease in patients undergoing percutaneous coronary intervention and cardiovascular surgery with cardiopulmonary bypass (CPB). The relationship between SII and CPB-related mortality rates remains unclear. Objective: This research was designed to investigate the use of SII to predict in-hospital mortality in patients undergoing cardiac surgery with CPB. Methods: Four hundred eighty patients who underwent a cardiac procedure involving CPB over 3 years, were obtained from the hospital's database. The demographic data, comorbidities, hematological and biochemical profiles, and operative data of the groups were compared. Multiple logistic regression analyses were done to determine independent predictors of mortality. Prognostic factors were assessed by multivariate analysis, and the predictive values of SII, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) for mortality were compared. A p-value <0.05 was considered significant. Results: Of 480 patients, 78 developed in-hospital mortality after cardiac surgery. SII was an independent predictor of in-hospital mortality (Odds ratio: 1.003, 95% confidence interval: 1.001-1.005, p<0.001). The cut-off value of the SII was >811.93 with 65% sensitivity and 65% specificity (area under the curve: 0.690). The predictive values of SII, PLR, and NLR were close to each other. Conclusion: High preoperative SII scores can be used for early determination of appropriate treatments, which may improve surgical outcomes of cardiac surgery in the future.