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    Absence of left anterior descending artery associated with atherosclerotic heart disease
    (WESTMINSTER PUBL INC, 2001) Ogus, NT; Cicek, S; Isik, O
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    Accelerated atherosclerosis in tertiary syphilis and successful treatment with saphenous vein grafting - A case report
    (SAGE PUBLICATIONS INC, 2001) Ogus, NT; Cakalagaoglu, C; Cakalagaoglu, F; Cicek, S
    A 48-year-old male patient having none of the known risk factors for atherosclerosis underwent coronary artery bypass graft (CABG) surgery because of double-vessel coronary artery disease. During the operation, the aorta, both internal thoracic arteries (L/R-ITA), and the femoral artery were sclerotic, and CABG was performed using only saphenous vein grafts. A diagnosis of tertiary syphilis had been confirmed by either microscopic or serologic tests. There were different degrees of sclerosis in different arteries of different sizes. The presence of coronary artery disease with no known atherosclerotic risk factors should include preoperative testing for connective tissue disorders, chronic inflammatory disease, and cold hemagglutinins, because of the possible use of obligatory deep hypothermia or total circulatory arrest due to a diseased ascending aorta.
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    Coronary artery bypass grafting alone - for advanced ischemic left ventricular dysfunction with significant mitral regurgitation: Early and midterm outcomes in a small series
    (Texas Heart Inst, 2004) Ogus, NT; Us, MH; Ogus, H; Isik, O
    In 31 consecutive patients with ischemic left ventricular dysfunction and mitral regurgitation ranging from 2/4 to 3/4 (mean, 2.87 +/- 0.34), we performed coronary bypass grafting alone and assessed early and midterm outcomes. Our patients' mean preoperative New York Heart Association functional class was 3.64 +/- 0.48, and their mean left ventricular ejection fraction was 0.25 +/- 0.05. Preoperative thallium imaging revealed that all patients had at minimum a partially reversible defect in the anterior wall. All patients survived the operation. Hospital length of stay ranged from 5 to 21 days (mean, 8.35 +/- 4.07 days), and mean length of follow-up was 21.35 +/- 13.24 months. Postoperatively, patients' functional classification improved to a mean of 1.32 +/- 0.6; left ventricular ejection fraction improved to a mean of 0.43 +/- 0.09; and severity of mitral regurgitation decreased to a mean of 1.35 +/- 0.96. Statistical analysis showed that all improvements were significant. Five late cardiac deaths occurred. Preoperative variables showed no correlation with late death. However postoperative left ventricular ejection fraction and mitral regurgitation did correlate with late death, which suggests that the reversibility of damaged ischemic myocardium plays an important role after revascularization. This study supports the concept that ischemic mitral regurgitation might well improve after myocardial revascularization regardless of its severity; therefore, it should not be corrected at the primary operation, except in patients with organic valvular changes.
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    Prevention of recurrent osteomyelitis using cyanoacrylate gluing in mediastinitis
    (ELSEVIER SCIENCE INC, 2000) Ogus, NT; Emir, M; Cicek, S; Isik, O
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    Reperfusion strategy after regional ischaemia: Simulation of emergency revascularization and effects of integrated cardioplegia on myocardial resuscitation
    (SAGE PUBLICATIONS LTD, 2004) Us, MH; Ogus, NT; Yildirim, T; Ogus, H; Ozkan, S; Ozturk, OY; Isik, O
    We induced ischaemia in the left anterior descending artery of 16 dogs while the heart was beating, followed by cardiopulmonary bypass (CPB), aortic cross clamping and blood cardioplegia. Half of the dogs received integrated blood cardioplegia and sudden uncontrolled reperfusion (group A) while the others received the same cardioplegia followed by pressure-controlled tepid initial reperfusion (group B). The effects on myocardial cell metabolism, oxidative stress and ultrastructure were recorded. The recovery period was significantly longer and cardiac output levels after CPB significantly lower in group A compared with group B. Group A showed a failure to uptake and utilize oxygen during the recovery period and significant lipid peroxidation. Marked tissue oedema was seen in group A but mitochondrial and organelle integrity was almost normal in both groups. We conclude that integrated cardioplegia could partially resuscitate the myocardium in this model, and pressure controlled reperfusion during the first 2 min is needed as an adjunct procedure.