Papers by Munacettin Ceviz
Türk kardiyoloji derneği arşivi, Dec 1, 2007
Atatürk Üniversitesi Tıp Dergisi, 2001
Multiple sinuses of valsalva aneurysms are very rare. This report describes a case of giant unrup... more Multiple sinuses of valsalva aneurysms are very rare. This report describes a case of giant unruptured aneurysms of the right and non-coronary sinuses of valsalva associated with moderate aortic regurgitation. Repair was performed by aortic valve and root replacement with flanged technique..
Turkish Journal of Thoracic and Cardiovascular Surgery, Jul 14, 2014
Bu çalışmada nefrostomi kateteri kullanılarak bilgisayarlı tomografi (BT) eşliğinde yapılan perik... more Bu çalışmada nefrostomi kateteri kullanılarak bilgisayarlı tomografi (BT) eşliğinde yapılan perikardiyal efüzyonların drenajının güvenliliği ve uygulanabilirliği değerlendirildi. Ça lış mapla nı:Aralık 2005-Kasım 2011 tarihleri arasında kliniğimizde 30 hastada (15 erkek, 15 kadın; ort. yaş 52.3 yıl, dağılım 18-80 yıl) BT eşliğinde perikardiyal efüzyon drenajı gerçekleştirildi. Yalnızca ekokardiyografi eşliğinde yapılan drenaj için uygun olmayan hastalar seçildi. Seldinger tekniği kullanılarak 8 veya 10F nefrostomi kateteri perikard boşluğuna ilerletildi. Bul gu lar: İşlem 29 hastada başarılı idi. Bir hastada kateter perikard boşluğuna yerleştirildi; ancak sıvı aspire edilemedi. Bu hasta ameliyata alındı. Perikard boşluğunda organize bir hematoma rastlandı. Ameliyat sırasında sağ ventrikülün anterolateral yüzeyinde küçük bir epikardiyal lazerasyon tespit edildi. On iki hastada (%41) seröz sıvı, 10 hastada (%35) hemorajik sıvı, yedi hastada (%24) transüd ve bir hastada (%3.3) pürülan sıvı aspire edildi. Ortalama 4±2 gün sonra kateterler çıkarıldı. İki hastada (%6.6) perikardiyal efüzyon tekrarladı ve aynı yöntemle başarılı bir şekilde drene edildi. Yeni nüksler gözlenmedi. İşleme bağlı ölüm gerçekleşmedi. So nuç: Çalışma sonuçlarımız ekokardiyografi eşliğinde yapılan drenaj için uygun olmayan hastalarda, nefrostomi kateteri ile BT eşliğinde yapılan drenajın etkili, güvenli ve uygun bir işlem olduğunu göstermektedir. Bununla birlikte, bu tekniğin ameliyat sonrası lokalize perikardiyal efüzyonlu hastalar için daha uygun olduğu görüşündeyiz. Anah tar söz cük ler: Kardiyak tamponad; perikardiyal efüzyon; perikardiyosentez. Background: This study aims to evaluate the safety and feasibility of computed tomography (CT)-guided drainage of pericardial effusions by using a nephrostomy catheter. Methods: We performed CT-guided drainage of pericardial effusions on 30 patients (15 males, 15 females; mean age 52±3 years; range 18 to 80 years) in our clinic between December 2005 and November 2011. Only patients who were ineligible for echocardiography-guided drainage were selected. By using the Seldinger technique, a 8 or 10F nephrostomy catheter was inserted into the pericardial space. Results:Procedure was successful in 29 patients. In one patient, the catheter was able to be placed in the pericardial space, but the fluid was unable to be aspirated. The patient was operated. An organized hematoma was found in the pericardial space. During surgery, a small epicardial laceration was detected on the anterolateral surface of the right ventricle. Serous fluid was aspirated from 12 patients (41%), hemorrhagic fluid from 10 patients (35%), transude from seven patients (24%) and purulent fluid was aspirated from one patient (3.3%). Catheters were removed after a mean duration of 4±2 days. In two (6.6%) patients pericardial effusion recurred and successful drainage was performed by the same method. No new recurrences were observed. No procedure-related death was occurred. Conclusion: Our study results suggest that CT-guided drainage with a nephrostomy catheter is an effective, safe and feasible procedure in patients who are ineligible for echocardiography-guided drainage. We also believe that this technique is more suitable for patients with postoperative localized pericardial effusions.
DergiPark (Istanbul University), Feb 12, 2023
Ö z e t Amaç: Mitral kapak hastalığının etyolojisinde çeşitli faktörler rol oynamaktadır. Mitral ... more Ö z e t Amaç: Mitral kapak hastalığının etyolojisinde çeşitli faktörler rol oynamaktadır. Mitral kapak hastalıklarında müdahalenin zamanı klinisyen için önemli bir problemdir. Müdahale kararı verilse bile kapak yapı ve morfolojisi seçilecek yöntemi etkilemektedir. Çalışmamızda mitral kapak hastalıklarında müdahalenin şeklini belirleyen en önemli faktörlerden biri olan kapak kalsifikasyonun derecesinin değerlendirilmesinde non-invazif bir yöntem olan Integrated Backscatter'in (IBS) geçerliliğini sınadık. Materyel ve metod: Bu amaçla çalışmaya mitral kapak replasmanı endikasyonu konulan 15 kadın, 5 erkek toplam 20 hasta alındı. Operasyon öncesi bütün hastalara standart transtorasik ekokardiyografi yapıldı. IBS ölçümleri parasternal uzun eksen, apikal dört boşluk, apikal iki boşluk pencerelerinden yapıldı. Her pencerede kapakta 5 noktadan IBS ölçümü yapılarak bulunan değerlerin ortalaması alındı. Kazanç etkisinden kurtulmak için kapak IBS değerlerinin interatrial septum ve sol atrial boşluk IBS değerleri toplamlarına oranı kullanıldı. Operasyonla çıkarılan kapaklardaki kalsiyum seviyesi atomik absorbsiyon yöntemi ile çalışıldı. Bulgular: Veriler ortalama ± standart sapma olarak ifade edildi. Gruplar arası farklılıklar Kruskal-Wallis ile test edildi. IBS değerleri ile kapak kalsiyum seviyesi arasındaki ilişki korelasyon analizi ile test edildi. Koralesyon analizinde mitral kapak kalsiyum konsantrasyonu ile IBS oranı arasında anlamlı ilişki gösterildi. (r: 0.7; p<0.05). Sonuç: Çalışmamızda IBS tekniğinin mitral kapak kalsiyum içeriğini tayin edebilen non-invazif, kantitatif bir yöntem olduğu gösterildi. Bu yöntem mitral kapak hastalıklarında müdahalenin şekli ve zamanlamasında yardımcı bir parametre olabilir. Anahtar kelimeler: Integrated backscatter, mitral kapak hastalığı, atomik absorbsiyon Abstract Objectives: A lot of factors play role in the etiology of mitral valvular disease. Timing and type of the intervention for mitral valve disease are difficult problems for clinicians. Albeit the decision of intervention such as surgery or percutenous balloon valvotomy is given, valvular structure and morphology have been affecting the type of the intervention. We tried integrated backscatter (IBS) method which measures tissue density non-invasively in evaluating of valvular calcification degree that is one of the most important factors affecting the type of intervention in mitral valvular disease. Methods: 20 patients, 15 females and 5 males, in whom indications of mitral valve replacement were present, were included. Routine transthoracic two-dimensional echocardiography was performed to all patients preoperatively. Also integrated backscatter records were taken in apical four chambers, apical two chambers and parasternal long axis views. IBS measurements were taken from five points for each leaflet and averaged. This approach was repeated in each echocardiographic window. To get rid of gain effect, total average valvular IBS value was divided by average value of interatrial septum plus left atrial cavity IBS value. Calcium level in the excised mitral valve was studied with atomic absorbtion spectrofotometry method. Results: All data were expressed as mean±Standard deviation. Multiple group comparison was performed with Kruskal-Wallis test. Relationship between IBS value and valvular calcium level was tested with correlation analysis. Correlation analysis showed significant relationship between calcium level and IBS ratio (r:0.7; p<0.05). Conclusions: In our study, it was documented that integrated backscatter imaging method determines non-invasively mitral valvular calcium level. This method might play a role in the timing and selection of the type of intervention in mitral valvular disease.
Turkish Journal of Medical Sciences, Dec 12, 2007
A 49-year-old male, who had undergone mitral valve replacement with mechanical cardiac valve and ... more A 49-year-old male, who had undergone mitral valve replacement with mechanical cardiac valve and coronary arterial bypass grafting six years previously, was admitted to our hospital with acute dyspnea. Transesophageal echocardiography revealed that one of the leaflets of the prosthetic valve was entirely immobilized in the closed position, and an immobile soft tissue mass was detected on the ventricular side of the obstructed leaflet. We performed re-replacement using a 29-mm mechanical prosthetic St. Jude valve under deep hypothermic circulatory arrest via right atrial thoracotomy. Postoperative course was uneventful, and the patient was discharged with oral anticoagulant therapy on day 7 postoperatively.
Revista da Sociedade Brasileira de Medicina Tropical
Türk Göğüs Kalp …, 2000
Amaç: Yüksek morbidite ve mortalite oranları olan, acil cerrahi girişim gerektiren periferik dama... more Amaç: Yüksek morbidite ve mortalite oranları olan, acil cerrahi girişim gerektiren periferik damar travmaları sunuldu. Bu vakalarda ilgili ekstremite ve hasta hayatı da risk altındadır. Tedavinin başarısını etkileyen faktörler ve cerrahi girişimlerimiz gözden geçirildi Metod: Ocak 1983-...
Türk Göğüs Kalp …, 2000
... Postoperatif dönemde heparinin ekstrasellüler matriksten endojen bFGF (Bazik Fibroblast Growt... more ... Postoperatif dönemde heparinin ekstrasellüler matriksten endojen bFGF (Bazik Fibroblast Growth Faktor) salınımını arttırarak yeni kollateral gelişiminin arttırılmasını ... İlk klinik denemeler İspanyol bir cerrah olan San Martin Y Satrustegui tarafından 1902'de 3 keçi üzerinde ...
The Annals of Thoracic Surgery, Feb 1, 1995
Journal of International Medical Research, Aug 1, 2003
We aimed to assess the effectiveness of subxiphoid pericardiostomy for treating patients with per... more We aimed to assess the effectiveness of subxiphoid pericardiostomy for treating patients with pericardial effusions (PE), and its contribution to defining the aetiology of these effusions. We undertook retrospective analysis of 240 PE patients who underwent subxiphoid pericardiostomy and tube drainage between 1990 and 2000. Echocardiography classified PE as severe in 132 patients, moderate in 99, and mild in nine. The main causes of PE were uraemic, idiopathic and undefined, tuberculous and non-tuberculous pericarditis, malignancy and trauma. Peri-operative myocardial injury requiring sternotomy, and recurrent effusion requiring further surgical intervention, occurred in three and 24 patients, respectively. Histopathological examination assisted the diagnosis in 94% of patients with malignancy, and 96% with tuberculous pericarditis. Overall 30-day mortality was 1.3% and pericardial constriction, requiring pericardiectomy, developed in seven cases. In conclusion, we believe that adults and children with PE can be safely, effectively and quickly managed with subxiphoid pericardiostomy, irrespective of its aetiology.
Annals of Saudi Medicine, 2008
Anévrisme de la veine jugulaire externe : une cause rare de gonflement du cou. À propos de trois ... more Anévrisme de la veine jugulaire externe : une cause rare de gonflement du cou. À propos de trois observations
Heart and Vessels, May 1, 2003
This report describes our experience in performing mitral valve replacement and tricuspid annulop... more This report describes our experience in performing mitral valve replacement and tricuspid annuloplasty via a right mini-thoracotomy in a patient with tracheostomy. A 24-year-old woman was admitted with shortness of breath and palpitations. She had subglottic tracheal stenosis and tracheostomy due to tracheal intubation of long duration. Echocardiography revealed chronic severe mitral and tricuspid valve regurgitation. We planned to perform at first the cardiac, and then the tracheal operation, because her left ventricular function was worsening. To eliminate the potential complications of sternotomy in patients with tracheostomy, we used right mini-thoracotomy. We performed mechanical mitral valve replacement for the mitral valve and De Vega annuloplasty for the tricuspid valve. The patient was transferred to the tracheal surgery clinic after the 20th day. Tracheal resection and anastomosis were performed in this department. Three months later, the patient was asymptomatic. We believe that the right minithoracotomy approach is a good technique for mitral valve replacement in patients with tracheostomy.
Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, Apr 1, 2009
Annals of Saudi Medicine, 2008
Predictors of obstructive sleep apnea in snorerst statistical errors To the Editor: I have read w... more Predictors of obstructive sleep apnea in snorerst statistical errors To the Editor: I have read with great interest the recently published article by Ibrahim and colleagues 1 in the Annals of Saudi Medicine and I appreciated the authors' efforts and work. However, I would like to make few comments on it because of the apparent flaws in results. First, the authors mentioned in the abstract that 39% of the females had obstructive sleep apnea (OSA) with a mean of respiratory disturbance index (RDI) of 27.8±26.5. In Table 1, it was shown that 17 of 41 females were RDI positive, which constituted 41.5% and not 39%. Second, in the results text, the authors stated that "OSA was seen more in nontQatari (n=84) subjects versus in Qatari subjects (n=38). The sum of both groups was 122, not 126 study participants, who were diagnosed as OSAso unless there were 4 participants of unknown nationality, there is an error. Third, the authors again contradict what was shown in Table 1 where they mentioned that females (of the OSA group) had a nontsignificant higher mean age of 51.8±8.2 years compared to 48.7±9.4 years in males. The table showed that figure 51.8±8.2 years belonged to females in the RDI negative group and not the OSA group, whereas the second figure did not exist at all. Moreover, the statistical analysis in the table compared between the age of OSA group and the negative group among males and females separately. Fourth, in the discussion, on page 424, the authors stated that "the frequency of PSG diagnosed OSA.was 72.4%", whereas the correct figure was previously mentioned by them as 66% (126
Interactive Cardiovascular and Thoracic Surgery, Dec 1, 2006
Objective: Brachial plexus injury is a rare complication after median sternotomy. We investigated... more Objective: Brachial plexus injury is a rare complication after median sternotomy. We investigated that injury to the brachial plexus was retrospectively assessed in the results of three patients who underwent median sternotomy for open heart surgery. Materials and methods: All patients were placed in the hands-up position after right internal jugular vein cannulation, and the internal mammary artery was prepared for all of those. Nerve conduction measurements and electromyography were performed besides neurological examination. Results: Brachial plexus injury was detected in three cases (0.5%) of 575 patients who underwent coronary artery bypass grafting with median sternotomy. The main symptoms were continuous pain, and motor and sensory disturbances at the affected upper extremity (left arm in all cases). The common feature was that in all cases the left internal mammary artery was harvested. While the symptoms were relieved in two patients about six months after the operation, the other one had intractable pain and paresthesia. Conclusion: The most important measure is careful sternal retraction and use of the hands-up position for the low incidence and benign course of brachial plexus problems. Inappropriate sternal retraction during preparation of internal mammary artery should be avoided.
Archives of the Turkish Society of Cardiology, Dec 1, 2007
International Journal of Cardiology, Jul 1, 2006
sions. As compared with patients receiving placebo, patients receiving intravenous methylpredniso... more sions. As compared with patients receiving placebo, patients receiving intravenous methylprednisolone had a somewhat shorter initial period of hospitalization (Pϭ0.05) and, at week 1, a lower erythrocyte sedimentation rate (Pϭ0.02) and a tendency toward a lower C-reactive protein level (Pϭ0.07). However, the two groups had similar numbers of days spent in the hospital, numbers of days of fever, rates of retreatment with intravenous immune globulin, and numbers of adverse events. Conclusions.-Our data do not provide support for the addition of a single pulsed dose of intravenous methylprednisolone to conventional intravenous immune globulin therapy for the routine primary treatment of children with Kawasaki disease. ᭤ Another therapy, when actually investigated objectively, does not prove to work.
Kocatepe Tıp Dergisi, Jan 3, 2023
Ventriküler septum defekt (VSD), sol ve sağ ventrikülü ayıran septuma yerleşen, bir ya da daha fa... more Ventriküler septum defekt (VSD), sol ve sağ ventrikülü ayıran septuma yerleşen, bir ya da daha fazla sayıda olabilen açıklık olarak tanımlanabilir. Ventriküler septal defektler konjenital veya akkiz olabilir. En sık görülen doğuştan kalp anomalisidir. Bu yazımızda Kliniğimizde cerrahi olarak tedavi ettiğimiz VSD leri literatürler eşliğinde değerlendirdik. GEREÇ VE YÖNTEM: Kliniğimizde 68 VSD hastasına girişim yapıldı. 39 olgu erkek (%57.3), 29 olgu kadın (%42.7) idi ve yaş ortalaması 9,10±9,13(1-48) yaş/yıl, kilo ortalaması 25±16,5(7-75) kg olarak bulundu. Preoperatif NYHA fonksiyonel kapasite(FK) karşılaştırıldığında FK-I 31 olgu(%45,5), FK-II 30 olgu(%44,1), FK-III 7 olgu(%10,2) olarak belirlendi. Preoperatif anomali olarak en sık 15 olgu(%22,05) aort yetmezliği(AY) ve aort valf prolapsusu (AVP); 18 olgu(%26,4) ASD; 8 olgu(%11,7) PDA mevcuttu. BULGULAR: VSD tiplerine göre girişim yöntemlerine bakıldığında perimembranöz tipte en sık 53 olgu (%77,9) ile sağ atriotomi, 1 olgu(%1,4) sağ atriotomi ve triküspit septal annulus radial kesisi; müsküler tipte 8 olgu (%11,7) ile sağ atriotomi ve Swiss-Chess tip olan 2 olguda (%2,9) sol ventrikülotomi; DCJA(Doubly Committed Jukstaarteryel) tipte 4 olgu (%5,8) ile sağ ventrikülotomi tercih edilmiştir. Postoperatif komplikasyonlar arasında en sık görülen 9 olgu(%15,3) ile rezidü VSD dir. Fatal seyreden 3 hastanın(%5,09) PAB 67±7,5mmHg; LV-RV şant 49±9,6mmHg; Qp/Qs 4,7±3,87; PVR 7,5±4,6 değerlerinin yüksek oldukları görülmüştür. Pre/postoperatif NYHA ve RVP karşılaştırıldığında istatistiki olarak anlamlı(p<0,05) olduğu görülmüş olup reoperasyonsuz yaşam olasılığı %93,2 olarak hesaplanmıştır. SONUÇ: Ventriküler septal defekt en sık görülen konjenital kalp hastalığıdır. Tanı ve sınıflandırılmasında EKO ve kardiak anjiografinin gelişiminin payı büyüktür. Defektleri çok iyi değerlendirip 3 aydan sonra kapatılması tercih edilmelidir.
Turkish Journal of Medical Sciences, 1996
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Papers by Munacettin Ceviz