Browsing by Author "Balkanay, Mehmet"

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    Intraoperative Tissue-Immunosuppressive Therapy Reduces Rejection Episodes in Heart Transplant Recipients
    (Baskent Univ, 2022) Rabus, Murat Bulent; Cekmecelioglu, Davut; Ata, Pinar; Salihi, Saleh; Selcuk, Emre; Balkanay, Mehmet
    Objectives: Our study was conducted to determine the effects of intraoperative antithymocyte globulin administration on donor hearts procured after cardiocirculatory death. We evaluated the impact of antithymocyte globulin on graft function and related parameters during isothermic blood cardioplegia.Materials and Methods: In this prospective and randomized single center study, 30 patients with orthotropic heart transplant were divided into 2 groups: group 1 included 15 patients who received retrograde antithymocyte globulin infusion via coronary sinus intraoperatively and immediately after organ procurement and group 2 included 15 patients who received traditional antithymocyte globulin infusion after implantationResults: Study patients had a mean age of 33.8 years (range, 15-56 y). All patients had panel reactive antibody less than 10% except for 3 patients. The cluster of differentiation 3-positive cell count decrease was more than 20%. The inotropic therapy dose required and the myocardial pressure (stiffness) were less for group 1 patients. These patients had less acute rejection episodes than group 2 (0% vs 13.3%; P < .05).Conclusions: Favorable clinical outcomes were observed in terms of less acute rejection episodes and better graft function at least during the early posttransplant period. Intraoperative antithymocyte globulin treatment may have a preventive effect for acute cellular rejection in heart transplant patients.
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    The Levitronix CentriMag ventricular assist device as a bridge to decision in patients with end-stage heart failure: Our single-center experience
    (Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2017) Rabus, Murat Bulent; Salihi, Salih; Hasanov, Sarkhan; Fedakar, Ali; Cevirme, Deniz; Balkanay, Mehmet
    Background: In this study, we report early outcomes of Levitronix CentriMag device implantation for bridge to decision for patients with end-stage heart failure in a single center. Methods: We retrospectively analyzed data of a total of 41 patients (30 males, 11 females: mean age 30.2 +/- 15 years; range 7 to 59 years) with end-stage heart failure who received a Levitronix CentriMag support for bridge to decision between December 2010 and September 2014. Devices were implanted in the left (n=38), right (n=1), or biventricular (n=2) configuration. Support was continued until recovery, transplantation or implantation of a long-term ventricular assist device. Results: The mean preoperative left ventricular ejection fraction was 17 +/- 2.3%. The mean support time was 38 (range 1 to 192) days. Sixteen patients (39%) survived and moved on to the next phase of the treatment. Of these patients, 11 (27%) underwent cardiac transplantation operations and five (12%) received long-term ventricular assist devices. After the CentriMag implantation, 30-day survival rate was 49% in 20 patients. Bleeding requiring re-operation was observed in 13 patients (32%). Two patients (4.8%) had sternal wound infections. Device dysfunction was observed in one patient (2.4%). Non-survivors had a higher rate of sepsis and renal failure, compared to the survivors (p<0.05). Conclusion: The CentriMag system provides an effective temporary mechanical circulatory support for cardiac failure. The ease of implantation and high rate of successful device weaning encourage the use of CentriMag system as a temporary ventricle support.
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    Son dönem kalp yetmezliği olan hastalarda karara köprülemede Levitronix CentriMag ventriküler destek cihazı: Tek merkez deneyimimiz
    (2017) Rabuş, Murat Bülent; Fedakar, Ali; Balkanay, Mehmet; Çevirme, Deniz; Salihi, Salih; Hasanov, Sarkhan
    Amaç: Bu çalışmada tek bir merkezde son dönem kalp yetmezliği olan hastalarda karara köprülemede Levitronix CentriMag ventriküler destek cihazı implantasyonunun erken dönem sonuçları sunuldu. Çalış­ma­ planı:­ Aralık 2010 - Eylül 2014 tarihleri arasında, karara köprüleme amacıyla Levitronix CentriMag desteği uygulanmış olan toplam 41 son dönem kalp yetmezliği hastasının (30 erkek, 11 kadın; ort. yaş 30.2±15 yıl; dağılım 7-59 yıl) verileri retrospektif olarak incelendi. Cihazlar sol (n=38), sağ (n=1) veya biventriküler (n=2) konfigürasyonda yerleştirildi. Destek iyileşmeye, transplantasyona veya uzun dönem ventriküler destek cihazı takılana kadar sürdürüldü. Bulgu­lar:­ Hastaların ameliyat öncesi ortalama sol ventrikül ejeksiyon fraksiyonları %17±2.3 idi. Ortalama destek süresi 38 (dağılım 1-192) gündü. On altı hasta (%39) yaşamını sürdürdü ve tedavinin bir sonraki aşamasına geçti. Bu hastalardan 11’ine (%27) kalp nakli yapıldı ve beş hastaya (%12) uzun dönem ventriküler destek cihazı yerleştirildi. CentriMag yerleştirildikten sonra 30 günlük sağkalım oranı 20 hastada %49 idi. On üç hastada (%32) yeniden ameliyat gerektiren kanama gözlendi. İki hastada (%4.8) sternal yara enfeksiyonları vardı. Bir hastada (%2.4) cihaz disfonksiyonu gözlendi. Sağkalan hastalara kıyasla, kaybedilen hastalarda daha yüksek oranda sepsis ve renal yetmezlik vardı (p<0.05). Sonuç:­ CentriMag sistemi kalp yetmezliğinde etkili bir geçici mekanik dolaşım desteği sağlamaktadır. İmplantasyon kolaylığı ve başarılı şekilde cihazdan ayrılma oranının yüksek oluşu, geçici ventriküler destek olarak CentriMag sisteminin kullanımını desteklemektedir.