Person: YILDIZELİ, BEDRETTİN
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YILDIZELİ
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BEDRETTİN
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Publication Open Access Esophageal perforation during intragastric balloon therapy: management of a patient with late referral(2023-01-01) ERMERAK, NEZİH ONUR; UPRAK, TEVFİK KIVILCIM; LAÇİN, TUNÇ; YILDIZELİ, BEDRETTİN; YEGEN, ŞEVKET CUMHUR; ERMERAK N. O., Uprak K. T., Emran M., LAÇİN T., YILDIZELİ B., YEGEN Ş. C.Minimally invasive treatment modalities like intragastric balloon therapy (IBT) gained popularity in the treatment of obesity [1]. Some morbidities have been reported in the literature, but it is limited. Esophageal perforation is the most feared complication of the procedure. Although endoscopic stent placement can be chosen as a treatment option in stable patients, most of the patients are treated with surgical drainage and primary repair [2]. We report an unusual case of intragastric balloon placement complicated with esophageal perforation which was successfully treated with a surgical approach after late referral.Publication Open Access The angiogenic gene profile of pulmonary endarterectomy specimens: Initial study(2023-01-01) ERMERAK, NEZİH ONUR; YILMAZ, BETÜL; BATIREL, SAİME; OLGUN YILDIZELİ, ŞEHNAZ; KOCAKAYA, DERYA; MUTLU, BÜLENT; YILDIZELİ, BEDRETTİN; ERMERAK N. O., YILMAZ B., BATIREL S., OLGUN YILDIZELİ Ş., KOCAKAYA D., MUTLU B., Tas S., YILDIZELİ B.© 2023 The Author(s)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) 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.Publication Open Access Change in pulmonary arterial compliance and pulmonary pulsatile stress after balloon pulmonary angioplasty(2022-01-01) KOCAKAYA, DERYA; YILDIZELİ, BEDRETTİN; Akaslan D., Ataş H., Aslanger E., Kanar B. G., Kocakaya D., Yıldızeli B., Mutlu B.Objective: Although the underlying pathology of chronic thromboembolic pulmonary hypertension (CTEPH) is mechanical obliteration of the major pulmonary vessels, high pulsatile stress penetrating into the normal distal pulmonary microvasculature resulting from reduced pulmonary arterial compliance (CPA) may cause progressive deterioration in pulmonary hemodynamics. Hypothetically, balloon pulmonary angioplasty (BPA) may be beneficial in reducing CPA and pulsatile stress in patients with CTEPH. Methods: In total, 26 patients with available pre- and post-BPA right heart catheterization results were included in the study. BPA was performed in a series of staged procedures by 2 experienced interventional cardiologists. Results: The median CPA showed a 59.2% increase (1.03 to 1.64 mL/mm Hg, p=0.005). The median pre-BPA pulsatile stress product decreased by 20.7% (4,266 to 3,380 mm Hg/min, p=0.003). A linear regression model established that the percent change in CPA after BPA accounted for 21.8% of the explained variability in the change in 6-minute walk test (p=0.009). Conclusion: Our results indicate that BPA decreases CPA and pulmonary pulsatile stress. These changes may be partly responsible for the improvement in functional capacity after BPA.Publication Open Access Pulmonary endarterectomy in patients with antiphospholipid syndrome-associated chronic thromboembolic pulmonary hypertension(2022-05-01) KOCAKAYA, DERYA; ALİBAZ ÖNER, FATMA; DİRESKENELİ, RAFİ HANER; YILDIZELİ, BEDRETTİN; İNANÇ, GÜZİDE NEVSUN; Taş S., Antal A., Durusoy A. F., Yanartaş M., Yıldız K., Olgun Yıldızeli Ş., Kocakaya D., Mutlu B., Alibaz-Öner F., Direskeneli H., et al.Background: Antiphospholipid syndrome is an autoimmune disease characterized by the occurrence of venous and/or arterial thrombosis. Chronic thromboembolism is one of the known established pathogenesis of pulmonary hypertension, known as chronic thromboembolic pulmonary hypertension. Pulmonary endarterectomy is the treatment of choice for chronic thromboembolic pulmonary hypertension. The aim of this study is to evaluate the efficacy and risk of pulmonary endarterectomy in patients with antiphospholipid syndrome-associated chronic thromboembolic pulmonary hypertension. Methods: Data were prospectively collected and retrospectively analyzed, for patients who underwent pulmonary endarterectomy between March 2011 and March 2020. Results: Seventeen patients (4 male and 13 female) were identified. Thirteen patients had primary antiphospholipid syndrome and 4 had secondary antiphospholipid syndrome. The mean age was 34.82 ± 10.07 years and the mean time interval between the diagnosis and surgery was 26.94 ± 17.35 months. Dyspnea on exertion was the main symptom in all patients. Seven patients had previous deep vein thrombosis, 5 patients had a history of recurrent abortions, and 2 patients had hemoptysis. Following surgery, mean pulmonary artery pressure decreased from 47.82 ± 13.11 mm Hg to 22.24 ± 4.56 mm Hg (P < .001), and pulmonary vascular resistance improved from 756.50 ± 393.91 dyn/s/cm−5 to 298.31 ± 132.84 dyn/s/cm−5 (P < .001). There was no in-hospital mortality with a mean follow-up of 75.29 ± 40.21 months. The functional capacity of all patients improved from 269.46 ± 111.7 m to 490 ± 105.34 m on a 6-minute walking test. Conclusions: Pulmonary endarterectomy is a safe and curative treatment in patients with antiphospholipid syndrome-associated chronic thromboembolic pulmonary hypertension. It has a favorable outcome by increasing the quality of life. A multidisciplinary experienced chronic thromboembolic pulmonary hypertension team is critical in the management of these unique patientsPublication Metadata only The effects of iron replacement on functional capacity in patients with group 1 and group 4 pulmonary hypertension(2022-10-01) ATAŞ, HALİL; KOCAKAYA, DERYA; YILDIZELİ, BEDRETTİN; MUTLU, BÜLENT; Akaslan D., Aslanger E., ATAŞ H., Kanar B. G. , KOCAKAYA D., YILDIZELİ B., MUTLU B.Objective: Abnormal iron handling complicates pulmonary hypertension and causes functional limitation and poor outcomes. Although preliminary results in group 1 pulmonary hypertension patients support the use of iron replacement, whether this applies to other PH subgroups is not known.Publication Open Access The effect of perioperative fluid management and operative modifications on mortality and morbidity in patients undergoing pulmonary endarterectomy(2023-01-01) YILDIZELİ, BEDRETTİN; Arslan A., Yanartaş M., Taş S., BOZBUĞA N., YILDIZELİ B.© 2023, Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe disease treated with pulmonary endarterectomy. Our study aims to reveal the differences in liquid modalities and operation modifications, which can affect the patients’ mortality and morbidity. Methods: One hundred twenty-five patients who were diagnosed with CTEPH and underwent pulmonary thromboendarterectomy (PTE) at our center between February 2011 and September 2013 were included in this retrospective study with prospective observation. They were in New York Heart Association functional class II, III, or IV, and mean pulmonary artery pressure was > 40 mmHg. There were two groups, the crystalloid (Group 1) and colloid (Group 2) liquid groups, depending on the treatment fluids. P-value 0.05). Mean duration of stay in the intensive care unit (ICU) for Group 1 was 6.2 days and for Group 2 was 5.4 days (P>0.05). Readmission rate to the ICU for respiratory or non-respiratory reasons was 8.3% (n=4) in Group 1 and 11.7% (n=9) in Group 2 (P>0.05). Conclusion: Changes in fluid management have an etiological significance on possible complications in patient follow-up. We believe that as new approaches are reported, the number of comorbid events will decrease.Publication Metadata only Transatrial balloon atrial septostomy to facilitate weaning off venoarterial ECMO after pulmonary endarterectomy(2022-10-01) AK, KORAY; TİRE, YAKUP; KARARMAZ, ALPER; YILDIZELİ, BEDRETTİN; AK K., Arslanhan G., TİRE Y., Tosun S., KARARMAZ A., HANTA İ., YILDIZELİ B.Atrial septostomy has been the last resort in the management of patients with the right ventricular failure related to pulmonary hypertension before lung transplantation. In this paper, we present a simple and safe technique (transatrial approach) for balloon atrial septostomy in a patient who required central venoarterial extracorporeal membrane oxygenation after pulmonary endarterectomy.Publication Metadata only Pulmoner arter sarkomanın cerrahi sonuçları: Histoloji sağkalımı etkiler mi(2023-08-01) BOZKURTLAR, EMİNE; OLGUN YILDIZELİ, ŞEHNAZ; MUTLU, BÜLENT; KOCAKAYA, DERYA; BEKİROĞLU, GÜLNAZ NURAL; YILDIZELİ, BEDRETTİN; Başar V., Olgun Yıldızeli Ş., Bozkurtlar E., Ercelep ., Mutlu B., Kocakaya D., Bekiroğlu G. N., Taş S., Sunar H., Küçükoğlu M. S., et al.Publication Metadata only Extracellular matrix collagen biomarker levels in patients who underwent pulmonary endarterectomy(2023-04-01) OLGUN YILDIZELİ, ŞEHNAZ; MUTLU, BÜLENT; YILDIZELİ, BEDRETTİN; Zengin A., Kalkan R., Aydin K. Y., OLGUN YILDIZELİ Ş., MUTLU B., Karakoc A. Z., Tas S., Sunar H., Kilic U., Yanartas M., et al.OBJECTIVES: The role of extracellular matrix collagen biomarkers in chronic thromboembolic pulmonary hypertension (CTEPH) is not well known. Our goal was to investigate the matrix metalloproteinase (MMP)-2 and -9 protein levels in patients with CTETH.Publication Metadata only Isolated pulmonary vasculitis diagnosed histopathologically after pulmonary endarterectomy: a case series(2019-03-01) GAZEL, ÜMMÜGÜLSÜM; KOCAKAYA, DERYA; YILDIZELİ, BEDRETTİN; ALİBAZ ÖNER, FATMA; DİRESKENELİ, RAFİ HANER; Gazel U., KOCAKAYA D., Salcinkaya Y., Inanc N., YILDIZELİ B., Alibaz-Oner F., DİRESKENELİ R. H.