Person: AK, KORAY
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AK
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KORAY
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Publication Open Access Huge thrombosed popliteal artery aneurysm(2023-09-29) DEMİRBAŞ, ELİF; AK, KORAY; DEMİRBAŞ E., AK K.Popliteal artery aneursyms (PAA) are the most common true peripheral aneurysm. We report a case of 66-year-old patient who has pulsatile mass posterior of the right knee diagnosed with massive PAA.Publication Open Access Surgical treatment of massive pulmonary thromboembolism due to renal cell carcinoma(2022-07-01) AK, KORAY; ÖZTÜRK, FATİH; ARSAN, SİNAN; Erol M. E., AK K., ÖZTÜRK F., TİNAY İ., ARSAN S.While renal cell carcinomas frequently invade the renal vein and inferior vena cava, the right atrial extension or formation of bilateral pulmonary massive embolism is quite unusual. A 65-year-old male patient underwent bilateral pulmonary tumor endarterectomy and total thrombectomy of the inferior vena cava combined with left nephrectomy under total circulatory arrest with antegrade cerebral perfusion. Both mediastinal and abdominal approaches facilitated the complete removal of the caval thrombus under the guidance of transesophageal echocardiography. The patient is still under follow-up for six months without metastasis. In conclusion, pulmonary thromboembolism due to renal cell carcinoma is rare, surgical treatment is possible.Publication Open Access Radial arterial thrombosis in COVID-19: A case report(2022-01-01) ÇİÇEK, FURKAN CUMA; EYÜPLER, ÇAĞLA; YETGİNOĞLU, ÖZGE; AK, KORAY; KOCAKAYA, DERYA; Durmus N. S. , ÇİÇEK F. C. , EYÜPLER Ç., Omur C., YETGİNOĞLU Ö., AK K., KOCAKAYA D.Thrombosis due to hypercoagulable state is an important cause of morbidity and mortality in coronavirus disease 2019 (COVID-19). Increased D-dimer levels are an important marker of the presence and risk of thrombosis. In this report, we present that a 59-year-old male patient developed thrombosis in the distal radial arteries despite normal D-dimer level. The patient was treated with enoxaparin, iloprost infusion, and cilostazol. This case should lead us to be very careful that people diagnosed with COVID-19 with normal D-dimer levels may also have thrombosis.Publication Metadata only Evaluation of Right Ventricular Function in Functional Tricuspid Insufficiency(2020) AK, KORAY; Ak, KorayPublication Metadata only Comparison of heat monitoring-based myocardial protection strategy with classic myocardial protection method in isolated coronary artery bypass surgery patients(ELSEVIER SCIENCE INC, 2020) AK, KORAY; Gojayev, Farid; Solgun, Huseyin Avni; Ak, Koray; Midi, Ahmet; Canillioglu, YaseminObjective: In this study, we aimed to compare patients who have a myocardial protection strategy based on myocardial temperature monitorization with those who had myocardial protection with conventional intermittent cardioplegia. Methods: Twenty-six patients undergoing coronary artery bypass graft surgery were included into the study. Patients were prospectively grouped into two; myocardial protection based on temperature monitoring (group 1, n = 11) and those who had cardioplegia every 20 min (group 2, n = 15) during aortic cross-clamping. In all patients, cold blood cardioplegia was used. Coronary sinus blood sampling was performed immediately before aortic cross-clamping, after 2, 20, and 40 min of aortic clamping and tumor necrosis factor-alpha, malondialdehyde, creatinine kinase-myocardial band isoenzyme (MB), troponin I, lactate, and pH were studied. In addition, myocardial biopsy was taken before and immediately after cross-clamping to evaluate cardiomyocyte apoptosis with caspase-3 tunnel immunostaining. Results: There were no differences in clinical parameters like early mortality, extubation time, inotropic requirements, postoperative drainage, intensive care unit, and hospitalization time between two groups. In addition, blood and blood products were similar in two groups. In group 2, after cross-clamping, troponin I and creatinine kinase-MB values were significantly higher than the other group. In myocardial biopsies, the caspase immunostaining score, before removal of aortic cross-clamp was significantly higher in group 2 than the samples taken before aortic clamping. Conclusion: Our results show that there is no difference between temperature-based myocardial protection strategy with conventional intermittent cardioplegia delivery. We think that the number of patients in our study is less and that the patient population is not a homogeneous structure is the most important limiting factor of our study. Increasing the number of patients, with particularly those who have myocardial dysfunction would help augment the possible different effects of two cardioplegic techniques on myocardial protection. (C) 2019 Elsevier Inc. All rights reserved.Publication Metadata only Trombin jenerasyon zamanı ve endotel disfonsiyon belirteçlerinin pulmoner endarterektomi sonuçlarına etkisi(2023-10-19) ERMERAK, NEZİH ONUR; LAÇİN, TUNÇ; TOPTAŞ, TAYFUR; OLGUN YILDIZELİ, ŞEHNAZ; AK, KORAY; YILDIZELİ, BEDRETTİN; TİRYAKİ G. G., Ertan R., Pasayev J., ERMERAK N. O., LAÇİN T., TOPTAŞ T., OLGUN YILDIZELİ Ş., Taş H., AK K., YILDIZELİ B.Publication Metadata only Does tapse/spap ratio predict early outcome followingpulmonary endarterectomy(2023-06-04) OLGUN YILDIZELİ, ŞEHNAZ; ERMERAK, NEZİH ONUR; MUTLU, BÜLENT; KOCAKAYA, DERYA; AK, KORAY; BEKİROĞLU, GÜLNAZ NURAL; YILDIZELİ, BEDRETTİN; TİRYAKİ G. G., Ertan R., OLGUN YILDIZELİ Ş., ERMERAK N. O., MUTLU B., KOCAKAYA D., TAŞ S., AK K., BEKİROĞLU G. N., YILDIZELİ B.Publication Metadata only Histopathologic evaluation of saphenous vein grafts in patients with type II diabetes mellitus undergoing coronary artery bypass grafting(ELSEVIER SCIENCE INC, 2021) AK, ESİN; Ak, Esin; Ak, Koray; Midi, Ahmet; Kervancioglu-Demirci, Elif; Arsan, Sinan; Cetinel, Sule; Pisiriciler, RabiaIntroduction: Diabetes Mellitus (DM) has been known to be a risk factor for the development of more severe form of saphenous vein graft disease after coronary artery bypass grafting (CABG). We aimed to evaluate the impact of type II-DM on histopathological features of great saphenous vein grafts of patients undergoing CABG. Patients and methods: Forty consecutive patients undergoing elective CABG were enrolled into the study. Patients were grouped into two; Diabetic group (n = 20); includes patients with preoperative diagnosis of type II-DM and Nondiabetic group (n = 20): those without type II-DM. In all patients, a short segment of the great saphenous vein graft at the level of medial malleolus was taken for light microscopy and transmission electron microscopy (TEM) evaluation. Moreover, immunoexpressions of Caveolin-1, Vascular cell adhesion protein 1 (VCAM-1) and endothelial nitric oxide synthase (eNOS) were studied. Results: There were no differences in the demographics of patients between two groups. The magnitude of intimal fibrosis in diabetic group was slightly higher than in nondiabetics (1.95 +/- 0.99 versus 1.3 +/- 0.8, P = .04). In TEM, vacuolization in endothelial cells, substance accumulation along with coarse collagen fibers and cytoplasmic degeneration with vacuolization in muscle cells were detected in diabetic group. While there were no differences in Caveolin-1 and VCAM-1 immunostaining, the intensity of positive eNOS immunostaining was significantly higher in endothelium (2.10 +/- 0.64 versus 1.55 +/- 0.68, P = .01) and tunica media 1.75 +/- 0.63 versus 1.2 +/- 0.52, P = .007) in nondiabetic group, respectively) compared with diabetic group. Conclusion: Type II DM might be a reason for decreased expression of eNOS and increased intimal fibrosis, vacuolization of endothelial and smooth muscle cells in saphenous vein grafts. The clinical implications of these alterations on the graft patency need to be evaluated. (c) 2021 Elsevier Inc. All rights reserved.Publication Open Access Mid-term results of surgical interventions of high-grade vena cava tumor thrombus(2022-01-01) ÖZTÜRK, FATİH; AK, KORAY; TİNAY, İLKER; ARSAN, SİNAN; Erol M. E. , ÖZTÜRK F., AK K., TİNAY İ., ARSAN S.© 2022 All right reserved by the Turkish Society of Cardiovascular Surgery. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes (http://creativecommons.org/licenses/by-nc/4.0/).Background: This study aims to investigate whether the coexistence of advanced renal cell carcinoma and inferior vena cava tumor thrombus could be treated with a multidisciplinary approach and teamwork and to evaluate early and mid-term results. Methods: Between January 2017 and December 2020, a total of 33 patients (28 males, 5 females; mean age: 55.8±13.2 years; range, 27 to 76 years) who underwent radical nephrectomy and thrombectomy of the inferior vena cava were retrospectively analyzed. Demographic characteristics of the patients, types of operations, postoperative data, mortality and morbidity rates were recorded. Results: Of the patients, 12% (n=4) had Stage 2 tumor thrombus, 60.6% (n=20) had Stage 3 tumor thrombus, and 27% (n=9) had Stage 4 tumor thrombus. A total of 55% (n=19) of the patients had right-sided renal cell carcinoma, while 45% (n=14) of them had a left-sided mass. Totally, 66% (n=22) of the patients underwent primary inferior vena cava repair. The thrombectomy procedure and a Dacron® patch was applied with patch plasty in 24% (n=8) of the patients, and Dacron® graft interposition was applied to the inferior vena cava in 9% (n=3) of the patients. The mean follow-up was 20.3±13.0 (range, 2 to 70) months. Deep vein thrombosis was detected in the follow-up of seven (21%) patients, and no pulmonary thromboembolism was observed during the postoperative follow-up period. The mean length of stay in the intensive care unit was 1.39±0.6 (range, 1 to 3) days. The 30-day mortality rate was 3%, due to the loss of one patient from massive pulmonary embolism intraoperatively. Conclusion: Vascular surgical procedures performed regardless of the stage of the tumor thrombus provide satisfactory mid-term results in patients with advanced renal cell cancer.Publication Metadata only Covid sonrası gelişen diğer bir uzun dönem komplikasyon ve cerrahi tedavisi: Post-Covid KTEPH(2022-11-05) ERMERAK, NEZİH ONUR; OLGUN YILDIZELİ, ŞEHNAZ; KOCAKAYA, DERYA; MUTLU, BÜLENT; AK, KORAY; YILDIZELİ, BEDRETTİN; ERMERAK N. O., OLGUN YILDIZELİ Ş., KOCAKAYA D., TİRYAKİ G. G., Güçtekin Y., MUTLU B., AK K., TAŞ S., YILDIZELİ B.