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OP-082 THE FOUNDATION, DEVELOPMENT AND THE LATEST SITUATION OF THE CARDIOVASCULAR SURGERY IN TURKISH REPUBLIC OF NORTHERN CYPRUS
S16
Oral Presentations / International Journal of Cardiology 155S1 (2012) S1–S89
Results: All patients were completed the follow-up. None of the patients were exhibited clinical, echocardiographic and biochemical evidences of cardiotoxicity. (Table) Body mass index (BMI) values were decreased significantly. However there was no significant correlation between the BMI reduction and adiponectin levels. Conclusions: The study evaluating effects of BMI reduction due to anthracycline chemotherapy on adiponectin showed that antracycline therapy do not have any effect on adiponectin levels. These findings suggest that adiponectin may be useful marker of anthracycline cardiomyopathy. Thursday, 1 March 2012
15:00–16:30
New Strategies in Coronary Bypass Surgery OP-082 THE FOUNDATION, DEVELOPMENT AND THE LATEST SITUATION OF THE CARDIOVASCULAR SURGERY IN TURKISH REPUBLIC OF NORTHERN CYPRUS M. Arikbuka, O. Emiroglu, H. Birtan, R. Kamiloglu. Cardiovascular Surgery Department, Nicosia State Hosapital, Nicosia, Turkish Republic of Northern Cyprus Objective: Our aim is to explain the foundation of the Cardiovascular Surgery (CVS) in Turkish Republic of Northern Cyprus (TRNC); the act of being freed from the addiction to abroud in the treatment of cardiovascular disease; the effects of these on the economy of the country and the psychology of the citizens. Methods: The avarage population of TRNC is 350,000. Before the foundation of the CVS clinic in the Nicosia State Hospital (NSH), the annual number of patients that have been sent abroud for CVS operations was about 300. After the foundation of catheter and angiography labaratory in 1996, the first diagnostic coronary angiography was done. The CVS operation hall and intensive care unit first opended on 24.04.2006 and the first coronary artery bypass grafting (CABG) operation performed on 22.06.2007. Results: In 2011, we performed 144 cardiac operations in CVS clinic, in NSH. We have performed izolated CABG operations in 110 patients. 22 cases of them were done with off pump, beating heart technique. 4 patients had CABG with concommitant valve surgery. 4 patients had izolated aortic valve replacement (AVR), 5 patients had izolated mitral valve replacement (MVR), 4 patients had multiple valve surgery. 3 patients had atrial septal defect repair and one patient had Bental prosedure. 8 patients had carotid endarterectomy and patch plasty operation.9 patients had endovascular aortic repair (EVAR) for abdominal aortic aneurysms, 1 patient had TEVAR for type B aortic dissection. One patient had carotid artery stenting (CAS) prosedure for carotid stenosis. The total number of cardiac operations that have been done, form June2007 till the end of 2011 reached 405. Our mortality in the cardiac operations in the 2011 is 4. That is the same as the CVS standards of the world. The avarage cost for an open heart surgery in TRNC is 5000 TL. Whereas it was about 20000 TL before when the patients sent abroud for CVS. Conclusions: The developments in the CVS, has provided the medical treatments of the people of the TRNC, for the cardiovascular disease available throughout 24 hours. This has solved the problem of the addiction to abroud in the treatment of CV diseases. This made the trust of the people to the Ministery of Health and the NSH, increase. The good job of CVS in NSH, also made a big contribution to the economic state of the island which is in a poor condition.
OP-083 GIANT THYMOMA AND CORONARY ARTERY BY PASS: CASE REPORT O. Bozoglan, B. Mese, E. Eroglu, M. Ari, S. Elveren, I. Yildirimdemir. Department of Cardiovasculer Surgery, Sutcu Imam University, Kahramanmaras, Turkey Objective: Although, tymomas are encapsulated and well differantiated; they may cause local invasion, pleural and extrathoracic metastasis. There is no consensus about the pathophysiology and management of tymomas. Methods: A 78 years man applied to clinic with dispnea. The chest x-ray showed a mass in mediastinum and left thorax. Thorax CT showed heterogenous structured giant solid mass which contains central hypodens areas and fills the left anterior hemithorax, beginning from the left anterior part of the mediastinum at the level of arcus aorta extending to cardiac apex approximately 12 cm; also the lung volume was decreased. As a result the pre-diagnosis was tymoma. In MRI, there was 180*155*120 mm sized solid tumoral mass, and on T1A sections it was isointense and in T2A sections it was isointense and central part was hyperintense. He was a smoker for 30 years. Past medical history included operation for BPH 15 years ago, and for inguinal hernia 5 years ago. Physical examination was normal except declining of respiratory sounds on left lung. We discovered type AB and type B tymoma in mediastinal biopsy. Because of the risk factors for coronary artery disease and symptoms, a coronary angiogram was performed. There was a long 70% stenosis on LAD proximal, CX and RCA was normal. We decided to elective tymectomy and coronary by-pass surgery. The mass was totally excised after ascending aorta cannulation at general anesthesia via median sternotomy. Following dual-stage venous cannulation, Ao-LAD safenous by-pass was performed under cross clemp. Results: He was discharged post-operative 8. Day without any problem. Conclusions: The possibility of encountering with mediastinal tumors in coronary artery surgery increases with age. In our opinion, performing complete resection for these cases are so important for long-term survey. According to our knowledge, this the first case in literature which diagnosed incidentally by telecardiogram and operated simultaneously for coronary artery and tymoma. Thursday, 1 March 2012
17:00–18:30
New Treatment Options in Peripheral Arterial Diseases OP-098 VASORELAXANT EFFECTS OF DOBUTAMIN AND LEVOSIMENDAN ON RAT THORACIC AORTA RINGS E. Dogan1 , R.O. Peker1 , O. Gokalp2 , S. Donmez3 . 1 Suleyman Demirel University, Medical Faculty, Cardiovascular Surgery Department, Isparta, Turkey; 2 Dicle University, Medical Faculty, Clinical Pharmacology Department, Diyarbakir, Turkey; 3 Nevsehir University, Faculty of Science, Chemistry Department, Nevsehir, Turkey Objective: In this experimental study the vasorelaxant effects of levosimendan and dobutamin is evaluate on isolated rat thoracic aorta and in organ bath. Methods: Sixteen Wistar Albino male rats were used. The thoracic aorta’s was removed carefully and they were transferred to petri dishes containing Krebs solution. Aortic rings of approximately 5 mm in length were prepared and placed in organ bath. Vessel isometric tension was recorded with the help of force transducers. The rings pre-contracted with phenylephrine. To the 8 aortic rings cumulative doses (10–8M-10–4M) of levosimendan, to the other 8 aortic rings cumulative doses (10–8M-10–3M) of dobutamine was performed. Dose-response curves of rat thorasic rings, were recorded by computer program ProtoWin v1.0. EC50 values were calculated with computer program Graph Pad Prisim 4.0. Statistical
Oral Presentations / International Journal of Cardiology 155S1 (2012) S1–S89
Results: All patients were completed the follow-up. None of the patients were exhibited clinical, echocardiographic and biochemical evidences of cardiotoxicity. (Table) Body mass index (BMI) values were decreased significantly. However there was no significant correlation between the BMI reduction and adiponectin levels. Conclusions: The study evaluating effects of BMI reduction due to anthracycline chemotherapy on adiponectin showed that antracycline therapy do not have any effect on adiponectin levels. These findings suggest that adiponectin may be useful marker of anthracycline cardiomyopathy. Thursday, 1 March 2012
15:00–16:30
New Strategies in Coronary Bypass Surgery OP-082 THE FOUNDATION, DEVELOPMENT AND THE LATEST SITUATION OF THE CARDIOVASCULAR SURGERY IN TURKISH REPUBLIC OF NORTHERN CYPRUS M. Arikbuka, O. Emiroglu, H. Birtan, R. Kamiloglu. Cardiovascular Surgery Department, Nicosia State Hosapital, Nicosia, Turkish Republic of Northern Cyprus Objective: Our aim is to explain the foundation of the Cardiovascular Surgery (CVS) in Turkish Republic of Northern Cyprus (TRNC); the act of being freed from the addiction to abroud in the treatment of cardiovascular disease; the effects of these on the economy of the country and the psychology of the citizens. Methods: The avarage population of TRNC is 350,000. Before the foundation of the CVS clinic in the Nicosia State Hospital (NSH), the annual number of patients that have been sent abroud for CVS operations was about 300. After the foundation of catheter and angiography labaratory in 1996, the first diagnostic coronary angiography was done. The CVS operation hall and intensive care unit first opended on 24.04.2006 and the first coronary artery bypass grafting (CABG) operation performed on 22.06.2007. Results: In 2011, we performed 144 cardiac operations in CVS clinic, in NSH. We have performed izolated CABG operations in 110 patients. 22 cases of them were done with off pump, beating heart technique. 4 patients had CABG with concommitant valve surgery. 4 patients had izolated aortic valve replacement (AVR), 5 patients had izolated mitral valve replacement (MVR), 4 patients had multiple valve surgery. 3 patients had atrial septal defect repair and one patient had Bental prosedure. 8 patients had carotid endarterectomy and patch plasty operation.9 patients had endovascular aortic repair (EVAR) for abdominal aortic aneurysms, 1 patient had TEVAR for type B aortic dissection. One patient had carotid artery stenting (CAS) prosedure for carotid stenosis. The total number of cardiac operations that have been done, form June2007 till the end of 2011 reached 405. Our mortality in the cardiac operations in the 2011 is 4. That is the same as the CVS standards of the world. The avarage cost for an open heart surgery in TRNC is 5000 TL. Whereas it was about 20000 TL before when the patients sent abroud for CVS. Conclusions: The developments in the CVS, has provided the medical treatments of the people of the TRNC, for the cardiovascular disease available throughout 24 hours. This has solved the problem of the addiction to abroud in the treatment of CV diseases. This made the trust of the people to the Ministery of Health and the NSH, increase. The good job of CVS in NSH, also made a big contribution to the economic state of the island which is in a poor condition.
OP-083 GIANT THYMOMA AND CORONARY ARTERY BY PASS: CASE REPORT O. Bozoglan, B. Mese, E. Eroglu, M. Ari, S. Elveren, I. Yildirimdemir. Department of Cardiovasculer Surgery, Sutcu Imam University, Kahramanmaras, Turkey Objective: Although, tymomas are encapsulated and well differantiated; they may cause local invasion, pleural and extrathoracic metastasis. There is no consensus about the pathophysiology and management of tymomas. Methods: A 78 years man applied to clinic with dispnea. The chest x-ray showed a mass in mediastinum and left thorax. Thorax CT showed heterogenous structured giant solid mass which contains central hypodens areas and fills the left anterior hemithorax, beginning from the left anterior part of the mediastinum at the level of arcus aorta extending to cardiac apex approximately 12 cm; also the lung volume was decreased. As a result the pre-diagnosis was tymoma. In MRI, there was 180*155*120 mm sized solid tumoral mass, and on T1A sections it was isointense and in T2A sections it was isointense and central part was hyperintense. He was a smoker for 30 years. Past medical history included operation for BPH 15 years ago, and for inguinal hernia 5 years ago. Physical examination was normal except declining of respiratory sounds on left lung. We discovered type AB and type B tymoma in mediastinal biopsy. Because of the risk factors for coronary artery disease and symptoms, a coronary angiogram was performed. There was a long 70% stenosis on LAD proximal, CX and RCA was normal. We decided to elective tymectomy and coronary by-pass surgery. The mass was totally excised after ascending aorta cannulation at general anesthesia via median sternotomy. Following dual-stage venous cannulation, Ao-LAD safenous by-pass was performed under cross clemp. Results: He was discharged post-operative 8. Day without any problem. Conclusions: The possibility of encountering with mediastinal tumors in coronary artery surgery increases with age. In our opinion, performing complete resection for these cases are so important for long-term survey. According to our knowledge, this the first case in literature which diagnosed incidentally by telecardiogram and operated simultaneously for coronary artery and tymoma. Thursday, 1 March 2012
17:00–18:30
New Treatment Options in Peripheral Arterial Diseases OP-098 VASORELAXANT EFFECTS OF DOBUTAMIN AND LEVOSIMENDAN ON RAT THORACIC AORTA RINGS E. Dogan1 , R.O. Peker1 , O. Gokalp2 , S. Donmez3 . 1 Suleyman Demirel University, Medical Faculty, Cardiovascular Surgery Department, Isparta, Turkey; 2 Dicle University, Medical Faculty, Clinical Pharmacology Department, Diyarbakir, Turkey; 3 Nevsehir University, Faculty of Science, Chemistry Department, Nevsehir, Turkey Objective: In this experimental study the vasorelaxant effects of levosimendan and dobutamin is evaluate on isolated rat thoracic aorta and in organ bath. Methods: Sixteen Wistar Albino male rats were used. The thoracic aorta’s was removed carefully and they were transferred to petri dishes containing Krebs solution. Aortic rings of approximately 5 mm in length were prepared and placed in organ bath. Vessel isometric tension was recorded with the help of force transducers. The rings pre-contracted with phenylephrine. To the 8 aortic rings cumulative doses (10–8M-10–4M) of levosimendan, to the other 8 aortic rings cumulative doses (10–8M-10–3M) of dobutamine was performed. Dose-response curves of rat thorasic rings, were recorded by computer program ProtoWin v1.0. EC50 values were calculated with computer program Graph Pad Prisim 4.0. Statistical