Diyarbakir Military Medical Hospital

Diyarbakır, Turkey

Diyarbakir Military Medical Hospital

Diyarbakır, Turkey
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Tavlasoglu M.,Diyarbakir Military Medical Hospital | Kurkluoglu M.,Surgery Academy | Arslan Z.,Gulhane Military Medical Academy | Durukan A.B.,Medicana International Ankara Hospital
Interactive Cardiovascular and Thoracic Surgery | Year: 2012

Median sternotomy is the most common method of access to the heart and great vessels in cardiac surgical procedures. However, particularly in obese and diabetic patients, complications such as dehiscence, osteomyelitis, mediastinitis and superficial wound infection or fistula formation may be encountered. To overcome these complications, some alternative surgical techniques and surgical equipment are designed for sternal closure. 'Nitinol thermoreactive clips' is one of them. In this study, we report a patient with detachment of thermoreactive clips from sternum in the late postoperative period due to wrong measurement of distance between intercostal spaces. © The Author 2012.


Cingoz F.,Surgery Academy | Tavlasoglu M.,Diyarbakir Military Medical Hospital | Ali Sahin M.,Surgery Academy | Kurkluoglu M.,Childrens National Heart Institute
Interactive Cardiovascular and Thoracic Surgery | Year: 2012

Anticoagulation management of a patient complicated by heparin-induced thrombocytopenia is one of the challenging situations in open heart surgery. A 40-year old male receiving warfarin for anticoagulation was admitted to our clinic with a history of heparin-induced thrombocytopenia and a diagnosis of inferior caval thrombosis. He was scheduled for inferior vena cava thrombectomy via the inflow occlusion technique on the beating heart. Warfarin sodium was stopped three days prior to the operation while fondaparinux sodium was begun twice a day. The operation was successfully performed and no postoperative complications were observed. © 2012 The Author 2012. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.


Tavlasoglu M.,Diyarbakir Military Medical Hospital | Durukan A.B.,Memorial Hospital | Gurbuz H.A.,Memorial Hospital | Jahollari A.,Surgery Academy | Guler A.,Surgery Academy
European Journal of Cardio-thoracic Surgery | Year: 2014

OBJECTIVES: There is growing evidence that practice on simulation models can improve technical skills in surgery. The aim of this study is to assess the effects of our tissue-based simulation model of vascular anastomosis on skill acquisition. METHODS: Five junior (Group I) and five senior (Group III) cardiovascular surgery residents, and five surgeons from different surgical departments (Group II) attended the study. A total of 180 vascular anastomoses on a bovine heart simulation model were performed in a 3-month period; each group performed 20 anastomoses per month (each participant in each group conducted four anastomoses per month). The anastomoses were evaluated according to criteria including, duration of the procedure, existence of anastomotic leak, additional suture requirements, matching between graft diameter and arteriotomy length, patency rates and inadvertent posterior wall injuries. Each practice was recorded with a video camera and eventually reviewed by three cardiovascular surgeons, who were blinded to groups. Results were compared for analysing the skill acquisition process in each group. RESULTS: The mean anastomosis time (Group I: 22.25 ± 2.02, 18.10 ± 0.78, 15.00; Group II: 17.05 ± 1.39, 15.45 ± 0.82, 13.00 ± 0.79; Group III: 13.65 ± 0.67, 11.45 ± 1.14, 10.50 ± 1.10) and additional suture requirements (Group I: 1.95 ± 0.68, 1.30 ± 0.80, 1.00 ± 0.32; Group II: 1.80 ± 0.41, 1.45 ± 0.60, 1.45 ± 0.60; Group III: 0.65 ± 0.48, 0.40 ± 0.50, 0.40 ± 0.50) decreased gradually (P < 0.0001 for each) in all groups. There was statistically significant improvement over time in anastomotic leakage (Group I: 90, 65, 20%; Group II: 50, 25, 5%; Group III: 20, 25, 5%), match between the arteriotomy and the graft (Group I: 35, 25, 75%; Group II: 60, 45, 85%; Group III: 85, 65, 95%), posterior wall injury (Group I: 70, 50, 15%; Group II: 50, 30, 5%; Group III: 30, 30, 5%) and patency (Group I: 45, 15, 75%; Group II: 60, 50, 95%; Group III: 80, 85, 95%) in all groups, except for the occurrence of anastomotic leaks and patency rates in the senior cardiovascular resident group (Group III). CONCLUSIONS: Although the most significant improvement was observed in Group I, all groups demonstrated improved skills with the simulation model. Therefore, it can be suggested that anastomosis training on tissue-based simulation models may be beneficial for the skill acquisition process. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.


Tavlasoglu M.,Diyarbakir Military Medical Hospital | Durukan A.B.,Medicana International Ankara Hospital | Arslan Z.,Gulhane Military Medical Academy | Kurkluoglu M.,Childrens National Heart Institute | And 2 more authors.
Journal of Surgical Education | Year: 2013

Introduction: Increased patient awareness, duty-hour restrictions, escalating costs, and time constraints in the operating room have revolutionized surgical education. A bovine heart model was designed for training in mitral valve repair procedures. In this article, we aimed to share our experience with this model and to test the validity of simulation with respect to skill acquisition during the training course. Methods: After reviewing instructional video recordings of mitral valve repair techniques, 5 junior residents (first and second year) and 5 senior residents (year 4 or higher), who had no experience in mitral valve repair surgery previously, performed mitral valve repair techniques on bovine heart model in a three-month period. Nine different internet videos demonstrating surgical techniques were watched prior to performance in each case. Different text books were studied before the study course. Following repair in each case, the left ventricle of each bovine heart was statically pressurized, the coaptation depth was measured, and the regurgitation (if any) was scored. Each performance was recorded. At the end of the study, video records were evaluated in a blind fashion by 3 different surgeons experienced in mitral valve repair techniques. The monthly scores obtained were statistically analyzed. Results: The mean coaptation depth values measured on a monthly basis were as follows: 2.75±0.63, 4.90±0.91, and 6.55±0.88 for the junior residents and 4.30±0.65, 5.45±0.68, and 7.00±0.64 mm for the senior residents. Regurgitation scores noted were 2.20±0.52, 1.65±0.58, and 0.10±0.30 for the junior residents and 1.50±0.60, 0.65±0.67, and 0.70±0.65 for the senior residents During the study period, the practice improved in terms of the aforementioned parameters in both groups (p<0.05). Conclusions: This simulation model of mitral valve repair helped in skill acquisition on monthly basis in both resident groups. © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.


Guler A.,Surgery Academy | Tavlasoglu M.,Diyarbakir Military Medical Hospital | Arslan Z.,Gulhane Military Medical Academy | Yesil F.G.,Surgery Academy
Interactive Cardiovascular and Thoracic Surgery | Year: 2013

Elevated plasma homocysteine (Hcy) is one of the suggested risk factors for endothelial dysfunction. There is evidence of association between raised plasma Hcy and an increased risk of developing peripheral arterial disease. A causal relationship, however, has not been established. In this report, a 37-year old male patient with the complaints of intermittent hand pain is presented. Brachial artery aneurysm accompanying a homozygous methylenetetrahydrofolate reductase mutation was detected. © The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.


Guler A.,Surgery Academy | Tavlasoglu M.,Diyarbakir Military Medical Hospital | Kadana M.,Surgery Academy | Barcinc C.,Gulhane Military Medical Academy
European Journal of Cardio-thoracic Surgery | Year: 2013

Paravalvular leakage after mitral valve surgery is a rare complication. The cause is usually the rupture of sutures. Although it may be asymptomatic, serious haemodynamic changes, heart failure and even death may be observed. Surgical treatment modalities have considerable morbidity rates. Over the last few years, new treatment strategies for paravalvular leakage have been described and recommended, particularly in patients with high surgical risk. We present the successful mitral paravalvular leakage closure by an Amplatzer duct occluder using the transapical approach in this article. © The Author 2012. Published by Oxford University Press on behalf of the European Journal of Cardio-Thoracic Surgery. All rights reserved.


Cingoz F.,Surgery Academy | Tavlasoglu M.,Diyarbakir Military Medical Hospital | Kurkluoglu M.,Childrens National Heart Institute | Sahin M.A.,Surgery Academy
Interactive Cardiovascular and Thoracic Surgery | Year: 2012

A case of the Guillain-Barré syndrome occurring after otherwise uneventful cardiac surgery using cardiopulmonary bypass is presented. Though the Guillain-Barré syndrome has been reported after surgical procedures, there are very few case reports after cardiopulmonary bypass surgery in the literature. The exact pathophysiological cause of the syndrome is still unknown. However, the most widely accepted hypothesis is that the syndrome is the result of an immune-mediated process. Cardiac surgery may be a trigger for immune-mediated response. © 2012 The Author 2012. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.


Guler L.,Gazi University | Tavlasoglu M.,Diyarbakir Military Medical Hospital | Yucel O.,Surgery Academy | Guler A.,Surgery Academy | And 8 more authors.
Journal of Anesthesia | Year: 2014

Purpose: Taurine, the major intracellular free amino acid found in high concentrations in mammalian cells, is known to be an endogenous antioxidant and a membrane-stabilizing agent. It was hypothesized that taurine may be effective in reducing ischemia-reperfusion injury after lung transplantation and an experimental study was conducted in a rat model. Methods: The number of Sprague-Dawley rats used in the study was 35. Animals were randomized into five groups of 7 rats each, including control, donor I, donor II, ischemia-reperfusion injury, and treatment groups. All animals were exposed to the same experimental conditions in the preoperative period. Rats were fixed in a supine position after the induction. After the rats were shaved, a left pneumonectomy was performed following sternotomy in control, donor I, and donor II groups. The harvested grafts in donor I and donor II groups were transplanted to the rats of the ischemia-reperfusion group and treatment group, respectively. However, taurine was administered intraperitoneally for 3 days before the harvesting procedure in donor II. All harvested lungs were kept in a Euro-Collins solution at +4°C for 24 h in a half-inflated manner. After harvesting and transplantation, lungs were sampled for histopathological and biochemical analysis. Results: Malondialdehyde and superoxide dismutase, glutathione peroxidase, and catalase levels were lower in the treatment group than the other groups (p < 0.05). Histopathological findings were better in treatment group than the ischemia-reperfusion group (p < 0.05). Conclusion: It was demonstrated that donor treatment with taurine resulted in preservation of transplanted lung tissue in respect to histopathological and biochemical findings. © 2013 Japanese Society of Anesthesiologists.


Cingoz F.,Surgery Academy | Tavlasoglu M.,Diyarbakir Military Medical Hospital | Sahin M.A.,Surgery Academy | Kurkluoglu M.,Childrens National Heart Institute | And 3 more authors.
Asian Cardiovascular and Thoracic Annals | Year: 2013

Background:We aimed to highlight the use of a minimally invasive approach in uncomplicated congenital heart surgery. Patients and methods: We investigated retrospectively 32 children below 10 years of age who underwent elective closure of ostium secundum type (n = 27), sinus venosus type (n = 4) and ostium primum type (n = 1) atrial septal defects through a limited skin incision and partial lower sternotomy between August 2001 and December 2008. All patients had cannulation through the same incision for cardiopulmonary bypass. Results: A pericardial patch was used to close the defect in 8 patients and direct suturing in 24. The mean time from the skin incision to cannulation was 56±23 min. Total bypass time was 27±12 min, and crossclamp time was 15±8 min. Mean length of hospital stay was 4±2 days. We did not encounter any complications or mortality. Conclusions: A minimally invasive approach, consisting of a limited skin incision and partial lower sternotomy, is a safe, reliable, and cosmetically advantageous method in uncomplicated congenital heart disease surgery, which can be performed widely, and may replace the standard approach without increasing mortality and morbidity. © 2012 The Author(s).


PubMed | Diyarbakir Military Medical Hospital
Type: Journal Article | Journal: Journal of surgical education | Year: 2013

Increased patient awareness, duty-hour restrictions, escalating costs, and time constraints in the operating room have revolutionized surgical education. A bovine heart model was designed for training in mitral valve repair procedures. In this article, we aimed to share our experience with this model and to test the validity of simulation with respect to skill acquisition during the training course.After reviewing instructional video recordings of mitral valve repair techniques, 5 junior residents (first and second year) and 5 senior residents (year 4 or higher), who had no experience in mitral valve repair surgery previously, performed mitral valve repair techniques on bovine heart model in a three-month period. Nine different internet videos demonstrating surgical techniques were watched prior to performance in each case. Different text books were studied before the study course. Following repair in each case, the left ventricle of each bovine heart was statically pressurized, the coaptation depth was measured, and the regurgitation (if any) was scored. Each performance was recorded. At the end of the study, video records were evaluated in a blind fashion by 3 different surgeons experienced in mitral valve repair techniques. The monthly scores obtained were statistically analyzed.The mean coaptation depth values measured on a monthly basis were as follows: 2.750.63, 4.900.91, and 6.550.88 for the junior residents and 4.300.65, 5.450.68, and 7.000.64mm for the senior residents. Regurgitation scores noted were 2.200.52, 1.650.58, and 0.100.30 for the junior residents and 1.500.60, 0.650.67, and 0.700.65 for the senior residents During the study period, the practice improved in terms of the aforementioned parameters in both groups (p<0.05).This simulation model of mitral valve repair helped in skill acquisition on monthly basis in both resident groups.

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