In the Department of Cardiovascular Surgery of our hospital, coronary bypass surgeries, heart valve surgeries, aortic vessel surgeries, carotid surgeries, arm and leg vascular surgeries, varicose surgeries and arteriovenous fistula operations are successfully performed by the team under the direction of Dr.Turan Ege.
Cardiac surgeries in our clinic are performed using a heart-lung machine (by stopping the heart) or without (without stopping the heart). In the selection of these surgeries, the decision is made by considering the current disease and the general condition of the patient.
CORONARY BYPASS SURGERY
Coronary arteries are vessels that meet the blood needs of the heart muscle. Chest pain occurs because the heart muscle cannot be fed sufficiently as a result of narrowing or blockage of these vessels. As a result of complete blockage of the vessel, the heart muscle cannot be fed and the clinical picture defined as heart attacks occurs.
Purpose in coronary bypass surgery; It is to provide blood to the coronary arteries that do not get enough blood as a result of narrowing or obstruction by feeding blood in different ways. In this way, it is aimed to improve the patient's life span and quality of life.
All of the current coronary bypass operation techniques are applied in our hospital. The duration of the operation varies depending on the number of bypass grafts to be performed, but it takes an average of 3-4 hours. After the operation, the patients are transferred to the intensive care unit and followed up here. Patients who do not have any problems during their follow-up in the intensive care unit are taken to the ward and discharged after several days of follow-up in the ward.
In coronary bypass surgeries, the patient's chest vein (IMA), arm vein (Radial artery) and leg veins (Saphenous vein) are routinely used. Bypass operations applied in our clinic;
-Traditional coronary artery bypass surgery
-Coronary artery bypass surgery (OPCAB) in beating heart
-Minimally invasive coronary bypass surgery (MIDCAB)
CARDIAC VALVE SURGERY
There are four caps on the heart. These are mitral, aortic, tricuspid and pulmonary valves. These caps allow one-way flow of blood. In cases of stenosis or insufficiency, blood flow is disturbed. In stenosis (stenosis), the blood cannot flow far enough forward as the valve opening narrows. In the case of insufficiency, the blood should go forward, while running backwards.
In valve diseases, the patient's own valve is tried to be repaired primarily. In cases where repair is insufficient, valve replacement is made. There are two types of artificial valves in the valve changes. These are biological valves and mechanical valves. Biological (Bioprosthetic) valves; are valves that are specially treated and taken from animals. It is preferred in special cases since the function of the valve starts to disappear after a while since its durability is low. It is used in young women who want to give birth or in patients who may have difficulties in using blood thinners.
Mechanical valves are specially designed valves made of metal. They are long lasting lids. It is widely used all over the world.
In our hospital, all valve surgeries are routinely performed. Radiofrequency ablation procedure, which is a special method in the same session, is also applied in rhythm disorders (Atrial fibrillation) that develop due to valve disease.
The aortic vein is the largest artery that progresses through the chest and abdominal cavity after exiting the heart. It gives the main branches that feed all organs and limbs in our body.
As the aortic wall weakens for different reasons, excessive enlargement may develop in certain areas. These enlargements are defined as aneurysms. Aneurysm rupture (burst) may develop when the aneurysm diameter increases above a certain level. For this reason, aneurysms must be treated without rupture.
Not all aneurysms need to be treated. In patients who do not reach the critical level of enlargement, first of all, risk factors causing enlargement should be controlled.
One of two treatment options is applied in patients where enlargement reaches a critical level. The first is the classical open surgical technique and the other is the closed endovascular treatment option.
Classical surgical treatment is a surgical treatment option that was used more frequently in the past. Currently, closed (endovascular) treatment option is preferred. This procedure is mostly done through small incisions from the inguen and with low risk. In patients where closed treatment cannot be applied, open surgery is performed.
CAROTID ARTERY SURGERY
The carotid arteries emerge from the aorta and run from both sides of the neck. They are the most important arteries in brain nutrition. Brain circulation can be significantly damaged as a result of the narrowing, blockage or parts broken from these arteries. The patient may have temporary or permanent paralysis. For this reason, stenosis should be treated before permanent paralysis occurs in the patient.
In treatment, one of the stent application and open surgical treatment options is applied. Due to the poor results of stent applications, surgical treatment is commonly applied. In our clinic, we apply surgical treatment to a relatively low risk. The average length of hospital stay after the operation is 2-3 days.
PERİPHERAL ARTERİAL DİSEASE AND CURRENT TREATMENT METHODS
The clinical picture resulting from the narrowing or blockage of the arteries feeding the arms and legs is defined as peripheral artery disease. Leg arteries are affected more than arm arteries. As a result of the narrowing or blockage in the arteries, when the patient walks, severe pain occurs in the thigh or calf muscles instead of the stenosis. When the patient, who cannot walk because of this pain, rests for 3-5 minutes and then walks the same distance, pain occurs. The important thing here is the walking distance at which pain occurs. The shorter this distance, the greater severity of the disease.
In these patients, walking distance is primarily evaluated. The level of congestion is determined as a result of the inspection. As an advanced examination, angiography is performed and the level of obstruction is determined, and the condition of the vessels after obstruction is evaluated. Treatment is planned according to the results of the findings. In treatment, one or more medical treatment, angioplasty, stent, atherectomy or open surgical treatment options are applied. All of these applications are carried out in our hospital.
VARICOSITY AND CURRENT TREATMENT
Venous are the veins that carry dirty blood from the body to the heart. In the venous on the legs, calf muscles play an important role as well as vascular structure. As the age progresses, as a result of the deterioration and relaxation in the vascular structure, it may occur as swelling in the leg, tingling, cramping, restless leg, the appearance of capillaries or large veins, thickening of the skin, brown color changes and finally wounds.
There is a varicose vein treatment unit in the cardiovascular surgery department of our hospital. Here, patients are examined in detail, and also evaluated by Doppler Ultrasonography. According to the data obtained, it is treated with one or more of the following treatment options. With medical treatment, complaints are reduced.
Dermal laser, thermocoagulation, sclerotherapy, foam therapy are applied for capillary varices. For larger varicose veins, treatment is done with radiofrequency, laser, foam or adhesive. After these treatment applications, the patient can return to his home and work on the same day. In very special cases, we apply classical surgical treatment.
In the treatment of varicose veins, the patient's complaints and findings are prioritized. If there is no significant deterioration in the veins, if the patient's complaints will not improve with the intervention, it will be a better decision not to interfere with these vessels.
Therefore, treatment of varicose veins should be done by a specialist who can evaluate all stages of the disease.
Sclerotherapy is an important method used in the treatment of varicose veins. Here, the drug is applied directly or foamed with an injector into small vessels. Which method is applied is determined by the patient. An elastic bandage is applied for three days after the procedure and the patient is recommended to wear varicose socks.
Since this method does not require anesthesia, it is a very comfortable and painless procedure for the patient. After the procedure, the patient can return to his normal life, there is no need for any restrictions.
Small brown spots may appear on the areas where the procedure is applied. These will pass greatly after 4-6 weeks. Since these color changes can become more evident in the summer, foam treatment is not preferred especially in the summer season.
LYMPHEDEM and CURRENT TREATMENT
The lymphatic system is the structures that carry the fluids accumulated in the tissues back into circulation. Any narrowing or blockage in the lymphatic pathways can lead to severe swelling, especially in the arms and legs. This may be congenital or related to subsequent damage. It is seen as unilateral or bilateral swellings. In the treatment, drug therapy, lymph drainage massage and high pressure compression therapy should be applied to open the lymph ducts.