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Yildiz M.,Kartal Kosuyolu Heart Training and Research Hospital | Gokdeniz T.,Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital | Aykan A.,Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital
Current Cardiology Reviews | Year: 2015

Atrial flutter (AFL) is a common arrhythmia which may decrease cardiac output and may cause embolic events. Direct current (DC) cardioversion, medical cardioversion and radiofrequency (RF) ablation are therapeutic options, but over all RF ablation therapy has the longest event free period. Although development of AFL after myocardial infarction is quite common it may spontaneously recover or results in atrial fibrillation. Herein we report a patient with medical and electrical cardiovercardioversion resistant AFL which developed in the early post-myocardial infarction period causing hemodynamic instability, who was successfully treated with RF catheter ablation © 2015 Bentham Science Publishers.

Yilmaz M.,Istanbul University | Sunar H.,Kartal Kosuyolu Heart Training and Research Hospital | Mert A.,Istanbul University
Infection | Year: 2013

We present a case of community-acquired left-sided Pseudomonas aeruginosa endocarditis in a person without intravenous drug use. The patient presented with facial numbness and did not have any predisposing condition for endocarditis. He was treated successfully with valvular surgery, along with combination antibiotics. © 2012 Springer-Verlag.

Yildiz M.,Kartal Kosuyolu Heart Training and Research Hospital | Aykan A.C.,Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital | Karakoyun S.,Kartal Kosuyolu Heart Training and Research Hospital | Gokdeniz T.,Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital | And 3 more authors.
Postepy w Kardiologii Interwencyjnej | Year: 2013

Introduction: Atherosclerotic renal artery stenosis (ARAS) is associated with uncontrolled hypertension and chronic renal failure. Aim: To evaluate the influence of gender and presence of chronic renal failure on the outcomes of percutaneous transluminal renal artery stenting (PTRAS) due to atherosclerosis. Material and methods: A total of 28 ARAS patients underwent PTRAS and 36 stents were placed. Basal characteristics, laboratory data and blood pressure of patients were recorded. The differences between genders and improvement/ deterioration of renal functions and blood pressure were analyzed. The predictors of outcomes were determined. Results: Baseline characteristics were similar between men and women. Significant improvement of systolic and diastolic blood pressure control was achieved after PTRAS (153.04 ±17.07 mm Hg vs. 124.75 ±11.40 mm Hg, p = 0.001 and 92.50 ±10.76 mm Hg vs. 77.54 ±8.23 mm Hg, p < 0.001, respectively). Although mean estimated glomerular filtration rate (eGFR) and creatinine levels did not significantly improve at the 6-month follow-up visit compared to baseline values, of the 28 patients 13 (46.4%) patients had improvement of renal functions. Conclusions: Our results suggest that PTRAS is a safe procedure and may offer blood pressure control but beneficial effects of PTRAS on renal function may be anticipated in a selected group of patients, especially those with a low eGFR.

Oduncu V.,Medical Park Fatih Hospital | Erkol A.,Kocaeli Derince Training and Research Hospital | Tanalp A.C.,Medicana International Hospital | Kirma C.,Kartal Kosuyolu Heart Training and Research Hospital | And 5 more authors.
Turk Kardiyoloji Dernegi Arsivi | Year: 2013

Objectives: We aimed to compare the efficacy of primary percutaneous coronary intervention (p-PCI) in patients ≥80 versus <80 years of age with ST-segment elevation myocardial infarction (STEMI). Study design: We retrospectively enrolled 2213 patients with acute STEMI. The patients were prospectively followed up for a median of 42 months. Early and late clinical outcomes were compared according to age. Results: One-hundred and seventy-nine (8.1%) of the 2213 patients were aged ≥80 years. Post-procedural TIMI grade 3 flow was significantly less frequent in the age ≥80 years patients (82.1% vs. 91.1%, p<0.001). Rates of mortality (14.5% vs. 3.4%, p<0.001), heart failure (20.7% vs. 10.5%, p<0.001), major hemorrhage (9.5% vs. 3.3%, p<0.001), secondary VT/VF (10.1% vs. 4.2%, p=0.002) and atrial fibrillation (12.8% vs. 4.3%, p<0.001) during the early hospitalization period were significantly higher in the age ≥80 years patient group. Overall rates of mortality (40% vs. 9.7%, p<0.001) and total stroke (5.6% vs. 1.1%, p=0.005) at long-term follow-up were also higher in the age ≥80 years patient group. However, there was no difference between the two groups with respect to the reinfarction/revascularization rates. Analysis, using the Cox proportional hazards model, revealed that age ≥80 to was an independent predictor of long-term mortality (hazard ratio 2.17, 95% CI 1.23-4.17, p=0.02). Conclusion: Age is an independent predictor of mortality after p-PCI for STEMI. Although it seems to improve early outcomes, the efficacy of p-PCI at long-term follow-up is limited in elderly patients. © 2013 Turkish Society of Cardiology.

Cincin A.,Marmara University | Tigen K.,Marmara University | Karaahmet T.,Istanbul University | Dundar C.,Kartal Kosuyolu Heart Training and Research Hospital | And 4 more authors.
Anadolu Kardiyoloji Dergisi | Year: 2015

Objective: The aim of this study was to explore right ventricular (RV) mechanical function in patients with hypertrophic cardiomyopathy (HCM) by 2-D speckle tracking echocardiography (2-D-STE). Methods: Forty-three patients with HCM (mean age 48, 17 females) and 40 healthy subjects were consecutively included in this cross-sectional study. The diagnosis of HCM was based on the presence of typical clinical, electrocardiographic (ECG), and echocardiographic features. Patients with LV systolic impairment, significant valvular disease, history of coronary artery disease, hypertension, malignancy, and chronic obstructive pulmonary disease were excluded. Right and left ventricular (LV) function was assessed by tissue Doppler imaging (TDI) and 2-D-STE. Hypertrophic cardiomyopathy patients were divided into two groups according to ACC/ESC guidelines (LVOT gradient below and above 30 mm Hg). Student t-test was used to compare differences between groups. Non-parametric tests (Mann-Whitney U) were used in cases of abnormal distribution. Results: Hypertrophic cardiomyopathy patients had a significantly larger right atrium and RV diameters compared to controls. Mean pulmonary artery pressures (mPAB) were significantly higher in HCM patients (19.01±13.09 mm Hg vs. 8.40±4.50 mm Hg; p<0.001). Although RV Sm measurements were similar, RV strain measurements (-28.51±5.36% vs. -32.06±7.65%; p=0.016) were significantly lower in HCM patients. Left ventricular global longitudinal, radial, and circumferential strain values were also significantly different between the two groups (-20.50±3.58% vs. -24.12±3.40%; p<0.001, 38.18±12.67% vs. 44.80±10.15%; p=0.012, -21.94±4.28% vs. -23.91±3.95%; p=0.036 consecutively). Rotational movement of LV in each apical, mid-, and basal left ventricular segment was determined, and only mid-ventricular rotation of the HCM patients was more clockwise (-1.71±2.16° vs. 0.04±1.72°; p<0.001). Although mPAP measurements were higher in HCM patients with significant LVOT obstruction (21.52±13.26 mm Hg vs. 12.31±10.53 mm Hg; p=0.049), none of the other TDI or 2-D-STE parameters was significantly different between groups. Conclusion: Speckle tracking echocardiography-derived right ventricular systolic function is impaired in HCM patients when compared with healthy subjects. However, RV systolic function is not affected form LVOT obstruction and left ventricular rotation dynamics in HCM patients. © Copyright 2015 by Turkish Society of Cardiology.

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