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Kul S.,Bezmialem Foundation University | Uyarel H.,Bezmialem Foundation University | Gul M.,Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital | Kucukdagli O.T.,Bezmialem Foundation University | And 3 more authors.
Nutrition, Metabolism and Cardiovascular Diseases | Year: 2014

Background and aim: Metabolic syndrome (MS) is associated with cardiovascular mortality and morbidity in patients with acute coronary syndrome. The purpose of this study was to evaluate the impact of MS on long-term clinical outcomes in patients with pure non-ST segment myocardial infarction (NSTEMI) or unstable angina pectoris (USAP). Methods and results: We prospectively enrolled 310 consecutive NSTEMI/USAP patients (74 females; mean age, 59.3±11.9 years). The study population was divided into two groups: MS(+) and MS(-). The clinical outcomes of the patients were followed for up to 3 years.Increased 3-year cardiovascular mortality and reinfarction were observed in the MS(+) group, as compared to the MS(-) group (15 vs. 3.4%, p=0.001, and 22.2 vs. 8.3%, p=0.001, respectively). Hospitalization rates for heart failure and stroke were not significantly different between the two groups on follow-up. By a Cox multivariate analysis, a significant association was noted between MS and the adjusted risk of 3-year cardiovascular mortality (odds ratio 3.4, 95% confidence interval, 1.24-9.1, p=0.02). Conclusion: These results suggest that MS is associated with an increased risk of 3-year cardiovascular mortality and reinfarction in patients with NSTEMI/USAP. © 2013 Elsevier B.V.


Iyigun T.,Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital | Ciloglu U.,Dr Siyami Ersek Thoracic Cardiovascular Surgery Training And Research Hospital | Ariturk C.,Dr Siyami Ersek Thoracic Cardiovascular Surgery Training And Research Hospital | Civelek A.,Karadeniz Technical University | Tosun R.,International Hospital
Heart Surgery Forum | Year: 2010

A 17-year-old female patient with a history of surgery for primary femoral and metastatic lung osteosarcoma was admitted to our clinic with palpitations. Upon evaluation, a metastatic osteosarcoma in the left ventricle was diagnosed. Based on the collaborative decision of the oncology and cardiovascular surgery clinics, surgery was performed and the patient was discharged without any problems. According to the recommendation of the oncology clinic, chemotherapy was postponed for 6 months after surgery. Five months postoperatively, however, she had a recurrence with 2 tumors. Based on the collaborative decision, chemotherapy was initiated and in 2 months the size of the recurrent tumors had diminished. The patient is still under the care of the oncology and cardiovascular surgery clinics and continuing her chemotherapy regimen. Osteosarcomas have a high mortality. Metastatic tumors of the heart are not common. The location of the metastasis and the characteristics of the primary tumor determine the treatment modality. In some previously published reports, various treatment choices have been described. In the present case report, we present a rare case with metastatic cardiac osteosarcoma. © 2010 Forum Multimedia Publishing, LLC.


PubMed | Istanbul University, Mehmet Akif Ersoy Thoracic & Cardiovascular Surgery Training and Research Hospital and Dr Sadi Konuk Training and Research Hospital
Type: Journal Article | Journal: Angiology | Year: 2015

Several publications have pointed out the importance of coagulation and fibrinolysis in the occurrence of chronic urticaria (CU), but only a few indicated the direct role of platelets. We assessed platelet aggregation and evaluated parameters of coagulation and fibrinolysis in patients with CU. Patients (n = 34) diagnosed as having CU and 36 healthy controls were enrolled. Platelet aggregation was assayed using an impedance aggregometer and adenosine diphosphate, arachidonic acid, thrombin receptor-activating peptide (TRAP), and ristocetin as agonists. In patients with CU, significantly decreased platelet aggregation to some agonists (ristocetin and TRAP) was observed. The D-dimer levels were elevated, mean platelet volume was decreased, but no alteration was observed in other coagulation assays. Elevated D-dimer levels indicated that coagulation and fibrinolysis are activated in the patients with CU. Evaluation of platelet function may contribute to identify the role of these cells in the pathogenesis of CU.


Aksu H.U.,Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital | Uslu N.,Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital | Aslan M.,Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital | Gul M.,Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital | Aksu H.,Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital
Echocardiography | Year: 2012

We report an unusual case of moderate mitral regurgitation caused by abnormal insertion of chordae tendinea to the interatrial septum and tethering the middle scallop of the anterior mitral leaflet. This is an extremely rare congenital abnormality causing mitral regurgitation. (Echocardiography 2012;29:E87-E90) Accessory chordae on the left atrial site is extremely rare. We report a case of aberrantly inserted chordae tendinea causing moderate mitral regurgitation. © 2011, Wiley Periodicals, Inc.


Tasal A.,Bezmialem Foundation University | Erturk M.,Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital | Uyarel H.,Bezmialem Foundation University | Karakurt H.,Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital | And 6 more authors.
Journal of Cardiology | Year: 2014

Background: The aim of this study was to investigate the effect of a levosimendan infusion on hematological variables in patients with acute decompensated heart failure (ADHF). The predictive value of these variables for in-hospital mortality was also evaluated. Methods: A total of 553 patients (368 males; mean age, 63.4 ± 14.9 years) with acute exacerbations of advanced heart failure (ejection fraction ≤35%) and treated with either dobutamine or levosimendan were included in this retrospective analysis. The patients that received levosimendan therapy were divided into two groups according to in-hospital mortality: group 1 (21%) included patients who died during hospitalization (n= 45), while group 2 (79%) included patients with a favorable outcome (n= 174) after levosimendan infusion. Changes in several hematological variables between admission and the third day after levosimendan infusion were evaluated. Results: The demographic characteristics and risk factors of the two groups were similar. A comparison of changes in laboratory variables after the infusion of levosimendan revealed significant improvement only in those patients who had not died (group 2) during hospitalization. The neutrophil to lymphocyte (N/L) ratio after levosimendan infusion was an independent predictor of in-hospital mortality (odds ratio: 1.310, 95% CI: 1.158-1.483, p< 0.001). In a receiver-operating characteristic curve analysis, a value of 5.542 for the N/L ratio after levosimendan administration was identified as an effective cut-off point for predicting in-hospital mortality (area under the curve = 0.737; 95% confidence interval = 1100-1301; p< 0.001). Conclusions: Levosimendan treatment was associated with significant changes in hematological variables in patients with ADHF. A sustained higher N/L ratio after levosimendan infusion is associated with an increased risk of in-hospital mortality in patients with ADHF. © 2013 Japanese College of Cardiology.


PubMed | Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital
Type: Case Reports | Journal: The heart surgery forum | Year: 2010

A 17-year-old female patient with a history of surgery for primary femoral and metastatic lung osteosarcoma was admitted to our clinic with palpitations. Upon evaluation, a metastatic osteosarcoma in the left ventricle was diagnosed. Based on the collaborative decision of the oncology and cardiovascular surgery clinics, surgery was performed and the patient was discharged without any problems. According to the recommendation of the oncology clinic, chemotherapy was postponed for 6 months after surgery. Five months postoperatively, however, she had a recurrence with 2 tumors. Based on the collaborative decision, chemotherapy was initiated and in 2 months the size of the recurrent tumors had diminished. The patient is still under the care of the oncology and cardiovascular surgery clinics and continuing her chemotherapy regimen. Osteosarcomas have a high mortality. Metastatic tumors of the heart are not common. The location of the metastasis and the characteristics of the primary tumor determine the treatment modality. In some previously published reports, various treatment choices have been described. In the present case report, we present a rare case with metastatic cardiac osteosarcoma.


PubMed | Bezmialem Foundation University and Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital
Type: Journal Article | Journal: Journal of cardiology | Year: 2014

The aim of this study was to investigate the effect of a levosimendan infusion on hematological variables in patients with acute decompensated heart failure (ADHF). The predictive value of these variables for in-hospital mortality was also evaluated.A total of 553 patients (368 males; mean age, 63.4 14.9 years) with acute exacerbations of advanced heart failure (ejection fraction 35%) and treated with either dobutamine or levosimendan were included in this retrospective analysis. The patients that received levosimendan therapy were divided into two groups according to in-hospital mortality: group 1 (21%) included patients who died during hospitalization (n=45), while group 2 (79%) included patients with a favorable outcome (n=174) after levosimendan infusion. Changes in several hematological variables between admission and the third day after levosimendan infusion were evaluated.The demographic characteristics and risk factors of the two groups were similar. A comparison of changes in laboratory variables after the infusion of levosimendan revealed significant improvement only in those patients who had not died (group 2) during hospitalization. The neutrophil to lymphocyte (N/L) ratio after levosimendan infusion was an independent predictor of in-hospital mortality (odds ratio: 1.310, 95% CI: 1.158-1.483, p<0.001). In a receiver-operating characteristic curve analysis, a value of 5.542 for the N/L ratio after levosimendan administration was identified as an effective cut-off point for predicting in-hospital mortality (area under the curve=0.737; 95% confidence interval=1100-1301; p<0.001).Levosimendan treatment was associated with significant changes in hematological variables in patients with ADHF. A sustained higher N/L ratio after levosimendan infusion is associated with an increased risk of in-hospital mortality in patients with ADHF.

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