Turkiye Yuksek Ihtisas Hospital

Ankara, Turkey

Turkiye Yuksek Ihtisas Hospital

Ankara, Turkey
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Karacan A.,Turkiye Yuksek Ihtisas Hospital | Turkvatan A.,Turkiye Yuksek Ihtisas Hospital | Karacan K.,Cumhuriyet University
Cardiology in the Young | Year: 2014

Purpose: The aim of this study was to investigate the frequency and gender distribution of variations in the aortic arch branching pattern using 64-slice computed tomograhic angiography. Materials and methods: A total of 1000 patients with a normal left-sided aortic arch who underwent computed tomographic angiography for various reasons were analysed retrospectively for the frequency of variation of aortic arch branching; the variations were categorised into seven types. Results: Of the 1000 patients, 79.2% had a normal aortic arch branching pattern - type 1 - and 20.8% had variations. The frequency of type 2 variation - brachiocephalic and left common carotid arteries arising from the aortic arch in a common trunk - was 14.1%, that of type 3 - left vertebral artery originating from the aortic arch - was 4.1%, that of type 4 - coexistence of type 2 and type 3 - was 1.2%, that of type 5 - aberrant right subclavian artery - was 0.6%, that of type 6 - coexistence of aberrant right subclavian artery and bicarotid trunk - was 0.7%, and that for type 7 - thyroidea ima artery arising from the aortic arch - was 0.1%. The incidences of the variations of aortic arch branching were similar among males and females (20% versus 22.1%). The incidence of an aberrant right subclavian artery - type 5 and type 6 - was higher among females compared with males (2.5% versus 0.5), whereas the frequencies of the other variations were either equal or similar in both genders. Conclusion: Recognition of variations of aortic arch branching is important because they may cause symptoms due to tracheoesophageal compression or complications during surgical or endovascular interventional procedures of the aorta and its branches. © Cambridge University Press 2013.


Turkvatan A.,Turkiye Yuksek Ihtisas Hospital | Erden A.,Ankara University | Turkoglu M.A.,Dumlupinar University | Yener O.,Turkiye Yuksek Ihtisas Hospital
Korean Journal of Radiology | Year: 2013

Though congenital anomalies of the pancreas and pancreatic duct are relatively uncommon and they are often discovered as an incidental finding in asymptomatic patients, some of these anomalies may lead to various clinical symptoms such as recurrent abdominal pain, nausea and vomiting. Recognition of these anomalies is important because these anomalies may be a surgically correctable cause of recurrent pancreatitis or the cause of gastric outlet obstruction. An awareness of these anomalies may help in surgical planning and prevent inadvertent ductal injury. The purpose of this article is to review normal pancreatic embryology, the appearance of ductal anatomic variants and developmental anomalies of the pancreas, with emphasis on magnetic resonance cholangiopancreaticography and multidetector computed tomography.


Ozbulbul N.I.,Turkiye Yuksek Ihtisas Hospital
Diagnostic and Interventional Radiology | Year: 2010

Urachal remnant disease is a relatively rare urological condition that presents a variety of clinical problems in adult patients. Contrast-enhanced multi-detector row computed tomography (MDCT) urography is a new diagnostic imaging technique providing comprehensive evaluation of the upper and lower urinary tract. MDCT urography performed with a combination of unenhanced, nephrographic phase, and excretory-phase imaging can demonstrate a wide spectrum of disease in these patients with a single study. We report a case of vesicourachal diverticulum containing calculus, which was diagnosed by MDCT urography. © Turkish Society of Radiology 2010.


Yurdakul M.,Turkiye Yuksek Ihtisas Hospital | Tola M.,Turkiye Yuksek Ihtisas Hospital
Journal of Ultrasound in Medicine | Year: 2011

Objectives-The proximal segment of the vertebral artery is a frequent site of obstructive atherosclerosis. The purpose of this study was to determine Doppler criteria for identifying proximal vertebral artery stenosis of 50% or more by comparison with digital subtraction angiography. Methods-Forty-eight patients with vertebral artery stenosis were examined prospectively with color Doppler sonography and digital subtraction angiography. The peak systolic velocity (PSV), end-diastolic velocity (EDV), peak systolic velocity ratio (PSVr), and end-diastolic velocity ratio (EDVr) were evaluated by receiver operating characteristic curve analysis for their ability to detect vertebral artery stenosis of 50% or more. The optimal criteria for identifying proximal vertebral artery stenosis of 50% or more were determined. Results-For identifying vertebral artery stenosis, the parameter with the highest accuracy was the PSVr (area under the receiver operating characteristic curve, 0.967 [95% confidence interval, 0.899-0.994]). A PSVr of greater than 2.2 was found to be the optimal criterion for identifying proximal vertebral artery stenosis of 50% or more, with sensitivity and specificity of 96% and 89%, respectively. The optimal thresholds for the other Doppler parameters in identifying proximal vertebral artery stenosis of 50% or more were as follows: PSV, greater than 108 cm/s; EDV, greater than 36 cm/s; and EDVr, greater than 1.7. Conclusions-Color Doppler sonography is an accurate method for identifying proximal vertebral artery stenosis. The PSVr is superior to other Doppler parameters for detecting vertebral artery stenosis. © 2011 by the American Institute of Ultrasound in Medicine.


Yuce G.,Turkiye Yuksek Ihtisas Hospital | Turkvatan A.,Turkiye Yuksek Ihtisas Hospital | Yener T.,Turkiye Yuksek Ihtisas Hospital
Journal of Cardiology | Year: 2015

Purpose: To investigate whether aortic atherosclerosis or epicardial adipose tissue (EAT) volume on multidetector computed tomography (CT) can predict the presence of significant coronary artery disease (CAD). Materials and methods: Coronary CT angiography was performed in 202 cases of CAD that were known or based on suspicion. Based on coronary CT angiography results, the patients with significant stenosis (≥50%) and without significant stenosis (<50%) were compared in terms of demographic characteristics, traditional cardiovascular risk factors, aortic atherosclerosis, and EAT volume. Results: Significant coronary artery stenosis was detected in 92 cases (45.5%). Although EAT volume was higher in the patients with significant stenosis, the difference between the two groups was not statistically significant. The presence of calcification in the descending aorta was significantly higher in the patients with significant stenosis than the patients without significant stenosis (50.4% and 15.4%, respectively, p=. 0.0001). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy rates of the presence of calcification in the descending aorta in predicting the presence of significant coronary artery stenosis were respectively found as 53.8%, 84.4%, 74.6%, 68.1%, and 70.3%. The sensitivity, specificity, PPV, NPV, and accuracy rates of the ≥2.45. mm wall thickness of the descending aorta in predicting the presence of significant coronary artery stenosis were respectively found as 75.3%, 74.3%, 71.4%, 77.9%, and 74.8%. Conclusion: There is a strong relationship between thoracic aortic atherosclerosis and CAD. However, the relationship between EAT volume and CAD is not significant. The presence of aortic atherosclerosis can be used as an additional marker together with traditional cardiovascular risk factors for predicting CAD. © 2014 Japanese College of Cardiology.


Cagli K.,Turkiye Yuksek Ihtisas Hospital
Annals of Thoracic Surgery | Year: 2010

Artificial chordal replacement with expanded polytetrafluoroethylene is an established technique for mitral valve repair. This report describes a simple technique of using Hegar dilators for making premeasured artificial chordal loops, whether as a single set of loops or as two connected sets of loops arising from the same stem. This technique uses a simple and widely available tool, the Hegar dilator, for preparation of chordal loops and further establishes the repair of opposing two segments of mitral valve by securing only one stem of the neochordae to the papillary muscle. © 2010 The Society of Thoracic Surgeons.


Tasoglu I.,Turkiye Yuksek Ihtisas Hospital | Lafci G.,Turkiye Yuksek Ihtisas Hospital
Texas Heart Institute Journal | Year: 2012

Herein, we describe a plate-fixation technique as an alternative method to close a fragile or fractured sternum. A 69-year-old obese woman with diabetes mellitus and chronic obstructive pulmonary disease underwent coronary artery bypass grafting. One week postoperatively, sternal instability was detected, and traditional rewiring was performed. A week later, because of multiple sternal fractures, we performed sternal resection, with use of longitudinally affixed titanium plates and figure-8 steel wires for the anterior chest wall. The procedure was uneventful, and, on short-term follow-up, the anterior chest wall was stable. This longitudinal plate-fixation technique can be tailored to each patient. We think that the technique is safe, effective, economical, and easy to implement, and it is readily reproducible. To evaluate any associated risks, long-term follow-up in additional patients is warranted. © 2012 by the Texas Heart® Institute, Houston.


Ozbulbul N.I.,Turkiye Yuksek Ihtisas Hospital
Diagnostic and Interventional Radiology | Year: 2011

A knowledge of normal anatomy as well as the most frequent variants and abnormalities of the portal venous system are of great importance for liver surgery and interventional procedures. An understanding of the varied MDCT appearances of these abnormalities will allow more definitive diagnoses and help avoid false diagnoses. © Turkish Society of Radiology 2011.


Buyukterzi M.,Turkiye Yuksek Ihtisas Hospital | Turkvatan A.,Turkiye Yuksek Ihtisas Hospital | Buyukterzi Z.,Turkiye Yuksek Ihtisas Hospital
Diagnostic and Interventional Radiology | Year: 2013

PURPOSE We aimed to evaluate the frequency and extent of coronary atherosclerotic plaques in patients with a coronary artery calcium (CAC) score of zero and establish the demographic characteristics and the cardiovascular risk factors that affect the formation of atheromatous plaques. MATERIALS AND METHODS Coronary computed tomography (CT) angiography was performed in 288 cases with a CAC score of zero. The plaques that were detected using coronary CT angiography were categorized into two groups: nonsignificant (<50%) and significant (≥50%). Based on the coronary CT angiography results, the patients who had plaque and those who did not have plaque were compared in terms of the demographic characteristics and the presence of cardiovascular risk factors. RESULTS Noncalcified plaques were detected in 50 cases (17.4%) on CT angiography, of which six cases (2.1%) had significant stenosis. The plaques were localized most frequently (38.2%) in the proximal left anterior descending artery. When all the plaques considered 50% of the plaques were localized in the proximal segments, 42.7% were in the mid-segments, and 7.3% were in the distal segments. Hypertension was a significant risk factor for coronary artery disease in both genders, and smoking was a significant risk factor in females. Additionally, diabetes mellitus was a borderline significant risk factor in both genders. CONCLUSION In patients with a CAC score of zero, the frequency of noncalcified plaques is too high to be ignored. The distribution of these plaques in the coronary artery is similar to calcified plaque localizations. Patients who have a CAC score of zero and cardiovascular risk factors need to be evaluated with additional tests for the detection of noncalcified plaques. © Turkish Society of Radiology 2013.


Ozbulbul N.I.,Turkiye Yuksek Ihtisas Hospital
Diagnostic and Interventional Radiology | Year: 2011

Celiac trunk variants and pathologies are relatively common occurrences. With the advent of computed tomography (CT) technology, these conditions are being diagnosed with an increased frequency even among asymptomatic patients. CT angiography is used noninvasively for preoperative staging and vascular mapping in patients with pancreatic and hepatobiliary neoplasm. Multidetector-row CT (MDCT) also allows the accurate depiction of the abdominal splanchnic vessels for stenosis, collateral vessels and atherosclerotic plaques. In this study, we describe the normal anatomy and variants of the celiac trunk as well as associated pathologic conditions, such as stenosis, occlusion, aneurysm and median arcuate ligament compression syndrome. The overall aim of this study was to emphasize the clinical importance of these abnormalities. © Turkish Society of Radiology 2011.

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