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  • Küçük Resim
    Öğe
    Association between bifurcation angle and coronary no-reflow following primary percutaneous coronary intervention in patients
    (TR- Dizin, 2021) Taşbulak, Ömer; Duran, Mustafa; Demir, Ali Rıza; Gülmez, Recep; Ertürk, Mehmet; Şahin, Ahmet Anıl
    Objective: Percutaneous coronary intervention (PCI) has become the treatment method for patients presenting with ST elevation myocardial infarction (STEMI). One of the well-known complications of PCI is no-reflow. Studies demonstrated a relationship between endothelial dysfunction and disturbed vascular flow due to angulation of vascular tree. Although the relationship between hemodynamic alterations and coronary angulation is evident, there is a lack of detailed analysis in terms of hemodynamic changes between vascular geometry and coronary no-reflow. We aimed to elucidate the relationship between vascular geometry and coronary no-reflow. Method: We reviewed PCI database of our hospital and enrolled a total of 120 patients with STEMI, who developed no-reflow following PCI, and sex and age matched 80 patients with normal flow. For each group, demographic and clinical characteristics, laboratory values and two dimensional quantitative coronary angiography measurements were evaluated. Results: Patients with no-reflow had a higher prevalence of hypertension and diabetes mellitus. In addition, serum C-reactive protein levels were higher in patients with no-reflow compared to patients with normal flow (p<0.001). On the other hand, serum hemoglobin levels were significantly lower in patients with no-reflow compared to patients with normal flow (p<0.001). With respect to 3 dimensional coronary measurements, calculated bifurcation angle of left anterior descending artery (LAD) and circumflex artery (CX) was significantly wider in the no-reflow group than in the control group [110.9° (21.8°) vs. 85.9° (15.8°), p<0.001]. Conclusion: Our data showed that a strong association existed between bifurcation angle of LAD-CX and no-reflow phenomenon in STEMI patients who underwent PCI.
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    Patients with intracardiac masses: 12-year observation from a tertiary referral hospital
    (BAYRAKOL MEDICAL PUBLISHER, 2021) Taşbulak, Ömer; Güler, Arda; Duran, Mustafa; Şahin, Ahmet Anıl; Uygur, Begüm; Bulut, Ümit
    Abstract Aim: Intracardiac masses are extremely rare and challenging to manage. Due to the rarity of the disease and the absence of data from large randomized clinical trials, recommendations for the diagnosis and management of intracardiac masses are still derived from expert opinion and observational cohort studies. In this study we aim to describe the epidemiological features, clinical characteristics, and prevalence of intracardiac masses. Material and Methods: The records of 133 patients aged >18 who underwent open surgery due to confirmed intracardiac masses were investigated retrospectively. Demographic and clinical characteristics of the patients, the indication for the procedure, and postoperative outcomes were retrospectively analyzed. For isolated intracardiac masses, the mass location, final histopathologic diagnosis, concomitant clinical conditions, and preferred surgical approach were analyzed. Results: The most common histopathologic diagnosis was atrial myxoma (n=62, 46.6%), followed by cardiac thrombus (n=33, 24.8%), and the most common location of the intracardiac masses was the left interatrial septum (n=48, 36.1%). The composite of all-cause mortality was the most common early outcome (n=11, 8.3%) while tumor-related mortality was the most common late outcome (n=15, 11.3%). Discussion: Our data show that intracardiac masses have diverse etiology and various clinical manifestations, and they often require cardiac surgery. In order to prevent complications, careful assessment and optimal timing of surgery is mandatory.
  • Küçük Resim
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    Predictive role of SEC in mitral restenosis following successful percutaneous balloon mitral valvuloplasty (PBMV)
    (BAYRAKOL, 2022) Taşbulak, Ömer; Duran, Mustafa; Şahin, Ahmet Anıl; Demir, Ali Rıza; Uygur, Begüm; Avcı, Yalçın; Çelik, Ömer; Yalçın, Ahmet Arif; Ertürk, Mehmet
    Aim: The aim of this study was to investigate the predictive role of spontaneous echo contrast (SEC) in mitral restenosis after percutaneous balloon mitral valvuloplasty (PBMV). Material and Methods: We retrospectively analyzed 341 consecutive patients who underwent PBMV at our hospital. Subjects who participated in the study were assigned to two groups: patients who had demonstrable SEC in the left atrial cavity and left atrial appendage and patients who did not have SEC in the left atrial cavity and left atrial appendage. For each group, the following variables were analyzed: demographic characteristics, past medical records, laboratory values, transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) parameters. Results: Compared to patients without SEC, patients with SEC were older, had a higher incidence of diabetes mellitus (DM), ischemic stroke and AF (p<0.05). With respect to TTE and TEE measurements, patients with SEC had lower estimated pre-procedural left ventricular ejection fraction (LVEF), a smaller calculated mitral valve area (MVA), a larger left atrial (LA) dimension and higher estimated preprocedural Wilkins score (p<0.05). In addition, the incidence of mitral restenosis following PBMV was significantly higher in patients with SEC compared to patients without SEC ( p <0.05), and this difference was more apparent in patients with grade 3-4 SEC compared to those with grade 1-2 SEC (p<0.05) Discussion: Our data showed that there is a strong association between SEC formation in the left atrium and left atrial appendage and mitral restenosis following PBMV