Publications by authors named "Çağın Mustafa Üreyen"

31 Publications

Transcatheter aortic valve implantation through the brachial artery.

Turk Kardiyol Dern Ars 2021 Apr;49(3):237-241

Department of Cardiology, Antalya Training and Research Hospital, Antalya, Turkey.

Summary- Transcatheter aortic valve implantation (TAVI) has been increasingly used in patients with severe aortic stenosis. The femoral artery is the most commonly used entry site for TAVI; however, other entry sites were also reported as transapical, transaortic, transaxillary/subclavian, and transcarotid in patients with occlusive peripheral arterial disease. In this report, a case of TAVI procedure through the brachial artery is presented.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5543/tkda.2021.51892DOI Listing
April 2021

Impact of direct stenting on clinical outcomes for small vessel coronary artery disease in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction.

Postepy Kardiol Interwencyjnej 2019 8;15(4):404-411. Epub 2019 Dec 8.

Department of Cardiology, Sakarya University Education and Research Hospital, Sakarya, Turkey.

Introduction: Direct stenting (DS) is associated with improved markers of reperfusion during primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI). However, data evaluating its impact in small vessel coronary artery disease (CAD) are lacking.

Aim: To compare DS and conventional stenting (CS) for small vessel CAD on clinical outcomes of patients with STEMI undergoing PPCI.

Material And Methods: A cohort of 616 STEMI patients treated with DS (202 patients) or CS (414 patients) in small vessel (≤ 2.75 mm) lesions was retrospectively analyzed. The primary endpoint was to compare the occurrence of major adverse cardiac events (MACE) between groups during 2-year follow-up. The secondary end points included in-hospital target lesion revascularization (TLR) and in-hospital death.

Results: The primary end-point, MACEs, occurred in 9.2% in the DS group and 12.3% in the CS group ( > 0.05). The rates of TLR, myocardial infarction (MI) and target vessel revascularization (TVR) were not significantly different between groups ( > 0.05). The stent thrombosis (ST) rate was significantly lower in the DS group (1.0% vs. 4.2%, = 0.04) at 2 years. However, DS was not found to be an independent predictor of ST in multivariate analysis. There were no significant differences in in-hospital rates of death and TLR. The DS compared to CS resulted in greater rates of postprocedural TIMI grade 3 flow, and lower risk of edge dissection. The procedure time, radiation exposure and contrast administration were found to be significantly lower in the DS group.

Conclusions: In selected patients with STEMI undergoing PPCI for small vessel CAD, DS is not only safe and feasible but also reduces ST rates, contrast load, and procedural and radiation exposure time.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5114/aic.2019.90214DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6956466PMC
December 2019

Percutaneous Coronary Intervention for Chronic Total Occlusion versus Percutaneous Coronary Intervention for Non-Complex Coronary Lesions: Is There a Different Impact on Thyroid Function?

Med Princ Pract 2020 20;29(2):188-194. Epub 2019 Sep 20.

Department of Cardiology, Sakarya University, Education and Research Hospital, Sakarya, Turkey.

Objective: This study assessed whether high levels of iodide administered during percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) differentially influenced thyroid function compared to PCI for non-complex coronary lesions.

Subjects And Methods: A total of 615 patients were enrolled in the study; 205 underwent elective PCI for CTO lesions (Group I) and 410 underwent elective PCI for non-complex lesions including non-CTO, non-bifurcation, non-calcified, and non-tortuous lesions (Group II). Patients were monitored for development of incidental thyroid dysfunction between 1 and 6 months after PCI.

Results: The patients in Group I were administered a median of 255 mL of contrast medium during PCI for CTO; a median of 80 mL was administered to the patients in Group II during non-complex PCI (p =0.001). Ten (5.4%) of the 186 euthyroid patients in Group I and 19 (5%) of the 379 eu-thyroid patients in Group II developed subclinical hyper-thyroidism (p = 0.854). However, 7 (50%) of the 14 subclinical hyperthyroid patients in Group I and only 3 (12%) of the 25 subclinical hyperthyroid patients in Group II developed overt hyperthyroidism (p = 0.019).

Conclusion: In euthyroid patients, PCI for coronary CTO lesions did not increase the risk for subclinical hyperthyroidism when compared to PCI for non-complex coronary lesions. However, in patients with subclinical hyperthyroidism at baseline, PCI for coronary CTO lesions significantly increased the development of overt hyperthyroidism when compared to PCI for non-complex coronary lesions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000503553DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098322PMC
January 2021

Is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (The SAKARYA study).

Anatol J Cardiol 2019 Jun;22(1):5-12

Department of Cardiology, Sakarya University Education and Research Hospital; Sakarya-Turkey.

Objective: It is still debatable whether diagnostic coronary angiography (CA) or percutaneous coronary interventions (PCIs) increase radiation exposure when performed via radial approach as compared to femoral approach. This question was investigated in this study by comparison of dose-area product (DAP), reference air kerma (RAK), and fluoroscopy time (FT) among radial and femoral approaches.

Methods: All coronary procedures between November 2015 and November 2017 were assessed; and 4215 coronary procedures were enrolled in the study. Patients with bifurcation, chronic total occlusion, cardiogenic shock, or prior coronary artery bypass surgery were excluded. These 4215 procedures were evaluated for three different categories: diagnostic CA (Group I), PCI in patients with stable angina (Group II), and PCI in patients with ACS (Group III).

Results: Age was significantly higher in the femoral arm of all groups. Among patients in the radial arm of Groups I and II, males were over-represented. Therefore, a multiple linear regression analysis with stepwise method was performed. After adjusting these clinical confounders, there was no significant difference with regard to DAP, RAK, and FT between femoral and radial access in Group I. In contrast, PCI via radial access was significantly associated with increased DAP, RAK, and FT in Groups II and III.

Conclusion: In spite of an increased experience with trans-radial approach, PCI of coronary lesions via radial route was associated with a relatively small but significant radiation exposure in our study. Compared to femoral access, diagnostic CA via radial access was not related to an increased radiation exposure.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14744/AnatolJCardiol.2019.06013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683214PMC
June 2019

Author`s Reply.

Anatol J Cardiol 2017 11;18(5):375-376

Department of Cardiology, Antalya Education and Research Hospital, Antalya-Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731291PMC
November 2017

Moderate sedation in cardiac electrophysiology laboratory: a retrospective safety analysis.

Heart 2017 10;103(19):1557-1558

Department of Cardiology, Sakarya University, Education and Research Hospital, Sakarya, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/heartjnl-2017-311797DOI Listing
October 2017

To know the radiation dose and the fluoroscopy time of each cardiac procedure is of great importance.

Int J Cardiol 2017 11;246:41

Sakarya University, Education and Research Hospital, Department of Cardiology, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijcard.2017.04.030DOI Listing
November 2017

Should deep sedation be used during all catheter ablation procedures as a routine?

Pacing Clin Electrophysiol 2017 11 9;40(11):1324. Epub 2017 Oct 9.

Sakarya University Education and Research Hospital, Sakarya, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/pace.13158DOI Listing
November 2017

Should physicians instead of industry representatives be the main actor of cardiac implantable electronic device follow-up? (Super Follow-up).

Anatol J Cardiol 2017 Jul 19;18(1):23-30. Epub 2017 Apr 19.

Department of Cardiology, Antalya Education and Research Hospital; Antalya-Turkey.

Objective: This retrospective study sought to research the adequacy of the follow-up and optimization of cardiac implantable electronic devices (CIEDs) performed by industry representatives.

Methods: A total of 403 consecutive patients (35% females; median age, 67 years; age range 18-97 years) with either pacemakers (n=246), implantable cardioverter-defibrillators (ICDs), (n=117) or cardiac resynchronization therapy with defibrillator (CRT-D) (n=40) applied to our hospital's outpatient pacemaker clinic for follow-up. These patients had been followed up by industry representatives alone until September 2013 and then by a cardiologist who is dealing with cardiac electrophysiology and has a knowledge of CIED follow-up.

Results: It was ascertained that 117 (47.6%) of 246 patients with pacemakers had a programming error. Forty-three (36.8%) of 117 patients were symptomatic, and after reprogramming, all symptoms diminished partially or completely during the follow-up. Moreover, 30 (25.6%) of 117 patients with ICDs had a programming error. Furthermore, 6 (15%) of 40 patients with CRT-Ds had a programming error. To conclude, when all patients with CIEDs were assessed together, it was ascertained that 153 (38%) of 403 patients had programming errors.

Conclusion: The prevalence of inappropriate programming of CIEDs by industry representatives was quite higher than expected. Therefore, our study strongly demonstrates that CIED follow-up should not be allowed to be performed entirely by manufacturers' representatives alone.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14744/AnatolJCardiol.2017.7374DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512194PMC
July 2017

Relationship between mean platelet volume and ischemic stroke in patients with patent foramen ovale.

Turk Kardiyol Dern Ars 2017 Jan;45(1):9-15

Department of Cardiology, Antalya Training and Research Hospital, Antalya, Turkey.

Objective: Patent foramen ovale (PFO) is commonly encountered in patients with cryptogenic stroke. Mean platelet volume (MPV), an indicator of platelet reactivity, has been reported in recent trials to be higher in patients with PFO than in normal population. The aim of this study was to investigate whether there is a difference in MPV between patients with PFO and stroke or transient ischemic attack (TIA) and that of patients with asymptomatic PFO.

Methods: Patients with PFO who were younger than 55 years of age were enrolled in this retrospective study. Hemogram parameters of patients with ischemic stroke or TIA (symptomatic group) were obtained during hospitalization once they had stable clinical status.

Results: Total of 108 patients, 51 of whom were symptomatic, were included in the study. MPV was determined to be higher in symptomatic group compared with asymptomatic group (median 10.0 fl [25th-75th percentile: 9.0-11.0] vs median 8.56 fl [25th-75th percentile: 8.0-9.0], respectively; p<0.001,. Cut-off point of 9.0 fl for MPV had 70% sensitivity and 86% specificity in predicting symptomatic PFO patients.

Conclusion: MPV is higher in symptomatic than in asymptomatic PFO patients. This finding may be a subsidiary risk factor to identify patients with PFO and high risk of cardioembolic stroke.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5543/tkda.2016.17971DOI Listing
January 2017

Myocardial Infarction after Ozone Therapy: Is Ozone Therapy Dr. Jekyll or Mr. Hyde?

Cardiology 2017 15;137(1):20-21. Epub 2016 Dec 15.

Department of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000454759DOI Listing
January 2018

Ozone Therapy and Its Use in Medicine: Dr. Jekyll or Mr. Hyde?

Cardiology 2017 13;136(2):145-146. Epub 2016 Sep 13.

Department of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000447996DOI Listing
January 2018

Aortopulmonary window in adulthood: Surviving at 22 years without intervention or pulmonary vascular disease.

Turk Kardiyol Dern Ars 2016 Jun;44(4):332-4

Department of Cardiology, Antalya Training and Research Hospital, Antalya, Turkey.

Aortopulmonary window is a rare anomaly, a communication between the ascending aorta and the main pulmonary artery. Prognosis in the absence of correction is poor, with mortality of around 40% in the first year of life. A case of aortopulmonary window without pulmonary vascular disease in adulthood is described in the present report.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5543/tkda.2016.94224DOI Listing
June 2016

Evaluation of the association between stroke/transient ischemic attack and atrial electromechanical delay in patients with paroxysmal atrial fibrillation.

Anatol J Cardiol 2016 Aug 25;16(8):572-578. Epub 2015 Nov 25.

Department of Cardiology, Antalya Education and Research Hospital, Antalya-Turkey.

Objective: This study aimed to evaluate the association between the history of stroke/transient ischemic attack (TIA) and inter- and intra-atrial electromechanical delay (EMD) in patients with paroxysmal atrial fibrillation (PAF).

Methods: Patients diagnosed with PAF were included in this retrospective study. Patients who had a history of stroke or TIA were defined as the symptomatic group, whereas those who did not have such a history were defined as the asymptomatic group. On the basis of the transthoracic echocardiographic records, atrial electromechanical coupling (time interval from the onset of the P wave on the surface electrocardiogram to the beginning of the A' wave interval with tissue Doppler echocardiography) and intra- and interatrial EMD were measured.

Results: In this study, 160 patients were included, 52 of whom were symptomatic. While the intra-left atrial EMD was 68.2±6.1 ms in the symptomatic group, it was found to be 50.8±6.5 ms in the asymptomatic group (p<0.001). Interatrial EMD was 91.3±5.0 ms in the symptomatic group, whereas it was 71.5±7.0 ms in the asymptomatic group (p<0.001). In multiple logistic regression analysis, intra-left atrial [odds ratio (OR): 1.417, 95% confidence interval (CI): 1.193-1.684, p<0.001] and interatrial EMDs (OR: 1.398, 95% CI: 1.177-1.661, p<0.001) were found to be independently associated with the presence of stroke/TIA.

Conclusion: Prolonged inter- and intra-left atrial EMDs in patients with PAF is associated with stroke/TIA. Evaluating this parameter in addition to the CHA2DS2-VASc score in patients with PAF may be helpful in identifying patients who are at a high risk of stroke/TIA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/AnatolJCardiol.2015.6424DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368512PMC
August 2016

Assessment of Impact of Weight Loss on Left and Right Ventricular Functions and Value of Tissue Doppler Echocardiography in Obese Patients.

Echocardiography 2016 Jun 29;33(6):854-61. Epub 2016 Jan 29.

Department of Cardiology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.

Objective: In our study, we aimed to evaluate the effect of weight loss on left and right ventricular functions in obese patients.

Methods: Thirty patients with a BMI greater than 30 kg/m(2) and without any exclusion criteria were included in the study. Left ventricular systolic and diastolic functions were assessed with conventional and tissue Doppler echocardiography (TDE). At the end of 3 months, echocardiographic examination was repeated in patients with weight loss for cardiac function evaluation and it was compared to the baseline echocardiographic parameters.

Results: At the end of 3 months of weight loss period, conventional Doppler echocardiography revealed an improvement in diastolic functions with an increase in mitral E-wave, a decrease in mitral A-wave and an increase in E/A ratio. Deceleration time and isovolumetric relaxation time were ascertained shortened and Tei index decreased. TDE showed an increase in left ventricular lateral wall systolic wave (Sm) and E-wave velocity (Em). Mitral septal annular isovolumetric acceleration time (IVA), Sm and Em, were found to be increased, whereas Tei index was ascertained reduced. Right ventricular tissue Doppler examination following weight loss revealed an increase in RV- IVA, RV-Sm, and RV-Em, and a decrease in Tei index.

Conclusion: We disclosed that left ventricular structural changes and diastolic dysfunction occur in obese patients, and by weight loss, these abnormalities may be reversible which we demonstrated both by conventional and TDE. In addition, obesity might impair RV function as well, and we observed an enhancement in right ventricular functions by weight loss.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/echo.13185DOI Listing
June 2016

Determinants of iatrogenic femoral pseudoaneurysm after cardiac catheterization or percutaneous coronary intervention via the femoral artery.

Turk Kardiyol Dern Ars 2015 Sep;43(6):513-9

Department of Cardiology, Ataturk University Faculty of Medicine, Erzurum, Turkey.

Objective: This study aimed to define the prevalence and predictors for pseudoaneurysm after coronary angiography, cardiac catheterization and percutaneous coronary interventions (PCIs) performed via the femoral artery.

Methods: The study included 8469 patients enrolled between January 2007 and December 2009 on whom cardiac catheterization, coronary and/or peripheral angiography and PCIs via the femoral artery were performed. All data, including clinical characteristics and complications, were obtained retrospectively from patient chart records.

Results: Pseudoaneurysm was detected in 65 (0.76%) patients. Pseudoaneurysm was ascertained more frequently in patients with a history of coronary artery disease (0.9% vs. 0.4%; p=0.012), in females than in males (1.4% vs. 0.5%; p<0.001), in patients older than 65 years (1.2% vs. 0.6%; p=0.002), in patients with a history of femoral artery intervention (1.2% vs. 0.6%; p=0.01), in hypertensives than in normotensives (1.3% vs. 0.5%; p<0.001), in patients taking low molecular weight heparin (1.0% vs. 0.2%; p<0.001), in patients taking clopidogrel (1.0% vs. 0.4%; p=0.007), and in patients with chronic renal disease (3.8% vs. 0.7%; p<0.001). There was no statistically significant trend (1.2% vs. 0.7%; p=0.053) towards more pseudoaneurysm formation in emergent interventions than in elective procedures.

Conclusion: Patients with a higher risk of pseudoaneurysm development following intervention via the femoral artery should be specified and extra attention given during the intervention. These patients should be informed of the increased risk of this complication and its results, and should be under close follow-up concerning development of iatrogenic femoral pseudoaneurysm.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5543/tkda.2015.30356DOI Listing
September 2015

Usefulness of mean platelet volume for predicting stroke risk in paroxysmal atrial fibrillation patients.

Blood Coagul Fibrinolysis 2015 Sep;26(6):669-72

aAntalya Training and Research Hospital, Antalya bTürkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.

Atrial fibrillation is the most common sustained arrhythmia in clinical practice. It is important to specify patients with a high risk of thromboembolus due to elevated procoagulant and prothrombotic state. The aim of this study is to assess the relation of stroke/transient ischaemic attack (TIA) with mean platelet volume (MPV), which is an indicator of platelet activation in patients with paroxysmal atrial fibrillation (PAF). Patients with PAF were enrolled in this study during years of 2012-2014. Patients were divided into two groups according to the presence or absence of stroke/TIA. Demographic data were registered and CHA2DS2VASc scores of patients were calculated. It was investigated whether there was a difference among groups regarding MPV levels. Ninety patients, 31 of whom had history of stroke/TIA (symptomatic group), were enrolled to study. CHA2DS2VASc score of symptomatic group was 4.77 ± 1.26, while CHA2DS2VASc score of asymptomatic group was 2.63 ± 1.41. Nevertheless, there was not any difference regarding CHA2DS2VASc score among two groups when 2 points due to stroke/TIA were subtracted in symptomatic patients. MPV was detected higher in symptomatic patients than asymptomatic patients (11.1 ± 1.3 vs. 9.1 ± 1.0 fL, P < 0.001, respectively). A value of 9.85 for the MPV ascertained with receiver operating characteristic (ROC) curve analysis to predict stroke/TIA was found to have a sensitivity of 87% and specificity of 78%. Elevated MPV levels were ascertained to be related with stroke/TIA in patients with PAF. Assessment of MPV apart from CHA2DS2VASc score in patients with PAF might be subsidiary to specify patients with an enhanced risk of stroke/TIA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MBC.0000000000000334DOI Listing
September 2015

Clinical and morphological features of patients who underwent endovascular interventions for lower extremity arterial occlusive diseases.

Postepy Kardiol Interwencyjnej 2015 22;11(2):114-8. Epub 2015 Jun 22.

Antalya Training and Research Hospital, Antalya, Turkey.

Introduction: Patients with peripheral arterial disease (PAD) are at increased risk for all-cause mortality and cardiovascular mortality.

Aim: To present anatomical and morphological characteristics of patients who underwent endovascular stenting with laboratory and our mid-term results.

Material And Methods: One hundred fifty-three patients (mean age: 62.8, 86% male) who underwent percutaneous intervention of lower extremity arteries were included in the study. Demographic characteristics, medical history, physical examination and laboratory findings of patients were analyzed. Patients' lesions were classified according to the TransAtlantic Inter-Society Consensus (TASC). Clinical outcomes included complications and mortality, 6-minute walking distance, functional class (NYHA) and patency rates.

Results: Seventy percent of patients had hypertension, 42% were smokers, 78% had coronary artery disease, 20% had coronary artery bypass grafting, 55% had diabetes mellitus and 71% had dyslipidemia. Six patients with diabetes mellitus and poor wound healing despite medical therapy were treated with stenting leading to alleviation of pain and avoidance of amputation. The initial technical success rate of revascularization was 95.6% (153/160). Our mid-term results show that percutaneous procedures in lower extremity arterial diseases can be performed with low complication and high success rates. Patients' 6-minute walk distance, ankle/brachial index values, functional class and the status of foot ulcers were evaluated.

Conclusions: Especially in patients with distal vascular disease, poor wound healing and no chance of surgical revascularization, percutaneous endovascular revascularization may provide good blood flow and prevent amputation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5114/pwki.2015.52284DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495127PMC
July 2015

Corrected balloon occlusive diameter to determine device size during percutaneous atrial septal defect closure.

Turk Kardiyol Dern Ars 2015 Jul;43(5):420-6

Department of Pediatric Cardiology, Atatürk University Faculty of Medicine, Erzurum, Turkey.

Objective: The aim of this trial was to investigate the impact of corrected balloon occlusive diameter (cBOD) on successful performance of percutaneous atrial septal defect (ASD) closure.

Methods: The trial comprised 86 patients (60 female, 26 male; mean age 36.5±14.3) on whom percutaneous ASD closure was performed. Patients were evaluated using transesophageal echocardiography (TEE). Relation of the defect to surrounding tissues and size of rims was also investigated. Balloon sizing was performed intraoperatively on all patients. Size of device was ascertained according to both durability of rims and whether or not they formed significant indentation, both of which determine cBOD.

Results: The ASD closure device was successfully implanted in 84 (97.5%) patients. Mean maximum defect size was 17.4±5.9 mm, and mean color flow diameter was 16.8±5.4 mm. Mean maximum defect size at the moment of loss of shunt flow was 18.4±5.9 mm with TEE, and 18.8±6.1 mm with fluoroscopy. Mean size of Amplatzer occluder device was 20.0±6.5 mm. Device embolization was observed in 2 patients. However, no death occurred during or after the procedure.

Conclusion: Percutaneous secundum ASD closure is a safe and effective treatment modality in experienced centers. Utilizing corrected balloon occlusive diameter may be of benefit in deciding the size of ASD occluder device.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5543/tkda.2015.68217DOI Listing
July 2015

Myocardial Infarction after Ozone Therapy: Is Ozone Therapy Dr. Jekyll or Mr. Hyde?

Cardiology 2015 27;132(2):101-104. Epub 2015 Jun 27.

Department of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.

We discuss the case of a 46-year-old male patient presenting to the emergency department with acute inferior myocardial infarction. Coronary angiography demonstrated a vasospasm of the left main coronary artery and proximal segment of the left anterior descending artery. Furthermore, a thrombotic total occlusion was ascertained in the right coronary artery. The vasospasm in the left main and left anterior descending artery disappeared after nitrate administration. We successfully implanted a stent to the thrombotic occlusion in the right coronary artery after predilatation. On detailed questioning, the patient stated that ozonated autohemotherapy had been applied that morning in a private clinic for the revitalization and regeneration of tissues. The patient did not have any traditional atherosclerotic risk factors. He denied any history of cardiac complaint. Factor V Leiden, prothrombin 20210 and MTHFR a1298c and c677t mutations were investigated and found to be negative except for MTHFR a1298c, which was a heterozygote. The levels of antithrombin III, homocysteine and protein C and S were all within normal ranges. Ozone as a medical therapy has been used in many medical conditions; unfortunately, however, like every other therapy, ozone therapy has side effects. The literature concerning ozone therapy supports possible strong vasoconstrictor and prothrombotic effects of ozone therapy, further supporting our suggestion that ozone can lead to acute coronary syndromes in human beings. In conclusion, to our knowledge, our case report reveals a possible complication of ozone therapy that has never been reported before. We think that this article will raise the awareness of the possibility of thrombotic complications after ozonated autohemotherapy. © 2015 S. Karger AG, Basel.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000431078DOI Listing
June 2015

The Relationship between Spontaneous Multi-Vessel Coronary Artery Dissection and Celiac Disease.

Korean Circ J 2015 May 27;45(3):242-4. Epub 2015 May 27.

Department of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.

Celiac disease (CD) is an immune-mediated enteropathy involving the small intestines. Genetic and environmental risk factors as well as autoimmunity have been linked to its etiology. Studies have shown that coronary artery disease, autoimmune myocarditis, arrhythmias and premature atherosclerosis are more prevalent in individuals with CD compared to individuals without the disease. In this case report a young male patient with CD presented with acute myocardial infarction with spontaneous coronary artery dissections of two vessels. To the best of our knowledge, this is the first case report of spontaneous multi-vessel coronary artery dissection in a patient with CD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4070/kcj.2015.45.3.242DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446819PMC
May 2015

Cardiovascular collapse after myocardial infarction due to centipede bite.

Wien Klin Wochenschr 2015 Jul 21;127(13-14):577-9. Epub 2015 May 21.

Department of Cardiology, Antalya Education and Research Hospital, Varlık mah. Kazımkarabekir Caddesi, Soğuksu, Muratpaşa, 07100, Antalya, Turkey.

Centipede bites have been reported to cause localized and/or systemic symptoms including local pain, erythema and edema, nausea and vomiting, palpitations, headache, lymphadenopathy, and rhabdomyolysis. However, acute myocardial infarction due to centipede envenomation is reported in only three cases in English medical literature.We present a case of 31-year-old male bitten by a golden colored centipede leading to myocardial infarction and cardiopulmonary arrest which is seen very rarely. The patient was admitted to emergency department with a swollen and painful right foot. However, typical chest pain became the major complaint and cardiopulmonary arrest developed while electrocardiography was being obtained. The patient was resuscitated successfully for 5 min and acute infero-posterolateral myocardial infarction was detected on electrocardiography.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00508-015-0801-zDOI Listing
July 2015

Thrombus formation during septal puncture.

Anatol J Cardiol 2015 May;15(5):434-5

Clinic of Cardiology, Antalya Education and Research Hospital; Antalya-Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/akd.2015.6243DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779193PMC
May 2015

Assessment of morphology of patent foramen ovale with transesophageal echocardiography in symptomatic and asymptomatic patients.

J Stroke Cerebrovasc Dis 2015 Jun 20;24(6):1282-6. Epub 2015 Apr 20.

Department of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.

Background: The frequency of patent foramen ovale (PFO) is greater in patients who have had a stroke and transient ischemic attack (TIA) than that in the general population. However, it is not well defined, which PFO would cause stroke or TIA. In this trial, we aimed to evaluate whether there was a difference regarding morphologic features of PFO in patients who were symptomatic (cryptogenic stroke or history of TIA) or asymptomatic according to the neurologic findings.

Methods: Symptomatic patients with PFO and cryptogenic stroke or TIA and asymptomatic patients with PFO who were symptomatic in terms of neurologic findings as well as patients without any neurologic symptoms in whom PFO was diagnosed incidentally by transesophageal echocardiography were enrolled to this retrospective study on the condition that they were aged younger than 55 years. Not only the clinical and demographic characteristics of 2 groups were compared but also their morphological features were assessed. The morphologic features of PFO that were assessed included the length and height of tunnel, atrial septal excursion distance, thickness of septum primum, and thickness of septum secundum.

Results: One hundred fifty-six patients, 64 of whom were symptomatic, were enrolled to this study. The height of PFO (median, 3.0 [interquartile range, 2.0-3.8]mm versus 2.0 [2.0-2.0]mm, P < .001), thickness of septum secundum (5.0 [5.0-7.0] versus 3.0 [2.0-3.0], P < .001), and septal excursion distance (7.0 [6.0-10.5] versus 4.0 [4.0-5.0], P < .001) were found to be greater in the symptomatic group than those in the asymptomatic group. There was no significant difference regarding the length of tunnel and thickness of septum primum. The ratio of length to height of PFO tunnel was less in the symptomatic group (3.0 [3.0-3.23] versus 5.0 [4.0-6.25], P < .001).

Conclusions: Our findings appear to indicate that a higher PFO tunnel, relatively greater interatrial septal mobility, thicker septum pellucidum, and the presence of an atrial septal aneurysm may help identifying the subjects at the age of or younger than 55 years with PFO who are at greater risk for cryptogenic stroke or TIA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2015.01.036DOI Listing
June 2015

A rare combination of vascular anomalies: Hypoplastic aortic arch, coarctation of the aorta and poststenotic aneurysm.

Turk Kardiyol Dern Ars 2015 Apr;43(3):272-4

Department of Radiology, Antalya Training and Research Hospital, Antalya, Turkey.

Coarctation of the aorta is the fifth most common congenital cardiac anomaly encountered in adults. It is important for prognosis to diagnose and treat this anomaly early. An aneurysm might develop due to tunica media abnormalities in patients with coarctation of the aorta. We hereby present an adult case with a very rare combination of vascular anomalies including ascending aorta aneurysm, hypoplastic aortic arch, coarctation of the aorta and poststenotic aneurysm.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5543/tkda.2015.89084DOI Listing
April 2015

Giant left ventricular aneurysm after recurrent mitral valve replacement.

Wien Klin Wochenschr 2015 Mar 19;127(5-6):227-30. Epub 2015 Mar 19.

Antalya Education and Research Hospital, Department of Cardiology, Varlik mah. Kazimkarabekir Caddesi, Soğuksu, 07100, Muratpaşa, Antalya, Turkey.

Left ventricular pseudoaneurysm after mitral valve replacement has been reported in various studies; however, as far as we know, a true aneurysm after redo mitral valve replacement has not been reported in any article yet. We herein present a patient who developed a true aneurysm and atrioventricular complete block after third surgery of mitral valve. DDD pacemaker was implanted, albeit the patient refused reoperation for aneurysmectomy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00508-015-0737-3DOI Listing
March 2015

Primum non nocere.

Anatol J Cardiol 2015 Jan 25;15(1):89-90. Epub 2014 Dec 25.

Department of Cardiology, Antalya Education and Research Hospital; Antalya-Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/akd.2014.5866DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336929PMC
January 2015

A new cause of silent myocardial infarction: Bonsai.

Anatol J Cardiol 2015 Jan 25;15(1):69-70. Epub 2014 Dec 25.

Department of Cardiology, Antalya Training and Research Hospital; Antalya-Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/akd.2014.5870DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336902PMC
January 2015

Mechanical prosthetic aortic valve dehiscence presenting as sudden cardiac death due to extrinsic compression of the left main coronary artery.

Anadolu Kardiyol Derg 2014 Oct 23;14(8):E21. Epub 2014 Oct 23.

Clinic of Cardiology, Antalya Education and Research Hospital, Antalya-Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/akd.2014.5734DOI Listing
October 2014