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Öğe Coronary aneurysm accompanied by a coronary artery fistula and atrial septal defect(Springer India, 2012) Akturk, Erdal; Battaloglu, Bektas; Yagmur, Julide; Eyupkoca, FerhatA 56-year-old female patient was admitted to our clinic with complaint of dyspnea on exertion with progressive worsening of the functional class in last months. Electrocardiography showed Atrial Fibrillation (AF) and Transthoracic Echocardiography (TTE) showed normal Left Ventricular (LV) systolic function with grade 3 tricuspide and grade 2 mitral insufficiency. Pulmonary arterial pressure was 45 mmHg and Right Atrium (RA) and right ventricle were dilated. Selective coronary angiography was performed. There was no obvious lesion on coronary arteries and their branches, except that the Right Coronary Artery (RCA) was dilated and tortuous and had an aneurysm. Multidetector computed tomography showed significantly dilated and tortuous RCA which significantly broadened distally and opened into the RA. Under cardiopulmonary bypass, right atriotomy was performed and an Atrial Septal Defect (ASD) revealed. This defect was closed and repaired primarily. Fistula ostium was seen from coronary sinus. Primary repair from coronary sinus window was performed. Severe regurgitation of tricuspid valve was observed and De Vega anuloplasty was performed.Öğe Early Left Atrial Mechanics and Volume Abnormalities in Subjects with Prehypertension: A Real Time Three-Dimensional Echocardiography Study(Wiley, 2012) Akturk, Erdal; Ermis, Necip; Yagmur, Julide; Acikgoz, Nusret; Kurtoglu, Ertugrul; Cansel, Mehmet; Eyupkoca, FerhatThe aim of this study was to evaluate left atrial (LA) volume and mechanical functions by real time three-dimensional echocardiography (RT3DE) in prehypertensive subjects. The study included 54 (34 male and 20 female) prehypertensive subjects and 36 (14 male and 22 female) healthy control subjects. Transthoracic echocardiography and RT3DE were performed in all patients. Interventricular septum thickness and isovolumetric relaxation time were significantly higher in prehypertensives than in controls (10.7 +/- 0.7 vs. 10.1 +/- 0.8 P = 0.001 and 89.9 +/- 10 vs. 82.4 +/- 11 P = 0.002, respectively). LA maximum volume, volume before atrial contraction, total and active stroke volume, total and active emptying fractions, expansion index, and LA max volume index were significantly higher in prehypertensives when compared with controls (P < 0.0001 for all). However, the passive emptying fraction was significantly lower in prehypertensives than controls (45.7 +/- 5.6 vs. 48.6 +/- 4.1, P = 0.006), and the minimum LA volume between the two groups was similar. The main finding of this study was that although LA volume and LA active systolic functions were significantly increased in prehypertensive people, there was a reduction in passive LA systolic functions. These parameters may be important in showing hemodynamic and structural changes in cardiac tissue caused by prehypertension. (Echocardiography 2012;29:1211-1217)Öğe Effect of Hemodynamic Changes During Percutaneous Mitral Balloon Valvuloplasty on Short and Long Term Clinical Outcome(Drunpp-Sarajevo, 2012) Akurk, Erdal; Kurtoglu, Ertugrul; Eyupkoca, Ferhat; Ermis, Necip; Acikgoz, Nusret; Yagmur, Julide; Cansel, MehmetAims: We aim of this study is to determine whether hemodynamic changes that occur before and after percutaneous mitral balloon valvuloplasty (PMV) procedure is a predictor in determining the short- and long-term clinical results in patients with mitral stenosis (MS). Methods: The study population consisted of 118 (26 males and 92 females) consecutive patients with symptomatic rheumatic MS, underwent successful PMV. Mean pulmonary artery pressure, pulmonary capillary wedge pressure (PCWP), mean transmitral gradient and mean left atrial was obtained before and immediately after valvuloplasty. Two separate groups were formed on the basis of these measured pressure differences. The first group pressure differences (PD) <= 15 mmHg and the second group PD > 15 mmHg. Results: There was no difference in immediate outcomes between two group. There was no significant difference in between groups in terms of primary endpoints. However, there was a difference in mean left atrial pressure difference (LAPD) between <= 15 mmHg group and > 15mmHg group. MVR and redo PMV rates were significantly lower in LAPD> 15mmHg group (p=0.027 and p=0.03, respectively), the difference between stroke and death rates was not statistically significant (p=0.6). Conclusion: The significant risk factors in determining long-term outcomes in patients undergoing PMV are; mitral valve morphology, atrial fibrillation, advanced age, NYHA class, post-PMV, MR grade, post-PMV MVA, prior surgical commissurotomy, post-PMV pulmonary artery pressure and echocardiographic score. In addition to these parameters we found that LAPD could also be a predictor of long term outcomes patients undergoing PMV.Öğe The effects of Ramadan fasting on heart rate variability in healthy individuals: A prospective study(Aves, 2014) Cansel, Mehmet; Tasolar, Hakan; Yagmur, Julide; Ermis, Necip; Acikgoz, Nusret; Eyupkoca, Ferhat; Pekdemir, HasanObjective: Ramadan fasting is one of the five fundamental rituals of Islam. Heart rate variability (HRV) is an independent predictor of increased mortality of patients with myocardial infarction and congestive heart failure. Although many patients in this region fast once a year, the effects of fasting on the HRV, which has a prognostic significance for patients with myocardial infarction and congestive heart failure, are not known. Therefore, the study on the effects of one month fast of HRV in healthy volunteers seems to be reasonable to address. Methods: Our study is a prospective cohort study that includes a total of 40 healthy volunteers with sinus rhythm between 19 and 40 years of age (16 female and 24 male). HRV was determined twice by ambulatory 24-hour Holter recordings at fasting in the middle of Ramadan and first week after Ramadan month. Mean values of continuous variables were compared by using the Student t-test or Mann-Whitney U test. Paired t-test or Wilcoxon test were used for comparison of variables between groups. Results: When two groups compared, statistically significant differences were found in terms of RR (p=0.049), SDNNI (p=0.010), rMSSD (p=0.009), pNN50 (p=0.015), T power (p=0.009), LF (p=0.008), Lfnu (p=0.002), HF (p=0.022) and Hfnu (p=0.013) values. Conclusion: In our study, HRV parameters were found to be increased in Ramadan month, so we think that Ramadan fasting enhances the activity of the parasympathetic system.Öğe Epicardial Fat Thickness in Patients with Chronic Obstructive Pulmonary Disease along with Right Ventricular Systolic Dysfunction(Elsevier Science Inc, 2013) Kaplan, Ozgur; Gozubuyuk, Gokhan; Acar, Zeydin; Eyupkoca, Ferhat; Pekdemir, Hasan[Abstract Not Available]Öğe Multivessel Coronary Thrombosis in a Patient with Idiopathic Thrombocytopenic Purpura(Texas Heart Inst, 2012) Yagmur, Julide; Cansel, Mehmet; Acikgoz, Nusret; Yagmur, Murat; Eyupkoca, Ferhat; Ermis, Necip; Akturk, ErdalA 49-year-old woman who had idiopathic thrombocytopenic purpura was admitted to our hospital with severe chest pain. Electrocardiography revealed inferolateral myocardial infarction. The patient underwent immediate coronary angiography, which revealed thrombi in the left coronary system. Percutaneous intervention was not indicated, because the thrombi had occluded the distal segments of multiple coronary arteries. Administration of tirofiban satisfactorily dissolved the thrombi. (Tex Heart Inst J 2012;39(6):881-3)
