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Publications (22)37.37 Total impact

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    ABSTRACT: We report the case of a 20-year-old woman who received corrective surgery for a secundum atrial septal defect, during which right atrial inflow obstruction developed because of inadvertent suturing of the eustachian valve to the interatrial septum. Although reliable cardiac surgical techniques are available, this rather rare complication may have deleterious results for patients. If a previously absent murmur is detected in the lower left parasternal border after atrial septal defect surgery, right atrial inflow obstruction caused by the eustachian valve should be kept in mind and further careful examination undertaken.
    The Canadian journal of cardiology 01/2011; 27(6):868.e9-10. · 3.12 Impact Factor
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    ABSTRACT: In this report, we describe a case with severe tricuspid stenosis associated with partial luminal obstruction of the right atrium and vena cava superior secondary to transvenous pacemaker leads in a 49-year-old patient who had a permanent pacemaker implanted 17 years ago. The patient had no specific symptoms related to above findings; however, after clinical suspicion, transthoracic and transoesophageal echocardiographic examination showed large mobile masses attached to the thickened transvenous pacemaker leads. Leads and generator were removed surgically, but some parts of transvenous leads could not be extracted due to massive fibrotic adhesions. It is possible that such cases will be more common due to increasing number of cardiac rhythm device implantations.
    European Heart Journal – Cardiovascular Imaging 06/2010; 11(5):E22. · 3.67 Impact Factor
  • Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 04/2010; 10(2):E7-8. · 0.72 Impact Factor
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    Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 01/2010; 10(1):E3. · 0.72 Impact Factor
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    ABSTRACT: Metabolic syndrome (MetS) is associated with increased risk for cardiovascular disease. We evaluated aortic stiffness and factors affecting aortic stiffness by echocardiography in patients with MetS. The study included 27 patients (18 men, 9 women; mean age 56+/-7.5 years) and 33 patients (20 men, 13 women; mean age 54.3+/-5.5 years) with and without MetS, respectively, according to the ATP-III criteria. Blood pressure, pulse pressure, waist circumference, and levels of total cholesterol, HDL and LDL cholesterol, triglyceride, and high-sensitivity C-reactive protein (hs-CRP) were measured. Systolic and diastolic diameters of the ascending aorta were measured by M-mode echocardiography from the parasternal long-axis views, and parameters of aortic stiffness (aortic strain and distensibility) were calculated. Compared to the control group, patients with MetS had significantly higher values of blood pressure, pulse pressure, waist circumference, and higher triglyceride, glucose, and hs-CRP levels and lower HDL cholesterol level (p<0.05). In the MetS group, aortic strain (9.0+/-3.5% vs. 6.3+/-3.8%; p=0.007) was significantly increased and aortic distensibility (2.7+/-1.9 cm(2)/dyn/10(3) vs. 4.8+/-1.9 cm(2)/dyn/10(3) p=0.001) was significantly decreased. Aortic distensibility was negatively correlated with age (r=-0.269, p=0.03), hs-CRP (r=-0.287, p=0.002), systolic blood pressure (r=-0.533, p<0.001), and diastolic blood pressure (r=-0.275, p=0.03). In age-adjusted multiple regression analysis, systolic blood pressure (beta=0.8, p<0.001), waist circumference (beta=0.5, p=0.02), and hs-CRP (beta=0.6, p=0.002) were independent predictors of aortic distensibility. Aortic stiffness is increased in patients with MetS. Using a noninvasive and readily available tool, transthoracic echocardiography, arterial stiffness can easily be assessed, so that the incidence of cardiovascular diseases and associated mortality can be decreased through appropriate treatment for risk factors.
    Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 01/2010; 38(1):14-9.
  • Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 09/2009; 9(4):E13. · 0.72 Impact Factor
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    ABSTRACT: In mitral stenosis (MS), left atrial (LA) compliance plays a crucial role in the occurrence of symptoms and pulmonary arterial hypertension and can alter pulmonary venous flows (PVF). The aim of present study is to compare LA compliance (net atrioventricular compliance-Cn) and PVF velocities in patients with different functional status despite similar mitral valve area (MVA). Additionally, the relationships of the same variables with each other and other echocardiographic parameters showing the hemodynamic severity of mitral stenosis were investigated. Thirty-one patients with moderate to severe mitral stenosis were studied. The patients were divided into two groups according to their NYHA functional classes (FC). The patients with lower FC (NYHA FC1 and FC2) were included in Group I(n = 15), and those with FC > or = 3 included in Group II (n = 16). All patients underwent comprehensive transthoracic and transesophageal echo Doppler examination. Despite similar LA size, MVA, and transmitral diastolic pressure gradients, systolic pulmonary artery pressure (SPAP) was significantly higher and LA compliance was significantly lower in Group II as compared to group I. Also, systolic PVF velocity (PVs), diastolic PVF velocity (PVd), and PVs/PVd ratio were significantly lower in Group II as compared to Group I. In whole group, significant positive correlations between LA compliance and PVs (r = 0.38, P = 0.035), as well as PVd (r = 0.40, P = 0.023) and, significant negative correlation between LA compliance and SPAP (r =- 0.36, P = 0.047) were noted. Our findings suggested that in patients with MS, when there is inconsistency between symptomatic status and conventional echocardiographic variables, simple and noninvasive Doppler parameters, LA compliance, and PVF could be measured before cardiac catheterization for more accurate and complete evaluation of patients.
    Echocardiography 08/2009; 26(10):1173-8. · 1.26 Impact Factor
  • Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 02/2009; 37(1):78.
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    ABSTRACT: We report a left ventricular pseudoaneurysm, an unusual complication of mitral valve replacement (MVR) in a 65-year-old man who had undergone coronary artery bypass grafting and MVR surgery two years ago. The patient was referred to our clinics because of progressive exertional dyspnea and palpitations. Transthoracic and transesophageal echocardiography showed a large pseudoaneurysm of the posterolateral left ventricular wall and computerized tomographic angiography (CTA) demonstrated the location and the size of the pseudoaneurysm and its neck. Urgent surgical repair was accomplished without complications.
    Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography 11/2008; 21(10):1178.e1-3. · 2.98 Impact Factor
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    Yeşim Güray, Kazim Başer, Ayça Boyaci
    Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 06/2008; 8(3):E19. · 0.72 Impact Factor
  • Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 06/2008; 8(3):227-9. · 0.72 Impact Factor
  • Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 06/2008; 8(3):E15-6. · 0.72 Impact Factor
  • Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 05/2008; 8(2):E11-2. · 0.72 Impact Factor
  • Yeşim Güray, Sezgin Oztürk, Ayça Boyaci
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    ABSTRACT: Early diagnosis of brucella endocarditis is of paramount importance because of its fatal consequences. The most commonly affected localization is the aortic valve, while mitral valve involvement is rare. A 44-year-old male patient with a history of rheumatic heart disease presented with fever, fatigue, and back pain. Three consecutive blood cultures revealed growth of Brucella melitensis. On transthoracic echocardiography, mitral valve area was 1.5 cm2 and there was mild mitral regurgitation. Transesophageal echocardiography showed multiple vegetations on the anterior and posterior mitral valve leaflets. Combination of medical and surgical treatment was planned for the patient with the diagnosis of brucella endocarditis.
    Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 02/2008; 36(5):329-31.
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    ABSTRACT: This study was sought to examine the effects of repetitive monomorphic premature ventricular contractions (PVCs) on left ventricular (LV) diastolic function. Thirty-three symptomatic patients (Study group, 10 males, mean age 40 +/- 8 years) with normal LV systolic function and repetitive PVCs originating from the right ventricular outflow tract (RVOT-PVCs) on 24-h Holter monitoring, and 30 healthy controls (Control group, 9 males, mean age 37 +/- 9 years) were enrolled in the study. None of the patients had structural heart disease. Diastolic function was assessed by echocardiographic mitral inflow pattern and tissue Doppler imaging. The study group displayed a lower E/A ratio, longer isovolumetric relaxation time (IVRT), and longer E-wave deceleration time (EDT). In the study group 13 patients showed impaired relaxation. While mean values of the systolic velocity (Sa), early diastolic velocity (Ea), and early/late diastolic velocity (Ea/Aa) ratio were significantly lower in the study group, the Aa velocity and E/Ea ratio were significantly higher. Ea velocity was <10 cm/s in 7 study patients. Mitral inflow pattern and Ea velocity was normal in all controls. Significant correlations were found between ventricular premature beats percentage and early to late transmitral flow velocity ratio, EDT, IVRT, Ea velocity, the Ea/Aa ratio, and the E/Ea ratio. In multivariate analysis, total PVC count and age were found to be independent predictors of impaired relaxation. These results suggest that repetitive monomorphic RVOT-PVCs lead to abnormalities of LV diastolic function that may contribute to clinical symptoms in patients with structurally normal hearts.
    Heart and Vessels 09/2007; 22(5):328-34. · 2.13 Impact Factor
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    ABSTRACT: Significant tricuspid regurgitation (TR) can contribute to increased morbidity and mortality in patients undergoing mitral valve surgery for mitral stenosis. The aim of this study was to evaluate the association between the severity of preoperative functional TR and late adverse outcomes in patients undergoing mitral valve replacement (MVR). The study group comprised 68 patients (54 women, 14 men; mean age 45 +/-10 years) with rheumatic mitral stenosis (MS) who had undergone MVR without tricuspid valve surgery between 4 and 13 years (mean 8.1 +/-2.6 years) before their last clinical examination. All patients underwent a complete preoperative and late postoperative color-Doppler echocardiographic examination. The severity of TR was assessed echocardiographically by using color-Doppler flow images and flow direction in the inferior vena cava or hepatic veins. Patients were classified into 2 groups; 42 with mild (62%) and 26 with significant (38%) TR. Patients with significant TR showed longer preoperative symptomatic period and more atrial fibrillation than those with mild TR. All patients had medical treatment. Functional capacity and NYHA class of the patients in both groups improved significantly after MVR. Freedom from symptomatic heart failure (functional class III or IV) was higher (86% vs 54%) and the need for hospitalization was significantly lower for the mild TR group. Significant preoperative functional TR diagnosed by echocardiography was associated with an adverse outcome. Therefore, further studies are needed to evaluate the effect of concomitant tricuspid valve repair on the late outcome of patients undergoing mitral valve surgery in order to prevent significant late morbidity.
    Angiology 01/2007; 58(3):336-42. · 2.37 Impact Factor
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    ABSTRACT: Anticoagulation treatment can prevent systemic embolism in patients with mitral stenosis (MS) and atrial fibrillation (AF), but this treatment is under debate if patients are in sinus rhythm. The authors aimed to determine the hemostatic changes in patients with MS and sinus rhythm. Forty-six patients (28 in sinus rhythm and 18 in AF) with mitral stenosis were enrolled in this study. They studied systemic venous fibrinogen, D-dimer, antithrombin-III, tissue plasminogen activator (tPA), plasminogen activator inhibitor-I (PAI-I), von Willebrand factor (vWF), and platelet factor 4 (PF 4) in these patients. The patients were first classified according to their rhythm as sinusal and AF, and then according to the presence of left atrial spontaneous echo contrast (LASEC). Fibrinogen, D-dimer, antithrombin-III, vWF, and PF 4 levels were significantly greater in patients with MS and sinus rhythm or atrial fibrillation compared to the control group (p < 0.05). Whether the rhythm was sinus or AF, fibrinogen, D-dimer, antithrombin-III, vWF, and PF 4 levels were significantly higher in patients with LASEC than in the control group (p < 0.05). Only PF 4 was higher in the AF group than in those with sinus rhythm (p < 0.05). As to plasminogen activator and PAI-I levels, only tissue plasminogen activator levels were found to be higher in the AF group than in those with sinus rhythm and the control group (p < 0.05). In patients with mitral stenosis and sinus rhythm, if LASEC is present, coagulation activation, platelet activation, and endothelial dysfunction are similar in patients with AF, and anticoagulation should be considered in these patients.
    Angiology 01/2007; 58(1):85-91. · 2.37 Impact Factor
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    ABSTRACT: As the endothelium and inflammatory cells play a crucial role in the development of collaterals after a sudden or slowly progressing stenosis of coronary arteries, the levels of soluble endothelial adhesion molecules (CAMs) including vascular cell adhesion molecule (VCAM-1) intercellular adhesion molecule-1 (ICAM-1) and E-selectin were compared between patients with poor coronary collaterals and patients with well-developed collaterals. In the study, 97 non-diabetic subjects with single-vessel disease were included. Collateral supply to the stenotic coronary artery was determined by angiographic grading system of 0-3 (Rentrop et al. J Am Coll Cardiol 1985; 5:587-592). Serum levels of adhesion molecules were measured by enzyme-linked immunosorbent assay. Patients were divided into two groups according to the collateral degree (group A: 50 patients with grade 0 and 1; group B: 47 patients with grade 2 and 3 collaterals). The groups were well matched with respect to baseline clinical and angiographic characteristics. Levels of soluble VCAM-1 (mean+/-SEM; 875+/-26.6 versus 742.7+/-35.1 ng/ml; P=0.004), ICAM-1 (322.4+/-12.4 versus 269.4+/-13.3 ng/ml; P=0.005), and E-selectin (43.6+/-2.6 versus 33+/-2.4 ng/ml; P=0.004) were found to be significantly higher in group A in comparison with group B. In addition, when patients were divided into four groups according to the collateral degree, patients with grade 0 collaterals had the highest values and those with grade 3 collaterals had the lowest values for all these molecules. We concluded that poor collateral circulation is associated with increased levels of soluble CAMs in patients with obstructive coronary artery disease. However, further studies are needed to elucidate the exact role of these inflammatory markers in the setting of poor collateral circulation.
    Coronary Artery Disease 12/2004; 15(7):413-7. · 1.11 Impact Factor
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    ABSTRACT: Systemic thromboembolism is a major complication of mitral stenosis (MS), especially in those patients having atrial fibrillation (AF). Recent evidence has suggested that regional left atrial coagulation activity may be increased in MS and may contribute to the pathophysiology of left atrial thrombus. However, the relation of left atrial coagulation activity to factors that predispose to left atrial thrombus formation is unknown. Also, the relations between left atrial and systemic coagulation activity, fibrinolysis, and platelet activation remain unresolved. Left atrial and peripheral venous levels of fibrinogen, antithrombin III, factor VII and factor VIII for coagulation, D-dimer, tPA and PAI-I, plasmin and antiplasmin for fibrinolysis, and platelet factor 4 and vWF for platelet activation, and endothelial dysfunction were measured in 46 patients with MS and normal clotting times who were undergoing percutaneous mitral valvuloplasty. Left atrial tPA, plasmin, PAI-I, antiplasmin, PF4, and vWF levels exceeded the corresponding peripheral venous levels (P < 0.05) in patients with MS, being more significant in the AF subgroup. There were no significant differences between left atrial and peripheral venous levels of fibrinogen, D-dimer, factor VII, and factor VIII within the patient group (P > 0.05). The results suggest that there are significant variations in the indices of coagulation, fibrinolytic system and platelet activation, and endothelial dysfunction between left atrial and peripheral venous blood samples of patients with MS that may be due to limited spillover from the left atrium to the systemic circulation.
    Japanese Heart Journal 09/2004; 45(5):779-88. · 0.40 Impact Factor
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    ABSTRACT: Adhesion molecules play an important role in the development and course of coronary atherosclerosis. In this study, soluble forms of vascular cell adhesion molecule (VCAM-1) intercellular adhesion molecule-1 (ICAM-1), E-selectin and P-selectin were evaluated in patients with various clinical presentations of coronary atherosclerosis and compared them to those with angiographically documented normal coronary arteries. Venous plasma samples were collected from 43 patients with acute myocardial infarction (AMI), 45 with unstable angina pectoris (UAP), 34 with stable angina pectoris (SAP) and 29 subjects with normal coronary arteries (control). The VCAM-1 level was significantly higher in patients with AMI (mean +/- SEM; 799.8 +/- 26.3 ng/ml) than those with UAP (644.2 +/- 26.7 ng/ml) and SAP (526 +/- 32.5 ng/ml) and controls (270 +/- 26.8 ng/ml). In patients with UAP, VCAM-1 was found to be significantly elevated as compared to the SAP group and controls. VCAM-1 level was also higher in SAP group than the controls. Serum levels ICAM-1 were similar among patients with AMI (424.1 +/- 15.2 ng/ml), UAP (403 +/- 12.3 ng/ml) and SAP (381.2 +/- 16.2 ng/ml); however, levels of ICAM-1 was significantly elevated in these groups as compared to the controls (244.3 +/- 11). The mean level of E-selectin was not different in AMI and UAP groups (47.2 +/- 2.2 vs. 42.6 +/- 2.1 ng/ml; respectively). However, it was significantly higher in acute coronary syndrome groups as compared to SAP (33.4 +/- 2.3 ng/ml) and control subjects (30.7 +/- 1.9 ng/ml). Serum levels of E-selectin were similar in SAP group and controls. For P-selectin, no significant difference was observed between AMI and UAP groups (187.5 +/- 7.2 vs. 181.7 +/- 4.7 ng/ml; respectively), however, it was significantly higher in both groups as compared to SAP group (146.1 +/- 7.4 ng/ml) and controls (108 +/- 6.6 ng/ml). Serum level of P-selectin was significantly higher in patients with SAP than the control group. In conclusion, determination of serum VCAM-1, E-selectin and P-selectin levels seems more useful for detecting coronary plaque destabilization.
    International Journal of Cardiology 09/2004; 96(2):235-40. · 6.18 Impact Factor