Mustafa Yildiz

Istanbul Training and Research Hospital, İstanbul, Istanbul, Turkey

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Publications (52)92.66 Total impact

  • Mustafa Yildiz, Gonenc Kocabay
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    ABSTRACT: Aluminium (Al) is the third most prevalent element, representing approximately 8% of total mineral components in the earth's crust (1). Chronic exposure to Al is mainly encountered at particular work places, for example, in foundries or in the Al powder industry, as an occupational exposure. In case of occupational Al exposure, inhalation is the main route of uptake. Chronic exposure to Al is associated with skeletal, neurological, hematological and lung changes. Studies regarding the Al powder industry showed that long-term inhalative exposure to Al can induce pulmonary fibrosis (2). Although there is only one report about ventricular tachycardia as a cardiac manifestation in occupationally exposed persons (3), in this report, we presented a case that had Mobitz type I second-degree atrioventricular block and nonsustained ventricular tachycardia. To our knowledge, this is the first report in chronic poisoning.
    Journal of forensic and legal medicine 08/2013; 20(6):760-2.
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    ABSTRACT: Prosthetic valve thrombosis (PVT) during pregnancy is life-threatening for mother and fetus, and the treatment of this complication is unclear. Cardiac surgery in pregnancy is associated with very high maternal and fetal mortality and morbidity. Thrombolytic therapy (TT) has been rarely used in these patients. The aim of this study is to evaluate the safety and efficacy of low-dose (25 mg), slow infusion (6 hours) of t-PA (tissue plasminogen activator) for the treatment of PVT in pregnant women. Between 2004 and 2012, t-PA was administered to 24 consecutive women in 25 pregnancies with 28 PVT episodes (obstructive n=15; non-obstructive n=13). Mean age of the patients was 29±6 years. TT sessions were performed under transesophageal echocardiography guidance. The mean dose of t-PA used was 48.7±29.5 mg (range 25-100mg). All episodes resulted in complete thrombus lysis following TT. One patient had placental hemorrhage with preterm live birth occurred at 30(th) week, and one patient had minor bleeding. Low-dose, slow infusion of t-PA with repeated doses as needed is an effective therapy with excellent thrombolytic success rate for the treatment of PVT in pregnant women. This protocol also seems to be safer than cardiac surgery or any alternative medical strategies published to date. TT should be considered as first-line therapy in pregnant patients with PVT.
    Circulation 06/2013; · 15.20 Impact Factor
  • H Kaya, M Ozkan, M Yildiz
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    ABSTRACT: The etiopathogenesis of prosthetic heart valve thrombosis (PHVT) is multifactorial. Since the relationship between PHVT and endothelial function is never studied, we aimed to analyze the role of endothelial function in patients with PHVT. Twenty-two patients with PHVT (14 female, 31.8% with atrial fibrillation, mean age 46.0±12.2) and 22 controls with prosthetic heart valves (17 female, 36.4% with atrial fibrillation, mean age 45.7±11.5) were prospectively evaluated. Two groups had similar demographic and echocardiographic characteristics. Endothelial function was evaluated in all patients by the non-invasive measurement of flow mediated dilatation (FMD) of brachial artery. High-resolution ultrasound was used to measure brachial artery diameter at rest, during reactive hyperemia (endothelium-dependent, FMD), and following sublingual administration of nitroglycerin (endothelium-independent, nitroglycerin-mediated vasodilatation, NMD). Functional capacity at presentation determined as mean NYHA functional capacity class was worse in patients with PHVT than in control group (2.1±0.6 vs. 1.3±0.6; p < 0.0001). FMD was significantly reduced in patients with PHVT compared with control group (4.01±1.52 vs. 8.48±3.37; p < 0.0001). NMD did not differ between two groups (11.77±2.30 vs. 13.38±3.50; p = 0.08). FMD level of < 5.65 predicted prosthetic valve thrombosis with an 82% sensitivity and 77% specificity (area under the curve = 0.888, p < 0.0001). This study demonstrated the endothelial dysfunction in patients with PHVT compared with well-matched control group. In this study, we found that patients with PHVT have endothelial dysfunction which might contribute to the development of thrombosis.
    European review for medical and pharmacological sciences 06/2013; 17(12):1594-8. · 1.09 Impact Factor
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    ABSTRACT: BACKGROUND: There are few reports in the literature on the development of a fistulous connection between the left internal mammary artery (LIMA) and the pulmonary vasculature (PV) after coronary artery bypass grafting (CABG). This type of fistula may cause angina after CABG. Various mechanisms in the pathophysiology of this rare condition have been proposed. METHODS: We evaluated 537 consecutive patients with CABG surgery who underwent coronary angiography at our institution between January 2011 and March 2012. The post-CABG angiograms were evaluated for LIMA-PV fistula formation. Presence of a LIMA-PV fistula was defined as opacification of the PV or parenchyma after injection of radiopaque contrast medium into the LIMA. RESULTS: We found that 5 of 537 patients (0.93 %) had a LIMA-PV fistula on post-CABG coronary angiograms. The mean age of patients with a LIMA-PV fistula was 61.4 years (range, 51-72 years) and all patients were male. Coronary angiography was performed in the setting of myocardial infarction for 2 patients with a LIMA-PV fistula, and stable angina pectoris was the indication for coronary angiography in the remaining 3 patients. The mean diagnosis time of LIMA-PV fistula after CABG was 3.4 years (range, 1-9 years). None of the patients had a history of redo-CABG, perioperative mediastinitis, or pneumonia. CONCLUSION: LIMA-PV fistulas may occur more frequently than reported on post-CABG angiogram findings. Angina in post-CABG patients may be associated with a LIMA-PV fistula, and selective cannulation of the LIMA with careful evaluation of the angiographic images may provide proper diagnosis and treatment of this entity.
    Herz 05/2013; · 0.78 Impact Factor
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    ABSTRACT: Cardiac resynchronization therapy (CRT) has become an accepted method fortreating refractory heart failure (HF). Arterial distensibility is an index of arterial stiffnessand a surrogate marker for atherosclerosis. The present study aims to assess the acute effects of ventricular resynchronization therapy with biventricular stimulation on arterial distensibility, echocardiographic parameters and serum norepinephrine levels in patients with drugrefractory HF. Fourteen cardiac HF patients (53.6 ± 9.1; 39-67 years, 7 woman) were enrolled for CRT. Patients had an advanced cardiac HF (NYHA III-IV functional class) due to non-ischemic dilated cardiomyopathy, with a left ventricular ejection fraction (LVEF) < 35% and QRS duration ≥120 ms. Blood samples for norepinephrine and B-type natriuretic peptidewere collected before 24 h biventricular implantation and after 48 h of CRT. Transthoracic echocardiography was used to evaluate arterial distensibility and cardiovascular condition. Although systolic blood pressure, diastolic blood pressure, LV end-diastolic diameter, LV end-systolic diameter, serum B-type natriuretic peptide, and serum norepinephrine levels significantly decreased after CRT implantation; EF and aortic distensibility significantly increased (p < 0.05). There was no significance in the hemodynamic and echocardiographic values, norepinephrine and B-type natriuretic peptide levels in pre- and post-CRT between man and woman. The major findings of this study are that in patients with cardiac HF in acute period, after implantation of CRT serum norepinephrine levels decrease and the arterial distensibility improves.
    Cardiology journal 01/2013; 20(3):304-309. · 1.15 Impact Factor
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    ABSTRACT: Atherosclerotic renal artery stenosis (ARAS) is associated with uncontrolled hypertension and chronic renal failure. To evaluate the influence of gender and presence of chronic renal failure on the outcomes of percutaneous transluminal renal artery stenting (PTRAS) due to atherosclerosis. A total of 28 ARAS patients underwent PTRAS and 36 stents were placed. Basal characteristics, laboratory data and blood pressure of patients were recorded. The differences between genders and improvement/deterioration of renal functions and blood pressure were analyzed. The predictors of outcomes were determined. Baseline characteristics were similar between men and women. Significant improvement of systolic and diastolic blood pressure control was achieved after PTRAS (153.04 ±17.07 mm Hg vs. 124.75 ±11.40 mm Hg, p = 0.001 and 92.50 ±10.76 mm Hg vs. 77.54 ±8.23 mm Hg, p < 0.001, respectively). Although mean estimated glomerular filtration rate (eGFR) and creatinine levels did not significantly improve at the 6-month follow-up visit compared to baseline values, of the 28 patients 13 (46.4%) patients had improvement of renal functions. Our results suggest that PTRAS is a safe procedure and may offer blood pressure control but beneficial effects of PTRAS on renal function may be anticipated in a selected group of patients, especially those with a low eGFR.
    Postepy w Kardiologii Interwencyjnej / Advances in Interventional Cardiology 01/2013; 9(3):228-33. · 0.16 Impact Factor
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    ABSTRACT: The aim of this study was to assess the effects of percutaneous bilateral renal artery stenting in patients with atherosclerotic renal artery stenosis and in-hospital and 4 month outcome of the procedure, focusing on the changes in renal function and blood pressure. Five consecutive patients (mean age: 64.8 ± 9.7 years, 1 women) with bilateral renal artery stenoses underwent percutaneous interventions. We compared blood pressure, number of oral antihypertensive medications, and renal function changes preprocedure and postprocedure at 4 months follow-up. A total of 5 bilateral atherosclerotic renal artery stenosis patients underwent percutaneous transluminal renal angioplasty and 10 stents were placed. Although systolic and diastolic blood pressures were significantly decreased in follow-up period, glomerular filtration rates were not significantly changed as compared with baseline data (p = 0.009, p = 0.008, p = 1.00, respectively). Also, the number of oral antihypertensive medications were significantly decreased at follow-up period (p = 0.03). Bilateral renal artery stenting provides a beneficial outcome such as stabilization of renal functions, significant improvement in blood pressure control and reduction in the number of oral antihypertensive medications at follow-up.
    Cardiology journal 01/2013; 20(1):25-8. · 1.15 Impact Factor
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    ABSTRACT: Gitelman's syndrome is a primary renal tubular hypokalemic metabolic alkalosis. Hypokalemia and hypomagnesemia can cause cardiac tissue excitability and conduction. Global ventricular mechanical function is directly related to the contractile properties of cardiac myocytes, which are largely dependent on the flow of ions such as potassium and magnesium. Here, we show that increased levels of potassium, in addition to magnesium, in a patient with Gitelman's syndrome significantly impacts the timing of ventricular wall motion and the pattern of ventricular strain and torsion. Two-dimensional speckle tracking echocardiography was used for evaluation of the hypokalemic-hypomagnesemic period (first day) and third day after potassium chloride and magnesium replacement therapy. The transthoracic echocardiography showed that the percent ejection fraction was similar in hypokalemic-hypomagnesemic (63%) and normokalemic-normomagnesemic (after potassium and magnesium therapy, 67%) hearts. However, decreased left ventricular apical 4-chamber peak systolic longitudinal strain, left ventricle global peak systolic strain, and global torsion values increased after potassium chloride and magnesium replacement therapy.
    Echocardiography 11/2012; · 1.26 Impact Factor
  • M Yildiz, G Kocabay
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    ABSTRACT: Adult patients with clinically related symptoms and high degree atrioventricular block are routinely referred for permanent pacing. The incidence of coronary artery disease is higher in a middle-aged group of patients presenting with atrioventricular block. In patients with stable coronary artery disease, ischaemic episodes may result in intermittent atrioventricular block with clinical symptoms. Herein, we present the clinical course of four consecutive patients admitted to our hospital with the diagnosis of atrioventricular block.
    Perfusion 10/2012; · 0.94 Impact Factor
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    ABSTRACT: Acute pulmonary embolism is an important emergency disease which frequently results in life-threatening complication. Systemic fibrinolysis is recommended as standard, first-line therapy in patients with massive pulmonary embolism. In the case described in this report, a 95-year-old woman was treated with low-dose prolonged infusion of tissue plasminogen activator for acute pulmonary embolism and mobile thrombus in the main pulmonary artery and right pulmonary artery. On the basis of echocardiographic findings, acute thrombolysis with low-dose prolonged infusion of tissue plasminogen activator was performed resulting in hemodynamic stabilization of the patient and complete resolution of the pulmonary artery thrombus.
    Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis 10/2012; · 1.25 Impact Factor
  • Ahmet Aykan, Ali Oguz, Mustafa Yildiz, Mehmet Özkan
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    ABSTRACT: Every year nearly 300 000 patients have heart valve operations and mostly prosthetic valves are inserted. Coumadin is the mainstay of therapy in these individuals but it has many side effects, mostly related to its anticoagulant effect. Rectus sheath haematoma (RSH) is a rare complication of abdominal trauma, surgery and excessive strain, however, anticoagulant agents may predispose to this condition without any precipitating event. Reversal of anticoagulation and resuscitation with fluids and blood products are necessary but anticoagulation is crucial in patients with prosthetic valves, as they have acquired thrombotic diathesis. Herein we report on a case of spontaneous RSH in a patient with prosthetic mitral and aortic valves and a history of prosthetic valve thrombosis. He was successfully managed medically.
    Cardiovascular journal of Africa. 07/2012; 23(6):e14-5.
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    ABSTRACT: The risk of systemic embolisation in patients with prosthetic heart valves who are receiving anticoagulation therapy is 0.5 to 1.7% per patient year and most cases present with cerebrovascular events. Here we report the case of a 42-year-old woman who was uneventfully treated with a low dose, prolonged infusion of tissue plasminogen activator because of non-obstructive prosthetic mitral valve thrombosis. It presented as coronary embolism and resulted in acute ST-elevation inferior myocardial infarction.
    Cardiovascular journal of Africa. 01/2012; 23(9):e7-8.
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    ABSTRACT: (Echocardiography ****;**:E1‐E3)
    Echocardiography 12/2011; 29(3):E82-4. · 1.26 Impact Factor
  • Gonenc Kocabay, Hakan Hasdemir, Mustafa Yildiz
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    ABSTRACT: Connective tissue diseases involve characteristic inflammatory lesions in the cardiovascular system, in addition to other systems. The involvement of the cardiovascular system in the course of connective tissue diseases may result in serious morbidity and mortality. Pulse wave velocity which is an indicator of arterial dilatation capacity may predict cardiovascular risk of patients. Pulse wave velocity is inversely proportional to arterial dilatation capacity. Decreased dilatation capacity leads to a reduction in arterial blood pressure and flow dynamics and impairment in coronary perfusion. In our study, we examined pulse wave velocity in frequent chronic inflammatory rheumatologic diseases: rheumatoid arthritis, systemic lupus erythematosus, and Behçet's disease. A total of 98 subjects participated in our study including 24 patients with newly diagnosed rheumatoid arthritis (4 males, 20 females; mean age 42.5 ± 11.5 years), 22 patients with newly diagnosed systemic lupus erythematosus (1 male, 21 females; mean age 35.8 ± 11.1 years), 33 patients with newly diagnosed Behçet's disease (26 males, 7 females; mean age 32.7 ± 8.0 years), and 19 healthy subjects in the control group (10 males, 9 females; mean age 36.2 ± 15.0 years). Aorta pulse wave velocity was determined by Complior Colson (Createch Industrie, Garges les Gonesses, France) device which allowed for pulse wave recording and automated measurement. Pulse wave velocity was higher in rheumatoid arthritis, systemic lupus erythematosus, and Behçet's disease groups compared to the control group. When all variables were included in the regression analysis only age was found to affect pulse wave velocity independently. Pulse wave velocity was found to be high in chronic inflammatory connective tissue diseases compared to the control group. However, no difference was found between groups. Age was determined as the most important independent variable in the regression analysis.
    Journal of Cardiology 11/2011; 59(1):72-7. · 2.30 Impact Factor
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    ABSTRACT: BACKGROUND: Myocardial contusion is a rare complication of blunt chest trauma. Transient conduction and rhythm problems, right ventricular dysfunction, or pulmonary embolism may occur after chest trauma, but these complications almost always occur early in the post-operative period. OBJECTIVES: The objective is to describe a case illustrating that trauma may induce high-grade atrioventricular block. CASE REPORT: We report the case of a patient who developed delayed onset of complete atrioventricular block after transient complete atrioventricular block and alternating bundle branch block secondary to blunt chest trauma. CONCLUSION: Even with an injury that does not seem to be caused by direct penetrating trauma to the heart, maybe every trauma patient needs an electrocardiographic evaluation. It is important to note that myocardial healing is a continuous process after trauma, and additional pathology may be revealed later in the course of healing from myocardial contusion.
    Journal of Emergency Medicine 11/2011; · 1.33 Impact Factor
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    ABSTRACT: In this study, we aim to investigate the simulation of the cardiovascular system using an electronic circuit model under normal and pathological conditions, especially the Eisenmenger syndrome. The Eisenmenger syndrome includes a congenital communication between the systemic and pulmonary circulation, with resultant pulmonary arterial hypertension and right-to-left reversal of flow through the defect. When pulmonary vascular resistance exceeds systemic vascular resistance, it results in hypoxaemia and cyanosis. The Westkessel model including Resistor-Inductance-Capacitance pi-segments was chosen in order to simulate both systemic and pulmonary circulation. The left and right heart are represented by trapezoidal shape stiffness for better simulation results. The Eisenmenger syndrome is simulated using a resistance (septal resistance) connected between the left ventricle and right ventricle points of the model. Matlab® is used for the model implementation. In this model, although there is a remarkable increase in the pulmonary artery pressure and right ventricle pressure, left ventricle pressure, aortic pressure, aortic flow, and pulmonary compliance decrease in the Eisenmenger syndrome. In addition, left-to-right septal flow reversed in these diseases. Our model is effective and available for simulating normal cardiac conditions and cardiovascular diseases, especially the Eisenmenger syndrome.
    Cardiology in the Young 09/2011; 22(3):301-6. · 0.95 Impact Factor
  • European Heart Journal – Cardiovascular Imaging 08/2011; 12(11):870. · 2.39 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate real-time 3-dimensional transesophageal echocardiography (RT-3D TEE) in the assessment of mitral paravalvular leakage curtaining surgery with a Dacron patch. RT-3D TEE was used before and after the operation. Repairing a mitral paravalvular leak with Dacron patch curtaining was a useful, simple and new technique with promising feasibility and durability. In selected patients in whom the mitral paravalvular defect is relatively large, and may thus not be suitable for closing with primary suture, Dacron patch curtaining may be feasible for repair guided with RT-3D TEE; both are described for the first time.
    Cardiology 07/2011; 119(1):34-7. · 1.52 Impact Factor
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    ABSTRACT: The purpose of this study was to investigate the differences between P wave dispersion, aortic elastic properties and transthoracic echocardiographic findings in the young and old football players compared to control groups in order to asses the influence of regular sportive activity on aortic distensibility and its potential effect on atrial electrophysiology. METHODS : We recruited 42 young football players with a training history of many years. The control group was formed by 27 healthy sedentary men. Twenty-three healthy retired football players of a professional football club aged over 50 years were included in the study as old group and 18 subjects over 50 year old who did not perform regular exercise when they were young were included in the control group of old subjects. The heart rate and ejection fraction were decreased in the young football players. There were no significant differences in the aortic elastic parameters and P wave dispersion between young football players and control group. But in old subjects with sustained participation in regular sportive activity, the significant difference of left ventricular dimension, wall thickness and systolic functions detected in the young group disappeared while increase in the left atrial diameter became significant. Potential effect of aortic elastic properties which changes with age, on atrial electrophysiology through increasing P wave dispersion was shown.
    Revista da Associação Médica Brasileira 06/2011; 57(3):280-5. · 0.77 Impact Factor
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    ABSTRACT: The 12-lead electrocardiogram shows a broad range of abnormal patterns in trained athletes. The primary end point of this study was to investigate P wave dispersion, and P wave durations and related factors in different genders applying for registration to the School of Physical Education and Sports. From 2006 to 2009, a total of 2093 students - 1674 boys with a mean age of 19.8 plus or minus 1.9 years and 419 girls with a mean age of 19.1 plus or minus 1.8 years - were included in the study. All 12 leads of the resting electrocardiogram were evaluated for P wave dispersion and electrocardiogram abnormalities. Baseline parameters such as age, body weight, body height, and body mass index, as well as electrocardiogram findings such as P wave maximal duration and P wave dispersion, were significantly higher in boys than in girls. Of all the parameters tested with correlation analysis, only gender (p = 0.03) (r = 0.04), body weight (p < 0.001) (r = 0.07), body height (p = 0.004) (r = 0.06), and body mass index (p = 0.01) (p = 0.05) were correlated with P wave dispersion. The frequencies of all electrocardiogram abnormalities, P wave dispersion, and P wave maximal duration were higher in boys as compared with girls in an unselected student population applying for registration to the School of Physical Education and Sports; in addition, P wave dispersion was correlated with gender, body weight, body height, and body mass index.
    Cardiology in the Young 04/2011; 21(5):545-50. · 0.95 Impact Factor

Publication Stats

109 Citations
92.66 Total Impact Points

Institutions

  • 2013
    • Istanbul Training and Research Hospital
      İstanbul, Istanbul, Turkey
  • 2008–2011
    • Koşuyolu Kalp ve Araştırma Hastanesi
      İstanbul, Istanbul, Turkey
  • 2010
    • Istanbul University
      • Department of Physiology
      İstanbul, Istanbul, Turkey
  • 2006–2009
    • Sakarya University
      • Faculty of Medicine
      Ada Bazar, Sakarya, Turkey