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Öğe A global perspective on mechanical prosthetic heart valve thrombosis: Diagnostic and therapeutic challenges(Turkish Society of Cardiology, 2019) Gürsoy, Mustafa Ozan; Kalçık, Macit; Yesin, Mahmut; Karakoyun, Süleyman; Bayam, Emrah; Gündüz, Sabahattin; Özkan, MehmetProsthetic valve thrombosis is one of the major causes of primary valve failure, which can be life-threatening. Multimodality imaging is necessary for determination of leaflet immobilization, cause of underlying pathology (thrombus versus pannus or both), and whether thrombolytic therapy attempt in the patient would be successful or surgery is needed. Current guidelines for the management of prosthetic valve thrombosis lack definitive class I recommendations due to lack of randomized controlled trials, and usually leave the choice of treatment to the clinician’s experience. In this review, we aimed to summarize the pathogenesis, diagnosis, and management of mechanical prosthetic valve thrombosis. (Anatol J Cardiol 2016; 16: 980-9). © 2016 by Turkish Society of Cardiology.Öğe Assessment of the Relationship Between C-Reactive Protein to Albumin Ratio and New-Onset Atrial Fibrillation in Patients with ST Elevation Myocardial Infarction(2019) Yesin, Mahmut; Çağdaş, Metin; Karabağ, Yavuz; Rencüzoğulları, İbrahim; Kalçık, Macit; Burak, Cengiz; Tanboğa, İbrahim HalilIntroduction: Previous studies reported that inflammatory markers are associated with the development of new-onset atrial fibrillation (NOAF) in patients with coronary artery disease. However, the predictive value of serum C-reactive protein (CRP) to serum albumin ratio (CAR) for the development of NOAF in patients with ST elevation myocardial infarction (STEMI) has not been investigated yet. Hence, the aim of the present study was to evaluate the potential utility of the CAR in predicting NOAF in patients with STEMI who underwent primary percutaneous coronary intervention (pPCI). Patients and Methods: The present study was a retrospective analysis of the data related to 1153 patients with STEMI who underwent pPCI. CRP levels were measured according to the immunoturbidimetric method, and serum albumin levels were analyzed by the bromocresol green method. The CAR was defined as the serum CRP level divided by the serum albumin level. Results: The incidence of NOAF during in-hospital stay was 5.2% (n= 62 patients). Patients with NOAF had higher CAR values than those without NOAF. Multivariate logistic regression analyses revealed that elevated CAR value was an independent predictor of NOAF (odds ratio 3.280, 95% confidence interval 1.564-6.878; p= 0.002). Furthermore, comparison of receiver operating characteristic curves yielded that the predictive performance of CAR was higher than CRP and albumin alone, respectively. Conclusion: In the present study, we observed that elevated CAR values were independently associated with NOAF development in patients with STEMI treated with pPCI.Öğe Assessment of the relationship between C-reactive protein-to-albumin ratio and slow coronary flow in patients with stable angina pectoris(Lippincott Williams & Wilkins, 2019) Yesin, Mahmut; Çağdaş, Metin; Karabağ, Yavuz; Rencuzoğulları, İbrahim; Burak, Cengiz; Kalçık, Macit; Karakoyun, SüleymanBackground The relationship between severity of coronary artery disease and inflammatory parameters has been previously demonstrated. However, there is a lack of data regarding the role of C-reactive protein-to-albumin ratio (CAR) in slow coronary flow (SCF) in patients with stable angina pectoris (SAP). In this study, we aimed to investigate the relationship between CAR and presence of SCF in patients with SAP. Patients and methods This study enrolled 217 patients undergoing coronary angiography for SAP. SCF was detected in 81 (37.3%) patients, and the control group included 136 patients. All clinical, demographical, and laboratory parameters were entered into a dataset and compared between SCF group and the controls. Results The mean age of the patients was 66.1 +/- 12.1 years (male: 57.1%). C-reactive protein and CAR were significantly higher in patients with SCF compared with controls (P = 0.004 and < 0.001, respectively). Logistic regression analysis demonstrated that high CAR level was an independent determinant of SCF (odds ratio: 1.023; 95% confidence interval: 1.013-1.034; P < 0.001). Conclusion Higher CAR level may be a valuable predictor of SCF in patients with SAP who undergo coronary angiography. Inflammation may play an important role in the pathogenesis of SCF.Öğe Comparison of different anticoagulation regimens in pregnant patients with mechanical prosthetic heart valves(Oxford Univ Press, 2017) Kalçık, Macit; Bayam, Emrah; Yesin, Mahmut; Gündüz, Sabahattin; Gürsoy, Mustafa Ozan; Karakoyun, Süleyman; Özkan, Mehmet[Abstract Not Available]Öğe Comparison of syntax score and syntax score II to predict “no reflow phenomenon” in patients with ST-segment elevation myocardial infarction(Springer Netherlands, 2017) Yesin, Mahmut; Çağdaş, Metin; Kalçık, Macit; Uluganyan, Mahmut; Efe, Süleyman Çağan; Rencüzoğulları, İbrahim; Karabağ, Yavuz; Gürsoy, Mustafa Ozan; Karakoyun, SüleymanEven though the relationship between syntax score (SS) and coronary no-reflow phenomenon has been studied, the relation between SS and syntax score II (SS II) in patients with no-reflow phenomenon is unknown. We aimed to define the relationship between coronary no-reflow phenomenon and SS II as compared with SS. This study enrolled 193 patients undergoing primary percutaneous coronary intervention for ST elevation myocardial infarction in whom 42 patients developed the no-reflow phenomenon. SS and SS II were calculated in all patients. Bland Altman analysis was used to compare receiver-operating characteristic (ROC) curve analysis results. SS and SS II values were significantly higher in the no-reflow group than the reflow group (28.3 ± 5.5 vs. 18.8 ± 10.1; p < 0.001 and 42.5 (22.1–58.5) vs. 26.1 (13–49.8); p < 0.001 respectively). SS II value >32.3 yielded an area under the curve value of 0.881 (95% CI 0.820–0.942; p < 0.001) and independently predicted no-reflow with a sensitivity of 88% and a specificity of 80% (OR 1.150, 95% CI 1.047–1.263, p = 0.003). Comparison of ROC curve results with Bland Altman analysis showed that area under curve of SS II was larger than that of SS (0.881 vs. 0.785, p = 0.01). SS II may be a more useful tool than SS for prediction no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST elevation myocardial infarction. © 2017, Springer Science+Business Media B.V.Öğe Echocardiographic measurement of epicardial adipose tissue thickness in patients with microvascular angina(Akademiai Kiado Zrt, 2019) Kalçık, Macit; Yesin, Mahmut; Güner, Ahmet; Bayam, Emrah; Yetim, Mücahit; Doğan, Tolga; Karavelioğlu, YusufIntroduction: Impaired coronary microcirculation, inflammation, and endothelial dysfunction were reported etiological factors for microvascular angina (MVA). Recently, increased epicardial adipose tissue (EAT) thickness has been associated with hypertension, metabolic syndrome, and coronary artery disease in general population. In this study, we aimed to evaluate the EAT thickness in patients with MVA. Methods: This study enrolled 200 patients (83 males; mean age: 55.4 +/- 8.2 years) who have been diagnosed with MVA and 200 controls (89 males; mean age: 54.4 +/- 8.5 years). All patients underwent transthoracic echocardiography, and EAT thickness was measured from a parasternal long-axis view as the hypoechoic space on the right ventricular free wall. Results: The mean EAT thickness was significantly higher in MVA patients than the controls (5.5 +/- 1.1 vs. 4.9 +/- 0.7 mm; p < 0.001). Multiple logistic regression analysis showed that increased EAT thickness was an independent predictor of MVA (OR = 1.183, 95% CI = 1.063-1.489; p = 0.023). In receiver operating characteristic curve analyses, EAT thickness above 5.3 mm predicted MVA with a sentivity of 68% and a specificity of 63% (AUC = 0.711, 95% CI = 0.659-0.762; p < 0.001). Conclusions: The EAT thickness was observed significantly higher in MVA patients as compared to controls. Increased EAT thickness may be associated with mechanisms that play a major role in the pathogenesis of MVA.Öğe Evaluation of the potential predictors of embolism in patients with left atrial myxoma(Blackwell Publishing Inc., 2019) Kalçık, Macit; Bayam, Emrah; Güner, Ahmet; Küp, Ayhan; Kalkan, Semih; Yesin, Mahmut; Gürsoy, Mustafa Ozan; Gündüz, Sabahattin; Karakoyun, Süleyman; Özkan, MehmetIntroduction: Cardiac myxomas are the most common primary intracardiac tumors. Although myxomas are histologically benign, they are potentially dangerous due to potential risk of systemic and cerebral embolism. In this study, we aimed to investigate the potential predictors of embolism in patients with left atrial myxoma. Methods: This single-center retrospective study enrolled 93 patients (mean age: 52.9 ± 15.3 years, female: 70 [75.3%]) with left atrial myxomas between 2014 and 2018. The patients were classified into two groups (embolic vs nonembolic) to investigate possible predictors of embolism. Demographic, laboratory, and echocardiographic parameters were recorded into a dataset and compared between patients with and without embolism. Results: The study population was composed of 13 (14%) patients in embolic (11 cerebrovascular and 2 peripheral) and 80 (86%) patients in nonembolic group. Demographic and laboratory parameters were similar between the groups. Tumor sizes were significantly higher in the embolic group than in the nonembolic group (5.59 ± 1.08 vs 4.29 ± 0.61; P = 0.001). By multivariate analysis, increased tumor size, increased left atrial diameter, and the presence of atrial fibrillation and irregular tumor surface were identified as independent predictors of embolism. In ROC curve analyses, tumor size above 4.6 cm predicted embolism with a sensitivity of 77% and a specificity of 73% (AUC: 0.858; 95% CI: 0.752–0.964; P < 0.001). Conclusion: The presence of atrial fibrillation, irregular tumor surface, increased tumor size, and increased left atrial diameter is associated with increased risk of embolism in patients with left atrial myxoma. Early surgery should be scheduled for such patients due to increased potential for embolism. © 2019 Wiley Periodicals, Inc.Öğe Evaluation of the relationship between platelet indices and spontaneous echo contrast in patients with mitral prosthetic heart valves(2020) Kalçık, Macit; Sayar, Ahmet Güner; Bayam, Emrah; Yesin, Mahmut; Kalkan, Semih; Gürsoy, Mustafa Ozan; Özkan, Mehmet AkifObjective: Spontaneous echo contrast (SEC) is defined as dynamic, smoke-like echoes within the cardiac cavities with a characteristic swirling motion seen on echocardiography. Clinical studies have demonstrated that SEC is a risk factor for left atrial thrombus formation and an important indicator for potential systemic embolism. Platelet indices have been associated with the presence of SEC in patients with mitral stenosis. The aim of this study was to investigate the relationship between platelet indices and SEC in patients with prosthetic heart valves. Methods: A total of 89 patients [female: 38 (42.4%); median age: 52 years (range: 36-67 years)] with SEC formation in the left atrium, and 257 control subjects [female: 123 (47.5%); median age: 56 years (range: 45-65 years)] without SEC formation were enrolled. All of the patients were evaluated by using transthoracic and transesophageal echocardiography. Laboratory tests including complete blood count and biochemical parameters were analyzed. Results: Patients with SEC formation had more frequent atrial fibrillation, higher left atrial diameter (LAD) and lower left ventriular ejection fraction values. Platelet indices including platelet count, platelet distribution width, mean platelet volume, and plateletcrit did not differ between the groups. Increased LAD was detected as the only independent predictor of SEC development. Conclusion: Platelet indices were not found to be associated with the presence of SEC formation in the left atrium among patients with mitral prosthetic valves. Therefore, the use of platelet indices alongside known echocardiographic and clinical risk factors to predict SEC development in patients with a mitral prosthesis is debatable.Öğe Fragmented QRS may predict new onset atrial fibrillation in patients with ST-segment elevation myocardial infarction(Churchill Livingstone Inc., 2018) Yesin, Mahmut; Kalçık, Macit; Çağdaş, Metin; Karabağ, Yavuz; Rencüzoğulları, İbrahim; Gürsoy, Mustafa Ozan; Efe, Süleyman Çağan; Karakoyun, SüleymanBackground Fragmented QRS (fQRS) has been shown to be a marker of local myocardial conduction abnormalities, cardiac fibrosis in previous studies. It was also reported to be a predictor of sudden cardiac death and increased morbidity and mortality in selected populations. However, there is no study investigating the role of fQRS in the development of atrial fibrillation in patients with ST segment elevation myocardial infarction (STEMI). In this study we aimed to investigate the relationship between the presence of fQRS after primary percutaneous coronary intervention (pPCI) and in-hospital development of new-onset atrial fibrilation (AF) in patients with STEMI. Material and methods This study enrolled 171 patients undergoing pPCI for STEMI. Among these patients 24 patients developed AF and the remaining 147 patients were designated as the controls. All clinical, demographical and laboratory parameters were entered into a dataset and compared between AF group and the controls. Results The presence of fQRS was higher in the AF group than in the controls (P = 0.001). Diabetes mellitus and fQRS was significantly more common in the AF group (P = 0.003 and P = 0.001 respectively) Logistic regression analysis demonstrated that the presence of fQRS was the independent determinant of AF (OR: 3.243, 95% CI 1.016–10.251, P = 0.042). Conclusions Increased atrial fibrillation was observed more frequently in STEMI patients with fQRS than in patients without fQRS. fQRS is an important determinant of AF in STEMI after pPCI. © 2017 Elsevier Inc.Öğe Identification of mechanical prosthetic heart valves based on distinctive cinefluoroscopic and echocardiographic markers(Sage Publications Ltd, 2019) Kalçık, Macit; Güner, Ahmet; Yesin, Mahmut; Bayam, Emrah; Kalkan, Semih; Gündüz, Sabahattin; Özkan, MehmetThe past 65 years have witnessed remarkable progress in the development of safe, hemodynamically favorable mechanical heart valves. Today, there are a large number and variety of prostheses in use and many prostheses have been used for a while and then discontinued. When patients lack reliable information about their heart valve prostheses, identification of valve model becomes difficult even for specialized physicians in this area. A combination of cinefluoroscopy and echocardiography makes it possible to provide accurate and detailed information regarding identification of prosthetic valve models. Fluoroscopic examination is a useful technique to evaluate patients following mechanical heart valve replacement. However, transthoracic echocardiography and transesophageal echocardiography have almost replaced cinefluoroscopy in the evaluation of prosthetic heart valves. Especially, real-time three-dimensional transesophageal echocardiography provides distinctive images of prosthetic heart valves, particularly for those in the mitral position. A large body of literature has been published to familiarize physicians with the radiological appearance of numerous mechanical prostheses. However, there is a lack of data regarding the identification of prosthetic valve models based on echocardiographic appearance. In this review, we aimed to describe distinctive echocardiographic and cinefluoroscopic markers for identifying the type and brand of several commonly used mechanical prosthetic heart valves.Öğe Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis(2020) Çakal, Beytullah; Kalçık, Macit; Güner, Ahmet; Gürsoy, Mustafa Ozan; Yesin, Mahmut; Karakoyun, Süleyman; Özkan, MehmetObjective: Prosthetic valve thrombosis (PVT) is a serious complication among patients with prosthetic heart valves. Thrombolytic therapy (TT) is now widely used as first-line treatment for PVT. Endothelial dysfunction has previously been reported in patients with PVT. The aim of this study was to investigate the changes in endothelial function soon after TT in PVT patients. Methods: The study group included 85 patients with PVT [female: 53 (62.3%); age: 48.7±13.9 years] who were evaluated prospectively before and shortly after TT. All of the patients were evaluated using transthoracic and transesophageal echocardiography. TT was administered in all cases with a low-dose, ultra-slow infusion regimen. Endothelial function was evaluated using a noninvasive measurement of flow-mediated dilatation (FMD) of the brachial artery during reactive hyperemia. Results: The study population included 38 (44.7%) obstructive and 47 (55.3%) non-obstructive PVT patients. The obstructive PVT patients had lower baseline FMD values than the non-obstructive PVT group (5.31±0.76% vs. 5.87±0.84%; p=0.003). TT was successful in 79 patients (92.9%). FMD was significantly increased in the successfully thrombolyzed patients after TT (5.65±0.86% vs. 7.13±1.26%; p<0.001). There was no significant difference in the FMD values after TT in patients who were unresponsive to TT (5.07±0.61% vs. 5.38±0.95%; p=0.371). There was a significant increase in FMD values after TT in patients with obstructive PVT (5.31±0.76% vs. 8.22±1.15%; p<0.001). However, this difference was not statistically significant for patients with non-obstructive PVT (5.87±0.84% vs. 6.11±0.95%; p=0.276). Conclusion: This study demonstrated that successful TT may contribute to improvement of impaired endothelial function in patients with obstructive PVTÖğe Increased Ventricular Activation Time in Patients with the Diagnosis of Cardiac Syndrome X(2019) Kalçık, Macit; Bayam, Emrah; Güner, Ahmet; Yesin, Mahmut; Yetim, Mücahit; Doğan, Tolga; Karavelioğlu, Yusuf; Bekar, LütfüIntroduction: Cardiac syndrome X (CSX) is defined as typical angina with detectable ischaemia on noninvasive stress tests without any evidence of coronary artery stenosis during coronary angiography. Impaired coronary microcirculation, inflammation and endothelial dysfunction are accepted aetiological factors for CSX. The ventricular activation time (VAT) has been reported to be prolonged in myocardial ischaemia due to the conduction delay in the Purkinje fibres and the myocytes. In this study, we aimed to investigate the electrocardiographic parameters including VAT in patients with CSX. Patients and Methods: This study enrolled 120 patients (mean age, 54.7 ± 8.6 years; male, 53) diagnosed with CSX and 130 healthy controls (mean age, 53.3 ± 8.9; male, 66) without ischaemia. All patients underwent electrocardiography and transthoracic echocardiography. VAT was defined as the interval from the beginning of the QRS complex until the peak of the R or R’ wave. Results: There was no significant difference in terms of demographic, laboratory and echocardiographic parameters between CSX patients and controls. Comparison of electrocardiographic parameters yielded that there was no significant difference in terms of the heart rate, P-wave duration, PR interval, QT and corrected QT intervals between the groups. However, the QRS duration (95.1 ± 13.8 vs. 90.4 ± 12.7 msec; p= 0.006) and VAT (34.8 ± 5.7 vs. 29.2 ± 5.6 msec; p< 0.001) were significantly higher in patients with CSX. Conclusion: The present study demonstrated that QRS duration and VAT were prolonged significantly in patients with CSX. This prolongation may be due to the presence of impaired microvascular perfusion and ischaemia-induced conduction delay.Öğe Intermittent malfunction and regurgitation of a mitral prosthetic valve due to entrapment by a residual subvalvular apparatus(Blackwell Publishing Inc., 2018) Güner, Ahmet; Kalçık, Macit; Yesin, Mahmut; Özkan, MehmetIntermittent malfunction is a rare but potentially serious complication of prosthetic heart valve (PHV) replacement. It may be observed in both mitral and aortic valve prosthesis and may lead to either paroxysmal obstruction or regurgitation, depending on the valve location and on the phase of the cardiac cycle during which the leaflet is entrapped. The most frequently encountered causes of intermittent valve malfunction are pannus formation, prosthetic valve thrombosis, vegetations, and remnants of subvalvular apparatus such as chordae tendineae and suture material. Intermittent severe regurgitation of PHV due to residual chordae tendineae is very rare clinical entity, and transesophageal echocardiography is an indispensable guide in the differential diagnosis. Here, we represent an interesting case of intermittent regurgitation of a mitral prosthetic valve due to entrapment by a residual subvalvular apparatus. © 2018 Wiley Periodicals, Inc.Öğe Kalp Yetersizliği Olan Hastalarda Dekompanse Oluşun Bir Belirteci Olarak Ortalama Trombosit Hacminin Önemi(2019) Kalçık, Macit; Yesin, MahmutAmaç: Konjestif kalp yetmezliği morbidite, bozulmuş yaşam kalitesi ve azalmış sağkalım ile ilişkili önemli bir halk sağlığı sorunudur. Konjestif kalp yetmezliği hastaları dekompanse olduklarında, artmış intra ve ekstraselüler sıvı birikimi çeşitli semptomlara yol açar. Dekompansasyon sırasında hücre içi sıvı birikiminin, ortalama trombosit hacmi gibi hücresel boyutlarla ilgili parametrelerde bir artışa yol açabileceğini düşünerek, bu çalışmada konjestif kalp yetmezliği hastalarında dekompanse ve stabil durumlar arasında ortalama trombosit hacmi açısından bir fark olup olmadığını araştırmayı amaçladık. Gereç ve Yöntem: Dekompanse konjestif kalp yetmezliği nedeniyle hastaneye yatırılan hastalar çalışmaya alındı. Transtorasik ekokardiyografik inceleme ve hemogram da dahil olmak üzere rutin kan testleri hastaneye başvuru sırasında kaydedildi. Tüm hastalar hastanede yatış sırasında diüretik tedavisi aldı. Hastaların fonksiyonel kapasiteleri, günlük idrar miktarı ve kilo kaybı hastanede yattığı sürece kaydedildi. Hastalar stabil halde taburcu edilirken rutin tetkikleri tekrarlanarak kaydedildi. Bulgular: Dekompanse konjestif kalp yetmezliği tanısıyla hastaneye yatırılan 120 hasta çalışmaya dahil edildi. Konjestif kalp yetmezliği hastalarında ortalama sol ventrikül ejeksiyon fraksiyonu % 31,8±5,3 idi. Hastaların ortalama hastanede yatış süreleri 7 (5-8) gün olarak hesaplandı. Günlük ortalama furosemid dozu 70 (50-80) mg iken, hasta başına günlük ortalama idrar çıkışı 2166±341 mL ve hasta başına toplam ortalama kilo kaybı 10 (8-11) kg idi. Dekompansasyon sırasında ortalama trombosit hacmi, taburculuk öncesi stabil haline göre önemli ölçüde daha yüksekti (10,1±1,5 vs. 8,1±1,2; p= 0,001). Ayrıca kilo verme miktarı ile hastanede yatış sırasındaki ortalama trombosit hacmi değerlerindeki fark arasında pozitif korelasyon izlendi (r2:0.93; p <0,001). Sonuç: Dekompanse konjestif kalp yetmezliği hastalarında ortalama trombosit hacmi artmış ve hastanede yatış sırasında diüretik tedavisine yanıt olarak azalmıştır. Bu nedenle, konjestif kalp yetmezliği hastalarının takibi sırasında ortalama trombosit hacmi dekompansasyonun bir belirteci olarak kullanılabilir ve klinisyene, diüretik tedavisinin başarısı hakkında bir fikir verebilir.Öğe Management of acute coronary syndromes in patients with prosthetic heart valves(Cambridge Univ Press, 2020) Güner, Ahmet; Kalçık, Macit; Yesin, Mahmut; Özkan, MehmetDear Editor, We have recently read with great interest the article reported by Donmez et al which was published in the last issue of Cardiology in the Young1 . We would like to contribute to the case report by drawing attention to the diagnosis and management of acute coronary syndrome due to coronary embolism in patients with prosthetic heart valves.Öğe Management of an acute ischemic stroke during thrombolytic treatment in a pregnant patient with prosthetic valve thrombosis(Akademiai Kiado Rt., 2017) Kalçık, Macit; Yesin, Mahmut; Bayam, Emrah; Gürsoy, Mustafa Ozan; Güner, Ahmet; Gündüz, Sabahattin; Özkan, MehmetProsthetic valve thrombosis (PVT) is a life-threatening complication in pregnant women with mechanical prosthetic heart valves. Thrombolytic therapy (TT) has evolved as an effective treatment alternative to surgery, which is associated with very high maternal and fetal mortality and morbidity in these patients. Acute ischemic stroke may rarely occur during TT for PVT. Here, we present a pregnant patient who was complicated with cerebral thromboembolism during TT for PVT and successfully managed with continuation of TT. © 2017 The Author(s).Öğe Multimodality imaging of a left ventricular aneurysm in a patient with normal coronary arteries: Unusual localization(Blackwell Publishing Inc., 2017) Yesin, Mahmut; Kalçık, Macit; Alizade, Elnur; Taşar, Onur; Özkan, MehmetLeft ventricular aneurysm (LVA) is rare but potentially fatal complication of myocardial infarction. It has been strictly defined as a distinct area of abnormal left ventricular diastolic contour with systolic dyskinesia or paradoxical bulging. It may be asymptomatic. However, complications including thromboembolism, heart failure, valvular regurgitation, arrhythmia, and rarely rupture may be the initial presentation. Diagnosis may be established by transthoracic echocardiography, left ventriculography, computed tomographic angiography, and cardiac magnetic resonance imaging. Here, we report a case of uncommonly located LVA in an adult patient with normal coronary arteries, which was diagnosed with multimodality imaging. © 2017, Wiley Periodicals, Inc.Öğe Noninvasive diagnostic tools available for discrimination pannus from thrombus in patients with prosthetic valve dysfunction(Blackwell Publishing Inc., 2019) Güner, Ahmet; Kalçık, Macit; Gündüz, Sabahattin; Yesin, Mahmut; Bayam, Emrah; Kalkan, Ali Kemal; Kalkan, Semih; Özkan, MehmetWe have recently read with great interest the article by Barroso Freitas?Ferraz et al1 entitled “Prosthetic aortic valve thrombosis: To fibrinolyse or not to fibrinolyse? That is the question!”. The authors reported a case of aortic prosthetic valve dysfunction (PVD), which was successfully treated surgically. We congratulate the authors for achieving a successful outcome in such a high?risk patient. However, we would like to discuss the importance of noninvasive diagnostic tools for differentiation of prosthetic valve thrombus and pannus, which are the major causes of PVD, before surgical treatment.Öğe Normal reference values for mechanical mitral prosthetic valve inner diameters and areas assessed by two-dimensional and real-time three-dimensional transesophageal echocardiography(Springer, 2021) Kalçık, Macit; Özkan, Mehmet; Gündüz, Sabahattin; Gürsoy, Mustafa Ozan; Yesin, Mahmut; Bayam, Emrah; Tanboğa, Halil IbrahimIt was previously observed that two dimensional (2D) Doppler derived and real-time three-dimensional (RT-3D) directly measured valve areas were smaller than reported manufacturer sizes. It may be helpful to obtain the ranges of inner diameters (IDs) and the geometric orifice area (GOA) during evaluation of prosthetic mitral valves. In this study, we aimed to provide reference dimensional parameters of bileflet mitral mechanical prosthetic valves. Patients with recent mitral valve replacement were examined by 2D and RT-3D transesophageal echocardiography (TEE) in the early postoperative period when the presence of pannus overgrowth was unlikely. Measurements of 2D IDs, 3D hinge to hinge (HHD) and edge to edge diameters (EED) and 3D GOA were obtained and compared with reported manufacturer sizes and areas. This study enrolled 126 patients with mitral prosthetic valves (38 ATS, 42 Carbomedics, 46 St. Jude Medical, all bileaflet). The measured 2D and 3D IDs and GOA were significantly smaller than reported manufacturer sizes in the majority of the valve sizes. This RT-3D TEE-guided study provides ranges of reference values for directly measured IDs and GOA of the three most commonly used mechanical mitral prosthetic valve types for the first time in a relatively large series.Öğe Oscillating left atrial appendage in a massive pericardial effusion due to severe paravalvular leakage after mitral valve replacement(Taylor and Francis Ltd., 2017) Yesin, Mahmut; Kalçık, Macit; Çağdaş, Metin; Karakoyun, Süleyman; Bayam, Emrah; Özkan, MehmetA 36-year-old female patient was referred to our hospital with a transient ischaemic attack (TIA) that had occurred three days before and with progressive dyspnoea for about one week.
