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Öğe Case of cerebrotendinous xanthomatosis with giant xanthomas and literature review(SPRINGER, 2023) Eliaçık, Sinan; Çil, GülsümIntroduction Cerebrotendinous xanthomatosis (CTX) is a rare autosomalrecessive disease that occurs as result of mutation in the CYP27A1 gene. Theclinical presentation of the disease is quite wide. We planned to briefyreview the literature with this case diagnosed as a CTX. Case A 50-year-old male patient was admitted to the neurologyoutpatient clinic complaining of progressive worsening of his walking, andswelling in his legs. Mild mental retardation was detected in our patient. Inaddition to the visual impairment that would be explained by cataracts, he hadxanthomas in both lower extremities. Signs related to bilateral cataractsurgery and intraocular lens were detected during an eye examination. Therewere no abnormal fndings in electroencephalography, electroneuromyography, andbrain magnetic resonance imaging of the patient, whom we learned that hervisual impairment started in childhood. The Mignarri Suscipion Index index wascalculated as 275. A genetic examination was requested and the CYP27A1 gene wasp.A216P (c.The mutation 646G>C) (CM044609) was detected as homozygous. Conclusion Due to the lowawareness of CTX and the variability of its clinical fndings, its diagnosis maybe delayed for years, as in our patient. When diagnosed, most patients may havesevere, often irreversible neurological damage. With the early recognition ofthe CTX and the start of treatment, patients can have a chance to quality life. Keywords Cerebrotendinous xanthomatosis, Xanthomatosis, Cholestanol, Osteoporosis, Juvenile bilateral cataract, CYP27A1 geneÖğe A Quadricuspid Aortic Valve with Mild Aortic Regurgitation(2019) Karavelioğlu, Yusuf; Ekinözü, İsmail; Yetim, Mücahit; Kalçık, MacitA 21-year-old male was admitted to our outpatient clinic with atypical chest pain. He had no history of cardiovascular disease. Physical examination revealed 2/4 diastolic murmur along the right sternal border, and his electrocardiogram was normal. Transthoracic echocardiography revealed mild aortic regurgitation in the parasternal long-axis view. Transaortic gradients were within the normal limitsÖğe A rare cause of abdominal pain: Mesenteric panniculitis(2021) Düzenli, Tolga; Köseoğlu, HüseyinA 54-year-old woman presented to the emergency department with complaint of abdominal pain lasting for 3 days. Her abdominal pain was in the epigastric region spreading to the left lower quadrant. Oral and IV contrasted abdominal computed tomography (CT) revealed inflammation surrounded by heterogeneous pseudocapsule in the mesenteric fatty tissue starting from the mesenteric root. This inflammation encircled the mesenteric artery and veins and there was a fat halo sign around the vein (Fig. 1). The patient’s condition significantly improved with conservative treatment including antibiotics (ceftriaxone i.v.) and nonsteroidal anti-inflammatory drugs (NSAIDs) (diclofenac i.m.).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 Incremental value of transesophageal echocardiography in the evaluation of patients before percutaneous closure of atrial septal defects(2019) Kalçık, Macit; Güner, Ahmet; Özkan, MehmetWe have recently read with great interest the article by Chen et al. (1) entitled ‘‘Transcatheter device closure of atrial septal defects guided completely by transthoracic echocardiography: A single cardiac center experience with 152 cases’’ published in Anatol J Cardiol 2018; 20: 330-5. We recognize authors’ effort in the report describing the transcatheter device closure of atrial septal defects (ASDs) fully guided by transthoracic echocardiography (TTE), which was a single-cardiac-center experience including 152 cases. On the other hand, we believe that there are some major drawbacks that need to be addressed here.Öğe Management of prosthetic valve thrombosis concomitant with coronary embolism(2019) Kalçık, Macit; Güner, Ahmet; Gündüz, Sabahattin; Özkan, MehmetWe have recently read with great interest the article by Olcay (1) published in Anatol J Cardiol 2018; 20: 365-7. We appreciate the author for his report describing the concomitant left main coronary artery and mitral prosthetic valve thrombosis (PVT) treatment. On the other hand, we believe that there are several major drawbacks that need to be addressed.Öğe Is fibrinolytic therapy really safe in the treatment of prosthetic valve thrombosis in patients with high INR?(Wiley, 2021) Güner, Ahmet; Kalçık, Macit; Gündüz, Sabahattin; Gürsoy, Mustafa Ozan; Özkan, MehmetTo the Editor, We have recently read with great interest the article by Farzaneh et al.1 entitled “Safety of thrombolytic therapy in patients with prosthetic heart valve thrombosis who have high international normalized ratio levels.” The authors reported the study of efficacy and safety of fibrinolytic therapy at elevated international normalized ratio (INR) in patients with prosthetic valve thrombosis (PVT).1Öğe Challenges in the management of patients with mechanical prosthetic heart valves during pregnancy(Taylor & Francis Ltd, 2021) Kalçık, Macit; Güner, Ahmet; Gürsoy, Mustafa Ozan; Özkan, MehmetTo the editor, We have recently read with great interest the article by Kai et al. entitled “Pregnancy managed by unfractionated heparin (UFH) after mechanical aortic valve replacement” [1]. The authors have reported the management of a pregnant patient with mechanical prosthetic valve in the aortic position. We congratulate the authors for achieving a successful outcome in such a high-risk patient for prosthetic valve thrombosis (PVT). However, we believe that the anticoagulation therapy proposed by the authors during pregnancy requires further discussion.Öğe Does low molecular weight heparin really protect against prosthetic valve thrombosis during pregnancy with strict anti-Xa monitoring?(Elsevier Taiwan, 2021) Kalçık, Macit; Güner, Ahmet; Kalkan, Semih; Özkan, MehmetDear Editor,We have recently read with great interest the article by EspiauRomera et al. entitled‘‘Mitral valve thrombosis in term pregnancy:A case report and review of the literature’’[1].Öğe Challenges in the management of pregnant patients with cardiovascular diseases(Bmj Publishing Group, 2021) Güner, Ahmet; Kalçık, Macit; Gültekin Güner, Ezgi; Ertürk, Mehmet; Özkan, Mehmet[Abstract Not Available]Öğe A well validated risk stratification index predicts weak material and fetal outcomes in pregnant women with cardiovascular disease(Elsevier, 2021) Güner, Ahmet; Kalçık, Macit; Özkan, MehmetWe have recently read with great interest the article by Khanna et al entitled ‘‘Maternal and fetal outcomes in pregnant females with rheumatic heart disease’‘. 1 We appreciate the authors for their study describing the predictors of adverse cardiac events in pregnant women with valvular rheumatic heart disease. On the other hand, we believe that there are some major drawbacks that need to be addressed.Öğe Intraoperative transesophageal echocardiography is essential for left atrial appendage closure(Wiley, 2021) Gültekin Güner, Ezgi; Çörekçioğlu, Büşra; Ulutaş, Ahmet E.; Kalçık, Macit; Güner, Ahmet; Ertürk, MehmetTo the Editor,We have recently read with great interest the article by Jianget al.1entitled“Left atrial appendage exclusion is effective in re-ducing postoperative stroke after mitral valve replacement.”Weappreciate the authors for their study describing that left atrialappendage (LAA) exclusion using a double?layer suture duringmitral valve replacement in patients with atrial fibrillation (AF) issafe and effective in reducing early ischemic stroke. On the otherhand, we believe that there are some major drawbacks that needto be addressedÖğe Systemic Fibrinolytic Therapy Versus Ultrasound-Assisted Catheter-Directed Thrombolysis for Acutentermediate-High Risk Pulmonary Embolism(Excerpta Medica Inc-Elsevier Science Inc, 2021) Güner, Ahmet; Gültekin Güner, Ezgi; Kalçık, Macit[Abstract Not Available]Öğe Intravascular ultrasound is essential for left main coronary artery bifurcation stenting(Polish Cardiac Soc-Polskie Towarzystwo Kardiologiczne, 2021) Güner, Ahmet; Gültekin Güner, Ezgi; Kalçık, Macit; Uzun, Fatih; Ertürk, MehmetTo the editor We have recently read with great interest the article by Kassimis et al.1 We appreciate the authors’ management of the patient with iatrogenic left main coronary artery (LMCA) dissection and the technical success of LMCA bifurcation stenting. However, we believe that there are some major drawbacks that need to be addressed.Öğe Should the Therapeutic Apheresis Method Be Added to Treatment in the COVID-19 Outbreak?(Karger, 2021) Şahin, Mustafa; Yıldız, AbdulkerimDear Editor, The coronavirus outbreak, which started in Wuhan, a city in China, in December 2019, soon spread across the world and was declared a pandemic by the World Health Organization. The disease was identified as novel coronavirus-induced (SARS-CoV-2) COVID-19. No effective antiviral agent or vaccine has been produced for the disease, and deficiencies of medical protective equipment and respiratory support devices are causing difficulties in the fight against COVID-19.Öğe Diagnosis, treatment & management of prosthetic valve thrombosis: the key considerations(Taylor & Francis Ltd, 2020) Gündüz, Sabahattin; Kalçık, Macit; Gürsoy, Mustafa Ozan; Güner, Ahmet; Özkan, MehmetIntroduction: Prosthetic heart valve thrombosis is a life-threatening complication after valve replacement surgery. Although subtherapeutic anticoagulation is the main cause, there are many other conventional and esoteric predisposing factors. Areas covered: The etiopathogenesis, diagnosis, and management of prosthetic heart valve thrombosis with particular focus on conventional and esoteric predisposing factors, diagnosis with multimodality imaging and current therapeutic approaches were covered. Expert opinion: Subtherapeutic anticoagulation remains the key driving force for the development of prosthetic valve thrombosis. However, cardiologists should be cognizant of other frequent or rare conventional and esoteric causes. The diagnosis is now more straightforward with the use of multimodality imaging. Transthoracic and transesophageal echocardiography with or without real-time three-dimensional imaging are the current gold standard modalities. Multidetector computed tomography is now a major complementary tool. The favorable clinical outcomes with recently introduced slow or ultra-slow infusions of alteplase, as compared to relatively poor surgical results, have rendered thrombolytic therapy the first-line treatment option in most eligible patients with prosthetic valve thrombosis. Surgical treatment could be reserved in whom thrombolytic therapy is contraindicated or has already failed. The efficacy and safety of thrombolytic therapy as compared to surgery should be confirmed with large observational cohorts, and ideally randomized trials.Öğe Low Dose and Slow/Ultra-Slow Infusion Thrombolytic Therapy Regimens are Effective and Safe in Patients With Prosthetic Valve Thrombosis(Elsevier Science Inc, 2020) Güner, Ahmet; Kalçık, Macit; Gündüz, Sabahattin; Kalkan, Semih; Gürsoy, Mustafa Ozan; Özkan, MehmetTo the Editor,We have recently read with great interest the article by Milneet al. entitled‘Management and outcomes of prosthetic valvethrombosis. An Australian case series from the NorthernTerritory’[1].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 Substantial Value of Cardiac Computed Tomography for the Evaluation of Patients with Suspected Prosthetic Valve Dysfunction(Karger, 2020) Kalçık, Macit; Güner, Ahmet; Gündüz, Sabahattin; Özkan, MehmetDear Editor, We recently read with great interest the article by Hsu et al. [1] entitled ‘‘Cine-Computed Tomography for the Evaluation of Prosthetic Heart Valve Function”. We appreciate the contribution made by these authors in this report on the beneficial use of cine-computed tomography (CT) in the evaluation of patients with suspected prosthetic aortic valve dysfunction. Furthermore, we would like to contribute to their report by drawing attention to the role of cardiac CT for the differentiation of periprosthetic masses as a complementary diagnostic tool to transesophageal echocardiography (TEE) in the evaluation of prosthetic heart valves (PHV).Öğe A comprehensive review of the diagnosis and management of mitral paravalvular leakage(Turkish Soc Cardiology, 2020) Gürsoy, Mustafa Ozan; Güner, Ahmet; Kalçık, Macit; Bayam, Emrah; Özkan, MehmetMitral paravalvular leaks (PVLs) commonly occur in patients with prosthetic valves. Paravalvular defects may be clinically inconsequential and may aggravate hemolysis or cause heart failure through regurgitation. Accordingly, patients may eventually require intervention such as redo surgery or a transcatheter closure of the defects. The introduction of purpose-specific closure devices and new steerable catheters has opened a new frontier for the transcatheter PVL closure. This mode of treatment is an initial therapy in most centers with experienced structural heart team. However, head-to-head data comparing two treatment modalities (surgery and transcatheter closure) are limited, and the world-wide experience is based on nonrandomized studies. Multimodality imaging, including three-dimensional transesophageal echocardiography, facilitates the delineation of mitral PVLs and provides essential data that aids the communication between the members of the structural heart team. In the near future, the success of interventional therapies will most probably increase in patients with mitral PVLs with the introduction of hybrid imaging modalities (echocardiography, cardiac computed tomography, and fluoroscopy). In conclusion, this paper summarizes the etiopathogenesis, clinical characteristics, diagnosis, and treatment of mitral PVLs.
