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  • Küçük Resim
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    Cateheter ablation treatment of atrioventricular nodal re-entrant tachycardia
    (Dicle Üniversitesi Tıp Fakültesi, 2012) Tanboğa, İbrahim Halil; Kurt, Mustafa; Işık, Turgay; Kaya, Ahmet; Aksakal, Enbiya; Ekinci, Mehmet; Bakırcı, Eftal Murat; Kaya, Hasan; Sevimli, Serdar
    Objectives: In this study, we aimed to evaluate our clinical experience about the catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT) including complications and long-term outcomes. Materials and Methods: The study population consisted of 166 patients with AVNRT, 52 of whom from hospital-1 and 114 of who from hospital-2. Radio-frequency (RF) ablation therapy was applied after the basic electrophysiology study. Complications in RF ablation and long-term recurrences were noted. Results: More than 90% of the patients had symptoms persisting for more than one year and again more than 90% of those were suffering at least 2 episodes per month. The success rate of RF ablation was 98.2% for the entire study population. The recurrence rate was observed to be 3% (n=5) throughout the follow-up period. In the multivariate Cox regression analysis; young age, operator`s experience (Hospital 1 vs. 2), and presence of atypical AVNRT were the independent predictors of long-term recurrence. Major complications related to AVNRT ablation are not encountered frequently. Death, myocardial infarction and stroke were not seen in any of the patients, however, two patients developed deep vein thrombosis. Minor complications in RF ablation included asymptomatic minimal/mild pericardial effusion (n=5), femoral hematoma requiring no transfusion (n=5) and transient AV block (n=5). Atrio-ventricular block requiring permanent pacemaker implantation was found only in one patient (0.6%). Conclusion: Radio-frequency catheter ablation in patients with AVNRT appears to be a safe and effective method. The presence of atypical AVNRT, young age and operator`s experience were observed to be the independent predictors of long-term recurrence.
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    General Features of Infective Endocarditis in the South-Eastern and Eastern Anatolia: A Retrospective, Multicenter Study
    (Dr M N Khan, 2012) Islamoglu, Yahya; Aksakal, Enbiya; Kaya, Zekeriya; Atilgan, Zuhal; Kayan, Fethullah; Sunbul, Sumen; Kalkan, Kamuran
    The present study aimed to evaluate general features of infective endocarditis (LE) in multiple tertiary university hospital. The study included 44 patients (23 women, 21 men; mean age 44 +/- 19 years; range 15 to 85 years) who were diagnosed as having definite IE, according to the modified Duke criteria, between June 2007 and June 2011. Data were reviewed on age, sex, underlying heart disease, echocardiographic and microbiological findings, treatment, complications, and mortality. Infective endocarditis developed on a native valve in 30 (72.7%), a mechanical prosthetic valve in 12 (27.3%). Prosthetic valves 12 (27.3%) were the most common preexisting valvular abnormality. The mitral valve was the most commonly affected valve in both native valves (50%) and prosthetic valves (66.6%). The most frequent symptom was fever (n=27, 61.4%). Electrocardiography showed abnormal findings in 22 cases (50%). Transthoracic and/or transesophageal echocardiography showed a vegetation in 41 cases (93.2%), and absce 3 cases (6.8%). Staphylococci (29.6%) and streptococci (25%) were the most common causative agents,and Brucella were 15.9%. Cultures were negative in 7 cases (15.9%). Nine patients (20.4%) underwent surgical treatment. Embolic events (n=6, 35.3%) were the major complications. In-hospital mortality occurred in 6 cases (13.6%). The data reflect epidemiological, clinical, and microbiological profile of IE in multiple tertiary hospital located in the South-eastern and Eastern Anatolia.
  • Küçük Resim
    Öğe
    İnfektif endokarditin klinik sonuçları üzerine hematolojik ve biyokimyasal parametrelerin etkisi
    (Dicle Üniversitesi Tıp Fakültesi, 2011) İslamoğlu, Yahya; Büyükkaya, Eyüp; Kaya, Zekeriya; Aksakal, Enbiya; Kalkan, Kamuran; Özaydoğdu, Necdet; Sümbül, Sümen; Soydinç, Serdar
    Amaç: Çalışmamızda İnfektif endokarditli (İE) hastalarda hematolojik parametrelerdeki değişiklikleri ve bu değişikliklerin komplikasyon ve mortalite oranları ile ilişkisini araştırmayı amaçladık. Gereç ve yöntem: Dicle Üniversitesi, Atatürk Üniversitesi ve Harran Üniversitesi Tıp Fakültelerinin kardiyoloji bölümlerinde İE tanısı ile Haziran 2007 den Haziran 2011 tarihleri arasında yatırılan 44 hasta retrospektif olarak değerlendirildi. İE tanısında Duke kriterleri esas alındı. Hematolojik ve biyokimyasal parametreler kaydedildi. Bulgular: Yaşayan hastalar ile karşılaştırıldığında, İE bağlı ölen hastalarda ortalama yaş, beyaz küre sayısı, nötrofil sayısı, ortalama trombosit hacmi ve komplikasyon oranı daha yüksek bulundu (sırasıyla, p <0.004, p <0.05, p <0.03, p <0.05, p <0.01, p <0.004). Ancak trombosit sayısı daha düşüktü (p <0.05). Bununla birlikte komplikasyon gelişen hastalar ile komplikasyon gelişmeyen hastalar karşılaştırıldığında laboratuar bulguları açısından gruplar arasında fark yoktu (p>0.05). Sonuç: İnfektif endokarditde yaş, ortalama trombosit hacmi ve komplikasyon varlığı mortalite için risk faktörleri olarak kullanılabilir. Ayrıca kan kültüründe S.aureus üremesi yüksek komplikasyon oranları ile ilişkilidir.
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    Preliminary results from a nationwide adult cardiology perspective for pulmonary hypertension: RegiStry on clInical outcoMe and sUrvival in pulmonaRy hypertension Groups (SIMURG)
    (Turkish Soc Cardiology, 2017) Kaymaz, Cihangir; Mutlu, Bulent; Kucukoglu, M. Serdar; Kaya, Baris; Akdeniz, Bahri; Avci, Burcak Kilickiran; Aksakal, Enbiya
    Objective: The present study was designed to evaluate the characteristics of pulmonary hypertension (PH) and adult cardiology practice patterns for PH in our country. Methods: We evaluated preliminary survey data of 1501 patients with PH (females, 69%; age, 44.8 +/- 5.45) from 20 adult cardiology centers (AdCCs). Results: The average experience of AdCCs in diagnosing and treating patients with PH was 8.5 +/- 3.7 years. Pulmonary arterial hypertension (PAH) was the most frequent group (69%) followed by group 4 PH (19%), group 3 PH (8%), and combined pre- and post-capillary PH (4%). PAH associated with congenital heart disease (APAH-CHD) was the most frequent subgroup (47%) of PAH. Most of the patients' functional class (FC) at the time of diagnosis was III. The right heart catheterization (RHC) rate was 11.9 +/- 11.6 per month. Most frequently used vasoreactivity agent was intravenous adenosine (60%). All patients under targeted treatments were periodically for FC, six-minute walking test, and echo measures at 3-month intervals. AdCCs repeated RHC in case of clinical worsening (CW). The annual rate of hospitalization was 14.9 +/- 19.5. In-hospital use of intravenous iloprost reported from 16 AdCCs in CWs. Bosentan and ambrisentan, as monotreatment or combination treatment (CT), were noted in 845 and 28 patients, respectively, and inhaled iloprost, subcutaneous treprostinil, and intravenous epoprostenol were noted in 283, 30, and four patients, respectively. Bosentan was the first agent used for CT in all AdCCs and iloprost was the second. Routine use of antiaggregant, anticoagulant, and pneumococcal and influenza prophylaxis were restricted in only two AdCCs. Conclusion: Our nationwide data illustrate the current status of PH regarding clinical characteristics and practice patterns.
  • Küçük Resim
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    Relationship between the severity of mitral regurgitation, left ventricular dysfunction and plasma brain natriuretic peptide level: An observational strain imaging study
    (Modestum Publishing Ltd., 2012) Elbey, Mehmet Ali; Arslan, Şakir; Aksakal, Enbiya; Şenocak, Hüseyin; Karakelleoğlu, Şule; Arıtürk, Zuhal; Tekbaş, Ebru Öntürk; Çil, Habib
    Objectives: The aim of the this study was to investigate the relationship between the degree of mitral regurgitation (MR), left ventricular (LV) dysfunction determined by strain (S)/strain rate (SR) imaging and plasma brain natriuretic peptide (BNP) levels. Materials and methods: This is an observational cross- sectional study which included 31 consecutive patients (15[48.4%] male) who had applied to our outpatient clin- ics and diagnosed as mitral regurgitation and 25 (12 [48.0%] male) healthy persons as control subjects. The mitral regurgitation patients were divided into two groups: those with moderate MR (n=14[45.2%]) and those with severe MR (n=17[54.8%]), and maximum strain / strain rate measurements of left ventricular wall segments and plasma brain natriuretic peptide levels were determined in these two groups and controls. Results: S/SR values of all wall segments of left ventricle were found to be decreased in patient with severe MR when compared with the control subjects and patients with moderate MR (p<0.001). Conclusions: Although left ventricle functions with conventional echocardiography in patients with mitral valve regurgitation were normal, subclinic deteriorations of left ventricle were detected in patients with severe mitral valve regurgitation.