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  • Küçük Resim
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    A comparison of postoperative complications following cardiac implantable electronic device procedures in patients treated with antithrombotic drugs
    (Wiley, 2022) Demir, Muhammed; Özbek, Mehmet; Polat, Nihat; Aktan, Adem; Yıldırım, Bünyamin; Argun, Lokman; İldırımlı, Kamran; Toprak, Nizamettin
    Background The incidence of postoperative complications following cardiac implantable electronic device (CIED) procedures in patients treated with antithrombotic drugs has not been studied sufficiently. Here we present a comparison of complications after CIED implantations. Methods Using an observational study design, the study included 1807 patients with a taking antiplatelet drugs (n: 1601), nonvitamin K anticoagulants (NOAC) (n: 136), and warfarin (n: 70) undergoing CIED surgery. Primary endpoint was accepted as cumulative events including composite of clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to device system. Secondary outcomes included each compenent of cumulative events. Multivariable analysis was performed to identify predictors of cumulative events. Results The overall cumulative event rate was 3.7% (67 of 1807). Cumulative events occured 3.1% (50 of 1601) in the antiplatelet, 5.1% (7 of 136) NOAC, and 14.3% (10 of 70) warfarin groups (p < 0.001). CSH occurred in 2 of 70 patients (2.9%) in the warfarin group, as compared with 5 of 1601 (0.3%) in the antiplatelet group (p: 0.032). However, no significant differences were found between NOAC and warfarin groups in terms of CSH (0.7% vs. 2.9% respectively, p: 0.267). Warfarin treatment was an independent predictor of cumulative events and increased 2.9-fold the risk of cumulative events. Major surgical complications were rare and did not differ significantly between the study groups. Conclusions The incidence and severity of complications may be lower in patients treated with periprocedurally antiplatelet or NOAC therapy when compared with warfarin therapy. Further randomized control studies are required to confirm our findings
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    Öğe
    A new trend to reduce adverse events in patients undergoing transcatheter aortic valve implantation: cusp overlap technique: a cross sectional study
    (Springer, 2023) Guzel, Tuncay; Demir, Muhammed; Aktan, Adem; Arik, Baran; Argun, Lokman; Ildirimli, Kamran; Sutcu, Mihriban
    BackgroundTranscatheter aortic valve implantation (TAVI) is currently the treatment of choice for the majority of patients at moderate or high surgical risk. However, some complications occur frequently with this procedure. In this study, we aimed to assess whether the cusp-overlap view (COP) technique may be associated with a reduced incidence of some of these complications compared with the classical three-cusp view (TCV) technique. MethodsIn this single-center, retrospective study we investigated; technical success, postprocedural permanent pacemaker implantation (PPMI), new-onset stroke, pericardial tamponade, arrhythmia development, acute renal failure, major bleeding, major vascular complications, procedure-related coronary obstruction, new-onset left bundle branch block (LBBB), paravalvular leak, peri-procedural myocardial infarction (MI), day of hospitalization, death, and major adverse cardiac and cerebrovascular events (MACCE) were determined as the clinical endpoints. ResultsA total of 281 consecutive patients who met the study criteria and underwent elective or emergency transfemoral TAVI using the self-expandable CoreValve Evolut valve were included. 176 consecutive patients implanted with the classical TCV technique and 105 consecutive patients implanted with the COP technique were compared. Compared with the TCV group, patients in the COP group had lower PPMI (3.8% vs. 10.8%, p = 0.039), in-hospital mortality (1.9% vs. 8.5%, p = 0.018), and 1-year death (4.8% versus 18.8%, p = 0.001), and MACCE rates (12.4% vs 31.3%, p < 0.001). ConclusionThe COP technique may help to reduce the conduction disturbances, PPMI requirement and complication rates that may develop following TAVI. In addition, it is an interesting result that it reduces mortality and MACCE rates in long-term follow-ups.
  • Küçük Resim
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    Trend of sex differences and predictors of complications of cardiac electronic device implantations in the Southeast Anatolian Region of Turkey: An observational study
    (Gaziantep Üniversitesi Tıp Fakültesi, 2022) Demir, Muhammed; Özbek, Mehmet; Polat, Nihat; Yıldırım, Bünyamin; Argun, Lokman; İldırımlı, Kamran; Toprak, Nizamettin; Aktan, Adem; Ateş, Kenan; Öztürk, Cansu
    Objective: The comparison of complications after cardiac implantable electronic device procedures has not been studied adequately between both genders. Here, we examined the effect of gender on complications in the Southeast Anatolian Region of Turkey. Methods: A total of 1640 patients from 3 centers in the Southeast Anatolian Region of Turkey were randomly selected. We compared major adverse cardiac events (clinically significant hematoma, pericardial effusion or tamponade, pneumothorax, and device infection) between genders. Univariate and multivariate analyses were plotted to identify predictors of outcomes between both genders. Results: The overall rate of major adverse cardiac events was 3.8% (63 of 1640). Major adverse cardiac events occurred in 4.1% (40 of 983) of the men and 3.5% (23 of 657) in the women groups (P=.557). The most complications were device-related infection (2.1%) and pneumothorax (1.3%) in both genders. Single- and dual-chamber pacemakers were more implanted in women than in men (11.7% vs. 6.2% and 32.6% vs. 20.1%, respectively, P < .001). On the contrary, single- and dual-chamber implantable cardioverter defibrillators were more implanted in men than in women (38.1% vs. 19.6% and 8.5% vs. 4.1%, respectively, P < .001). Additionally, warfarin treatment and history of heart failure were found predictors of major adverse cardiac events in multivariable analysis. Conclusions: This small-scale, real-life patient data revealed no remarkable distinction in terms of complications between both genders. Multinational randomized large-scale cohort trials are required to support our results.