Intracoronary stent implantation, without predilation, is a developing technique. İt has the potential to have a favorable impact on procedure cost by reducing the number of devices used, contrast administered, and procedure time. Restenosis may be reduced by direct stenting compared with stenting after pre-dilatation. We conducted this study to evaiuate the immediate and sixth months results of direct stenting with ephesos stent (Medistar, Türkiye). 55patients (male 45 (81.8%), female 10 (18.2%) and age 57.8±11.4) who had direct stent implantation (58 stents for 58 lesions in 55 patients) included to the study. There was not any death, acute Mİ or need for emergent CABG vvithin first 48 hours. One patient had an acute MI and re-revascularization in the first week due to discontiniouing of ticlopidin. Procedural success was 94.8%. There was not any death, acute MI or re-revaskülarization vvithin 30 days. Ali patients were undervvent angiographic evaluation at the sixth month's follow-up. Stent was patent in 45 patient (81.5%) and there were critical in-stent restenosis in 10 patients (18.5%). Our findings suggest that direct stenting is a new and safe methode in selected conditions.

Key Words: Direct stenting, Restenosis, Ephesos stent

A majör adverse cardiac event (MACE) was defined as myocardial infarction (Q wave or Non-Q wave), need for repeat target vessel revascularization or cardiovascular death that occurred follovving PCI. End points were evaluated at the end of in hospital period, 1st, 3rd and 6th month.

CRP tevel was < 0.5 mg/dl in 63 (54%) and > 0.5 mg/dl in 53 (46%) pts. There were no significant diffe-rences betvveen two groups up to 30 days. At the end of 3rd and 6th month the difference betvveen two groups were significant according to the MACE [1.6% - 11% , (p<0.05) and 9.5%- 24.5% (p<0.05) sequentially]. The positive predictive value of CRP was 24% and negative predictive value was 90.5% in 6th month. As the CRP levels were sig-nificantly increased in ali groups of pts vvith different clinical presentation after PCI ; it had no influence on MACE at the end of 6th month.

MACE was higher in the pts who have higher CRP levels before PCI, in the long term follovv up period. The negative predictive value of CRP was significantly high in both the early and the late follovv up period. PCI itself increases the CRP levels. These results shows us that CRP levels are independently important among the other risk factors and it must be measured before PCI,   to predict the risc group of the pts for MACE.

A total number of 32 patients were enrolled in the study in whom sinüs rhythm was maintained pharmacologically in 17, spontaneously in 10 and electrically in 5 of them. AH patients were underwent transthoracic echocardiography before, 4 hours, 24 hours, 7 days and 30 days after cardioversion.

A significant decrease in left atrial size were detected in ali three groups in which left atrias were dilated before car¬dioversion. Although there were no significant changes in mitral E wave velocities and E wave velocity time integrals during the 30 days follow up period, A wave velocities and A wave velocity time integrals showed a significant increase. There were no significant differences in groups of spontaneous, electrical and pharmacological cardioversion in 24 hour hours, 7 days and 30 days after cardioversion when compared for the development of atrial stunning. Similarly to the mitral valve flow patterns, peak A wave velocity and A wave velocity time integrals recorded from the tricuspit valve measurements shovved significant increase after cardioversion. Hovvever it was seen the recovery of the mechanical functions of the right atrium was earlier than the left atrium.

As a result; it was shown that the delay of the left atrial mechanical functions was not related with the cardiover¬sion method and besides the left atrial mechanical dysfunction, right atrial mechanical dysfunction had also occured, but the recovery of the right atrial mechanical activity was earlier.

Distal protection can be suggested to proximal lesions with high thrombus content currently. Randomised tri-als are needed for rutine application.

While the majority of patients with LMCA disease have a history of unstable coronary syndromes and/ or myocar¬dial infarction, there are completely asymptomatic individuals as well. LMCA lesions can be broadly classified as ostial and non-ostial. Ostial lesions are usually discrete and eccentric, and are more frequently seen in women.

Complications related to catheterization procedures are significantly more common in the setting of LMCA steno¬sis. Development of procedural adverse events are knovvn to be influenced by several factors, such as congestive heart failure, systemic hypertension, female gender and distance betvveen catheter tip and lesion. Post procedural mortality have also been related to a number of clinical features, namely, advanced age, new- onset angina, low ejection fraction and high left ventricular end-diastolic pressure.

Acut occlusion of the LMCA is a rare but clinically drastic event with a very high mortality. İt is imperetive that reperfusion be provided in this patients as rapidly as possible. On the other hand chronic total occlusion of the LMCA has a quite varied clinical picture and occurs in 0,04- 0,042 % of patients undergoing coronary angiography characteristi-cally individuals with chronic LMCA obstruction are highly dependent on an extensive collateral circulation that perfu-ses the LMCA supplied areas from the right coronary artery.

Coronary artery by-pass grafting is the therapeutic modality of choice in LMCA stenosis. For patient in whom surgery could not be undertaken, percutaneos coronary balloon angioplasty with or without stenting has been succesfully performed. İn particular, stenting has been demonstrated to be superior to sole application of angioplasty in terms of procedural success moreover, stent placement is considered to have a favorable influnce on early term mortality rates.

Homocysteine is an amino acid present in the plasma and it is regarded as a risk factor for the development of coronary artery disease (CAD) by means of endothelial dysfunction. Folat, vitamin B6 and vitamin B12 can decrease plasma homocystein levels and improve endothelial dysfunction. The association betvreen hyperhomocysteinemia and CAD or restenosis after percutaneous coronary interventions and vvhether decreasing plasma homocysteine levels can reduce these risks remains controversial and different studies show different results.

Key Words: Homocysteine, Coronary artery disease, Restenosis

Physical examination findings was only 2/6° systolic sufl at the aortic localization. Diagnosis was confirmed with the aid of two-dimensional echocardiography annd aortography.a 8x8 cm diameter of pseudoaneursym at anterior surface of ascending aorta and proxmity of tr.brachiocephalicus vvhich had calcification around it was found by echo and aortography.

We planed surgery for treatment. The formation of a pseudoaneursym following pericardiectomy is a rare complication. So we present this case report. Nowwe know that, ascending aorta pseudoaneursym follovving pericardiec¬tomy can be generated as a complication. VVe suggest that a patient undergo pericardiectomy has to be evaluated carefully because of pseudoaneursym formation.