Interventional Cardiology in Turkey:
Results of year 2002
Aytekin V, Ömürlü K, Kozan Ö, Payzın S, Sancaktar O, Özmen F.
Comparing with previous year
more number of coronary angiography and angioplasty was performed in 2002.
In 63 cardiac centers 143.275 coronary angiography, 187.760 cardiac
interventions were applied. Coronary angioplasty was done to 33.440 lesions.
81.189 of them balloon angioplasty and 25.251 of them intracoronary stent.
New devices were performed to 914 patients.
In 2002 mitral balloon
valvuloplasty was applied 408 patients, pulmonary valvuloplasty to 57
patients, closure of PDA to 3 patients, closure of ASD to 1 patients. The
cost all cardiac procedures was 133.4 trillion Turkish Liras in 2002.
Key Words:
Interventional cardiology in Turkey go to up
Increased corrected QT disperision in
patients with isolated coronary artery ectasia
Atak R, Turhan H, Şenen
K, İleri M, Hisar İ, Kütük E.
To determine corrected QT
dispersion (QTcD) as a possible indicator of increased risk for ventricular
arrhythmias and sudden cardiac death in patients with isolated coronary
artery ectasia (CAE).
The study included 54
consecutive patients (41 male, 13 female, mean age 53±6) with isolated CAE
without significant stenosis (> 50% stenosis) (group I) and 54 age and
gender matched healthy control subjects with normal coronary arteries (group
II). Twelve-lead electrocardiogram was recorded for each subject. QT
interval was measured from the onset of the QRS complex to the end of the T
wave, defined as its return to the T-P isoelectric baseline. QT dispersion
was defined as the difference between the maximum and minimum QT interval
measurements occuring among any of the 12-lead on a standard
electrocardiogram. QTc (heart rate-corrected QT interval) was calculated
according to Bazett's formula as follows: QTc= QT/square root of the RR
interval. QTcD was calculated in a manner similar to QT dispersion.
Selective coronary angiography was performed using Judkins technique in
multiple projections. Coronary diameters were measured quantitatively.
According to the angiographic definition of Falsetti and Carroll, CAE was
defined as nonobstructive lesion of the epicardial coronary arteries with a
luminal dilation exceeding the 1.5- to 2.0-fold of normal diameters.
No statistically significant
difference was detected when maximum QTc interval of group I and group II
were compared (433±32 ms vs 424±25 ms respectively, p>0.05). However,
minimum QTc interval of group I was found to be significantly lower than
those of group II (371±23 ms vs 395±31 ms respectively, p=0.005).
Consequently, QTcD (QTcmax - QTcmin) in group I was found to be
significantly higher than in group II (62±19 ms vs 29±10 ms respectively,
p<0.0001).
QTcD, indicating increased
risk for ventricular arrhythmias and cardiovascular mortality, is
significantly higher in patients with isolated CAE than in those with normal
coronary arteries.
Key Words:
QT dispersion, coronary artery ectasia go to up
The relation between plasma fasting
insulin level, insulin resistance and coronary artery disease in nondiabetic
patients
Demir M, Dönmez Y,
Kanadaşı M, Sert M, Avkaroğulları M, Akpınar O, Çaylı M, Usal A.
The relation between plasma
fasting insulin level, insulin resistance and the coronary artery disease
(CAD) is still controversial. Some authors report high plasma insulin level
and insulin resistance accelerate the CAD development if metabolic syndrome
(MS) factors are present. The aim of this study was to investigate the
effects of plasma insulin level and insulin resistance over CAD. Ninety-five
patients with chest pain who underwent elective coronary angiography
enrolled in our study. Patients were divided into three groups. Group I
consisted of 26 patients with no CAD and MS. Group II consisted of 41
patients with CAD and no MS. Group III consisted of 28 patients with both
CAD and MS. We asked the CAD risk factors and investigated the MS presence
of all subjects. Total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol
(HDL-C), triglyceride (TG), glucose and insulin levels measured from the
venous blood sample after 12 hours fasting. Insulin resistance was
calculated according to HOMA formula.
The patients who had >50%
lesion in any epicardial coronary artery were considered to have coronary
artery disease. Hypertension frequency was higher in Group III compared to
the other groups (p<0.05). Positive family history was higher in Group II
and III (p<0.05). Group III had higher TG, insulin level, insulin resistance
and TC/HDL-C ratio compared to the other groups. Also HDL-cholesterol levels
were lower in this group (p<0.05)Insulin levels and resistance were not
different in uni and multi-variate analysis regarding the CAD. In
conclusion, our study showed that high insulin levels and insulin resistance
were not independent risk factors for CAD development, but they participated
the development of CAD when other risk factors present.
Key Words:
hyperinsulinemia, insulin resistance, metabolic syndrom, coronary artery
diseasego to up
Elective percutaneous transluminal
coronary angioplasty indications and results
Özmen F, Atalar E.
To indicated the presence
of ischemic chest pain and/or the objective evidence of myocardial ischemia
is need for percutaneous transluminal coronary angioplasty. Candidate for
coronary angioplasty is the patients who have various levels of ischemia and
have clinically asymptomatic or seriously symptomatic or unstable angina.
The selection of the
suitable patients for coronary angioplasty depends on their clinical
specifications as well as the laboratory and anatomic features.
The coronary angioplasty is
applied to the patients who has contraindications to the thrombolytic
treatment or immediately after or early or deffered the thrombolytic
treatment in acute myocardial infarction. Coronary angioplasty is also
indicated in patients with recurrent ischmeia.
Coronary angioplasty reduces
the mortality rate in cardiogenic shock. With the accompaniment of
intraaortic balloon pumping the efficiency of coronary angioplasty increases
and rate of mortality reduces.
Key words:
Percutaneous transluminal, coronary angioplastygo to up
Stenting performed in two days to chronic
total occlusion of saphenous vein graft and overcoming the slow flow
phenomenon with adenosin
Demiralp E, Cebeci B.S,
Kardeşoğlu E, Çelik T, Özmen N, Ulusoy E, Aparcı M.
It has been shown that 15-30
% of saphenous grafts fails after one year from coronary artery bypass graft
surgery (CABG) and 50% of grafts develops significant stenosis by ten years.
Baloon angioplasty and stenting for selected cases may have more advantages
than the reoperation although they have some important complications such as
distal embolization, the slow flow and no reflow. Recently, percutaneous
interventions to the degenerated sapheneous vein lesions may be performed
more succesfully with pharmocologic agents and mechanical distal protection
devices to prevent no reflow and distal embolisation .
We present the intervention
to chronic total occlusion of saphenous vein graft (Aort-LAD) with stent
graft in two days and the overcoming the slow flow phenomenon with the
adenosin.
Key words: Saphenous graft lesion,
stent graft, slow flow, adenosin
go to up
Coronary artery fistula between left
anterior descending coronary artery and a left ventricular pseudoaneurysm as
a late complication of stent deployment
Topsakal R, Gür M, Eryol
N.K, Ergin A.
Coronary artery perforation
caused by percutaneous transluminal coronary angioplasty (PTCA) occurs
rarely and most often leads to fistulization to the pericardial space.
We report a case where PTCA caused fistulization between left anterior
descending coronary artery (LAD) and left ventricular pseudoaneurysm after
stent deployment LAD.
Key Words: Coronary artery fistula, stent
complication go to up
Asymptomatic, a cor triatriatum dexter case in
advanced age
Arslan Ş, Bozkurt E.
Cor triatriatum dexter is an
unusual cardiac abnormality with division between the sinus and primitive
atrial portions of the right atrium. This anomaly is frequently associated
with severe malformations of the other rigt heart structures: right heart
chamber hypoplasia is the most common association. We aimed to inform a cor
triatriatum dexter case asymptomatic and not to accompany congenital
malformations in advanced age.
