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ComparasIon of classIc left atrIotomy technIque and alternatIve
transseptal and superIor septal technIques In mItral valve
surgery
Erdoğan M.B, Uygur F, Batyraliev T,
Yamak B.
Providing a good exposure is one of the most
important determinants those affect success of mitral valve surgery. Due to
high frequency of rheumatic valve diseases in our country, mitral valve
operations are the most common disease group of cardiac surgery. Classic
left atriotomy is the most common approach to reach mitral valve.
Furthermore, alternative techniques have been discussed because of left
atriotomy is hard to expose mitral valve in some cases. Majority vast of
these alternative techniques are superior septal and transseptal approaches.
Mitral valve replacement (MVR) were performed by superior septal approach (SSA)
to 62 patients whose left atrium diameter smaller than 50 mm between January
2000 - January 2007 in our hospital. In same time period, 62 patients whose
left atrium diameter smaller than 50 mm and used classic left atriotomy were
called as control group. Each group was compared according to their
operative and postoperative findings. Whilst SSA provides a good exposure in
mitral valve surgery, it does not increase morbidity and mortality rates
when compared with classic left atriotomy.
Key Words: Mitral
valve surgery, Superior septal technique, Transseptal approach, Left
atriotomy
RestenosIs and unstable angIna frequency after coronary stentIng
of saphenous veIn grafts
Koçak A, Abdramanov
K.A, Batyraliev T.A, Niyazova Karben Z.A, Avsar O.
Degenerative changes
in autotransplant are the reasons for using graft through
the veins of the lower extremity (v. saphena magna) in
coronary artery by-pass (CABG).
Approximately, 30% of degenerative changes took place in
venous graft in the period of one year; later there was a
significant increase in the relapse rate. According to re-CABG
surgery, this further operation is accompanied by high
mortality . In addition, perioperative of myocardial
infarction carries a large risk for reoperation (MI), and
cardiovascular complications have significantly decresed In
the treatment of graft lesions, the success rate in
percutaneous transluminal coronary (PTCA) intervention is
90% . Hospital mortality does not exceed 1%, myocardial
infarction is less than 4%, and the emergency coronary
artery by-pass requirement is approximately 2%. However, an
expanded segment with graft is 42% - in 61 patients
restenosis appeared over a six month period.
It is well
known that there is a risk of more immediate clinical events
after unstable angina (NS) than after stable angina (SA).
Unfortunately, in patients with vein graft, restenosis is
generally defined as a form of unstable angina. To find the
frequency of restenosis with PTCA in vein graft and to
investigate the risk factors of unstable angina will be the
goals of our research.
A comparatIve study the effects of RamIprIl and Eprosartan on
blood pressure and dIastolIc functIon In patIents wIth essentIal
hypertensIon
Liuba P, Carauş A, Batyraliev T.
The renin-angiotensin
system is the major contributor to development of
hypertension, atherosclerosis, and many other cardiovascular
diseases. Angiotensin II, one of the main effectors of this
system, contributes to the pathogenesis of hypertension and
developing left ventricular hypertrophy, which plays an
important role in evolution diastolic dysfunction and induce
congestive heart failure or sudden death. The effect on
diastolic dysfunction is not known, either by angiotensin
converting enzyme inhibitors or angiotensin receptor
antagonists, are still not well understood.
A double-blind,
randomized, prospective study of either ramipril (10-20 mg
daily) or eprosartan (600-800 mg daily) over a 6-months
period was conducted in 100 patients (48 males, 52 females).
Diastolic dysfunction was evaluated by transmitral Doppler
echocardiography measured: E/A ratio, isovolumic relaxation
time (IVRT) and dece-leration time (DT). Antihypertensive
action evaluating by measuring parameters using ambulatory
blood pressure mo-
nitoring (ABPM).
After a 6-months treatment with ramipril or eprosartan,
significant systolic blood pressure (SBP) (from 156,9±2.0
mmHg to 128.0±2.2 mmHg, P < 0.0001) and a greater
reduction response were found in the eprosartan group
(18,4% in eprosartan versus 10% in ramipril). The diastolic
blood pressure (DBP) reduced in both the ramipril group (from
95,4±1,6 to 84,6±1,3 mmHg, P < 0.0001) and eprosartan group
(from 94,8±1.38 to 82.1±1.56 mmHg, P < 0.0001). Additionally,
were observed the best effects in the indices of diastolic
function in patients administered treatments of eprosartan.
Eprosartan is effective and well-tolerated in the treatment
of mild-to-moderate hypertension, and the SBP response
reduction to eprosartin was better than that to ramipril.
The benefits of both agents cannot be explained solely by
their antihypertensive effects and possibly may be mediated
through their unique effect on angiotensin blockade.
The effect of trImetazIdIne on In-hospItal mortalIty In
patIents wIth acute coronary syndrome wIthout InterventIonal
therapy
Bıyık İ, Özdemir A,
Salman A, Tayyar N.
To evaluate the effect of
trimetazidine on in-hospital mortality in patients with non-ST elevation
acute coronary syndromes (NSTE-ACS) treated with medical therapy only.
In the registry of 2547
cases, patients were divided as unstable angina pectoris (UAP) (Group-1) and
non-ST segment elevation myocardial infarction (NSTEMI) (Group-2). Two
subgroups of each group were constituted whether patients treated with
standard therapy (heparin, acetyl salicylic acid, clopidogrel, beta blocker,
nitrates) and trimetazidine or patients treated with standard therapy only.
In-hospital mortality rates of all groups were compared.
In 1221 patients with UAP, 2
of 477 patients taking trimetazidine as an adjunct to standard therapy (group-1a)
and 15 of 744 patients not taking (group-1b) were died of cardiac causes. In-hospital
mortality rates were found 0.4 % and 2 %, respectively, (p =0.003). The in-hospital
mortality rates of patients with UAP were lower in patients taking
trimetazidine. In 1326 patients with NSTEMI, 27 of 852 patients taking
trimetazidine as an adjunct to standard therapy (group-2a) and 18 of 474
patients not taking (group-2b) were died of cardiac causes. In-hospital
mortality rates were found 3.2 % and 3.8 %, respectively, (p>0.05). Although,
the results are not statistically significant, in-hospital mortality rates
of patients with NSTEMI were lower in patients taking trimetazidine.
This analysis reveals that
trimetazidine added to standard therapy in patients with NSTE-ACS treated
with medical therapy only may provide in-hospital mortality benefit. However,
to verify these results, large scale, randomized clinical trials are needed.
RemodelIng of heart In
pathogenesIs of Influency of blood cIrculatIon and dIlated
syndrome at non-coronary dIseases of myocardIum
Arystanova A, Avşar Ö, Dokumacı B,
Batyraliev T.
The review
article represents brief literary review on modern condition
of the problem of intimate insufficiency, remodeling and
myocardial dysfunction. The basic mechanisms of development
of remodeling, its types and quantitative methods of
diagnostics are described.
A case of sInus venosus type
atrIal septal defect (SuperIor Vena Cava Type) accompanIed
by partIal anomalous pulmonary veIn connectIon dIsplayed
by multIslIce computed tomography
Soylu A, Altunkeser B.B.
Management of patients
with congenital heart disease requires detailed information
on cardiac and great vessel morphology. However, the
identification of some malformation (like pulmonary vein
malformation) through traditional methods can be both
difficult and time consuming as well. Here, we have the aim
of demonstrating the utility of multislice computed
tomography in the identification of a complex congenital
cardiac malformation of sinus venosus type atrial septal
defect (superior vena cava type) accompanied by partial
anomalous pulmonary vein connection.
Emergency coronary stentIng for
complete thrombotIc occlusIon of an unprotected left maIn
coronary artery In acute myocardIal InfarctIon complIcated by
cardIogenIc shock: A Case Report
Akkuş M.N, Seyis S.
Acute total occlusion of the
left main coronary artery is a rare angiographic finding
with very poor prognosis. Herein, we report on the
successful deployment of a bare-metal stent in a 42-year-old
women who had experienced acute myocardial infarction and
cardiogenic shock consequent to an occluded left main
coronary artery. After an uneventful period, the patient was
discharged at day eleven.
Key Words:
Left Main Coronary Artery, Thrombotic occlusion, Acute
myocardial infarction, Cardiogenic Shock, Stenting
Pseudo-aneurysm of palmar dIgItal
artery:Case Report
Erdoğan M.B.
The patient who has a
story of cutter injury in 25th age has admitted to the
hospital with the complaint of swelling and pain in his
right hand medial 3 months later. A pulsatile mass of
approximately 3,4 cm size is detected in the right hand
medial surface. Upon the presence of trill and murmur on the
mass and the observation of mass which shows vascular
filling, the patient was taken to operation. Aneurism which
is originated from 2,3 superficial common palmar digital
artery is detected. The patient to whom the aneurism
resection artery ligation was applied is discharged without
any problem.
