Yazar "Oztas, Didem Melis" seçeneğine göre listele
Listeleniyor 1 - 9 / 9
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Addition of the duration of ST segment depression to Duke treadmill score for diagnostic accuracy of exercise electrocardiography to predict obstructive coronary artery disease(Taylor & Francis Ltd, 2022) Caglar, Fatma Nihan Turhan; Gok, Gulay; Oztimer, Gulsum; Katkat, Fahrettin; Karakozak, Dilay; Oztas, Didem Melis; Beyaz, Metin OnurIntroduction Exercise electrocardiography (EET) is a safe and cost-effective method to predict the presence, prognosis, and severity of coronary artery disease (CAD). Various score models have been developed to increase predictive power of EET. In this study, we aimed to evaluate whether adding ST depression duration could have an effect on increasing the value of Duke treadmill score (DTS) in predicting obstructive CAD. Methods In this single centred, cross-sectional study, we evaluated a total of 258 patients who presented with a complaint of chest pain and undergone coronary angiogram in result of a positive EET. DTS was calculated for all the patients. The new score-revised DTS- was calculated by adding total ST depression time to classical DS parameters. We compared area under the curve (AUC) of DTS and revised DTS by Delongi method. Results Mean age of the group was 58.43 +/- 9.37, and 37.2% (n = 96) were female. Mean total ST-depression duration was 171.72 +/- 91.43 msec in normal artery group,241.54 +/- 118.11 msec in non-obstructive CAD group, and 281.26 +/- 113.64 in obstructive CAD group.ST-depression duration in both exercise and recovery, and total ST depression duration were significantly higher in obstructive CAD group than non-obstructive and normal artery groups (p = 0.024, p = 0.01, p < 0.01, and p < 0.01, respectively). Revised DTS had significantly higher predictive value of obstructive CAD compared to classical DS (AUC (95%CI): 0.744 vs. 0.626, p < 0.001). The AUC of DS was significantly lower than the new score (z-score:3.274, p = 0.011). Conclusion In conclusion, adding ST depression duration to DTS calculation is increasing the discriminative value of DTS to predict obstructive CAD. Benefits of EET within the context of the management of CAD is well-known, hence, it is clear that physicians may use revised DTS.Öğe Carotid artery plaque structure in the context of symptomatic/asymptomatic nature of carotid artery stenosis(Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2021) Oztas, Didem Melis; Bilen, Bukem Tanoren; Sener, Leyla Turker; Beyaz, Metin Onur; Ulukan, Mustafa Ozer; Unal, Orcun; Unlu, Mehmet BurcinObjective: In this paper, we examined the relationship between atherosclerotic plaque characteristics and symptomatic carotid artery disease. Material and methods: Twenty-two patients who underwent carotid endarterectomy were enrolled into the study. Thirteen patients were male and remaining 9 patients were female. The mean age was 60.2 +/- 9.6 years. The carotid artery stenosis ranged between 75% and 99%. Eight patients were asymptomatic and remaining 14 patients were symptomatic. Ten patients suffered stroke. One of them had recurrent transient ischemic attacks, 4 patients had dizziness, and one of them had amaurosis fugax. The extracted plaques were evaluated by scanning acoustic microscopy (SAM) and micro-computerized tomography (micro-CT). Results: Smaller acoustic impedance values that reveal collagen-rich plaque formation were detected in patients who had stroke, while higher acoustic impedance values that reveal calcium-rich plaque formation were detected in the asymptomatic patients' plaques. Conclusions: Determination of plaque characteristics with modern radiographic techniques, rather than relying on the degree of stenosis in patients with carotid artery disease, may be helpful to discriminate patients requiring intervention.Öğe Carotid artery screening in asymptomatic individuals of different ethnic origins(Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2022) Beyaz, Metin Onur; Onalan, Mehmet Akif; Oztas, Didem Melis; Ugurlucan, MuratBackground and aims: Certain chronic conditions such as hypertension, diabetes mellitus (DM), hyperchole-sterolemia, and smoking were well defined as a risk factor for carotid stenosis. However, the development of carotid stenosis in different ethnic groups has not been researched adequately. This study aims to evaluate the carotid artery stenosis in patients of different ethnic origins. Methods: This prospective study included 246 (61.2%) Turkish natives and 153 (39.8%) Syrian immigrants, and carried out during March and September 2018 in Istanbul. All of the 399 participants were between the age of 50 and 65 years, and have at least one of the risk factors of hypertension, hyperlipidemia, DM, obesity, heavy socio-economic stress, and smoking. Patients were examined for bilateral carotid arterial system with Doppler ultrasound. Results: The mean age of the patients were 54.2 +/- 7.2, and there were 50.4% of women. Hypertension was the foremost risk factor of both groups (41.1% vs. 47.7%, p = 0.596). Smoking was higher among Turkish natives (p = 0.022). Hyperlipidemia, DM, and stress were similar between the groups (p >0.05). The overweight and obesity rates were also similar among Turkish natives and Syrian immigrants (p = 0.071 and p = 0.279). Patients with mild (<50%), moderate (50-70%) and severe (>70%) carotid stenosis were 332 (83.2%), 33 (8.3%) and 34 (8.6%). No statistical significance was found between the two ethnic groups in terms of the severity of carotid stenosis (p >0.05). Conclusion: Syrian immigrants and Turkish natives have a similar rate of moderate and severe carotid artery stenosis. It can be explained by racial similarity and having a similar risk factor.Öğe The Effect of Renin-Angiotensin Blockers on COVID-19 Related Mortality: A Tertiary Center's Experience(Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2022) Oflar, Ersan; Koyuncu, Atilla; Alp, Murat Erdem; Karaosmanogul, Hayat Kumbasar; Unal, Orcun; Beyaz, Metin Onur; Oztas, Didem MelisBackground: The first reports on coronaviruse disease 2019 (COVID-19) revealed an exaggerated mortality rate in hypertensive patients. In this regard, concerns about angiotensin-converting enzyme (ACE) inhibitors' and angiotensin-receptor blockers' (ARBs) have been aroused. Our aim in this study was to evaluate the potential bad outcome effect of hypertension and anti-hypertensive therapy on COVID-19. Methods: 183 patients with polymerase-chain-reaction (PCR)-proven COVID-19, who were admitted to our hospital and consulted to cardiology department between 15th of March and 15th of April 2020 were inclu-ded. Data were recruited from hospital records. Results: Thirty-two out of 183 patients with COVID-19 died in hospital. Hypertension incidence was not sta-tistically different between patients who survived and died (76 [50.3%] vs 19 [59.4%, p = 0.352]). Although the usage rate of ACEI were similar among groups, ARB usage rate was significantly higher in patients who died than survived (11 [34.4%] vs 23 [15.2%], p = 0.011). Binary regression analysis showed an association between ARBs and mortality (OR: 0.032, 95% CI 1.045-2.623, p = 0.032). Conclusion: Our study confirmed previous concerns regarding a potential harmful effects of ARBs on COVID-19 related mortality.Öğe Efficiency of Prophylactic Ablation of the Tributary Venous Pathways Draining Around the Saphenofemoral Junction to Decrease the Rate of Future Varicose Vein and Symptoms Occurence(Elsevier Science Inc, 2021) Ulukan, Mustafa Ozer; Karakaya, Atalay; Erkanli, Korhan; Beyaz, Metin Onur; Oztas, Didem Melis; Ugurlucan, MuratBackground: There are various other collaterals draining into the venous system around the saphenofemoral junction in addition to the great saphenous vein. We aimed to determine the efficiency of prophylactic ablation of tributary veins in long term varicose vein and symptom recurrence. Methods: Two hundred and sixty-three consecutive patients whom underwent radiofrequency ablation therapy for the treatment of superficial venous reflux disease were investigated. There were 129 patients who received isolated great saphenous vein ablation (Group A) where as 134 patients underwent ablation of the other tributary veins in addition to the great saphenous vein (Group B) between June 2015 and January 2017. The tributary superficial veins; refluxing and/or not refluxing, draining into the saphenofemoral junction were selectively catheterized and ablated in Group B. Patients are followed at least 1 year after the procedures regulary and researched for recurrence of varciose veins and symptoms. Results: Gender, mean age, body mass index, diameter of the great saphenous veins, small saphenous vein disease, and grade of deep venous insufficiency did not differ significantly between the two groups. The mean number of tributary veins were similar in both groups (n: 1.9 +/- 0.4 in Group A vs. n: 1.8 +/- 0.7 in Group B) which were detected preoperatively as well as during the procedure. The mean number of ablated tributary venous pathways could be 1.4 +/- 0.6 in Group B. During the follow up period symptoms related with varicose veins recurred in 19 patients in Group A where as in 7 patients in Group B ( P < 0.05). Three of these symptomatic patients in Group B were the ones in whom the tributary pathways could not be catheterized ablated where as 14 patients in Group A were diagnosed with newly refluxing tributary pathways. All the symptomatic patients in both groups were managed medically and/or with additional interventions. Conclusion: The absence of any fascial unsheathing and the parietal weakness are suggestive of a lower resistance of the tributary veins wall, so collapse and size of veins make it more complex to catheterization regarding to great saphenous vein. Ablation of the tributary superficial venous pathways during the treatment of great saphenous vein reflux disease decreased the rate of recurrence of superficial venous reflux disease and patients symtoms in our modest cohort.Öğe Follow-up Results of Endovascular Aneurysm Repair Following Abdominal Visceral Debranching(Soc Brasil Cirurgia Cardiovasc, 2022) Oztas, Didem Melis; Ugurlucan, Murat; Sayin, Omer Ali; Ekiz, Feza; Onal, Yilmaz; Beyaz, Metin Onur; Umutlu, MuzafferIntroduction: The aim of this study is to present a series of six cases with thoracoabdominal aneurysm treated with hybrid technique in our center. Methods: Between May 2015 and December 2018, the data of six patients with thoracoabdominal aneurysms and various comorbidities who underwent visceral debranching followed by endovascular aortic aneurysm repair were reviewed retrospectively. Results: Patients' mean age was 65.3 +/- 19.6 years. All of them were male. Comorbidities were old age, congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, previous surgical interventions, and/or esophageal hemangioma. Except for one patient who underwent coronary artery bypass grafting (inflow was taken from ascending aorta), debranching was performed from the right iliac artery. Debranching of four visceral arteries (superior mesenteric artery, celiac trunk, and bilateral renal right arteries) was performed in three patients, of three visceral arteries (superior mesenteric artery, celiac trunk, right renal artery) was performed in one, and of two visceral arteries (superior mesenteric artery, celiac trunk) was performed in two patients. Great saphenous vein and 6-mm polytetrafluoroethylene grafts were used in one and five patients, respectively, for debranching. Endovascular aneurysm repair was performed following debranching procedures as soon as the patients were stabilized. In total, three patients died at the early, mid, and long-term follow-up due to multiorgan failure, pneumonia, and unknown reasons. Conclusion: Hybrid repair of thoracoabdominal aneurysms may be an alternative to fenestrated or branched endovascular stent grafts in patients with increased risk factors for open surgical thoracoabdominal aneurysm repair; however, the procedure requires experience and care.Öğe Increased CRP/albumin ratio is associated with superficial venous reflux disease and varicose vein formation(Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2021) Unal, Orcun; Oztas, Didem Melis; Beyaz, Metin Onur; Erdinc, Ibrahim; Meric, Mert; Ulukan, Mustafa Ozer; Karakaya, AtalayBackground: It has been recently postulated that inflammation may have an effect on varicose vein development and prognosis, besides increased venous pressure. CRP/albumin (CAR) is a novel inflammatory marker associated with poor prognosis in a various group of patients. Our aim in this study was to investigate the relation between varicose greater saphenous vein (VSM) diameter and CAR. Methods: A total of 150 patients with patients VSM insufficiency (Group 1, n: 114) and normal VSM (n: 36) were included in the study. The diameter of the VSM was measured with B-mode ultrasound, and reflux was quantified based on valve closure time using Doppler spectral tracings. Blood samples were taken during recruitment. The CAR value is determined by dividing the serum CRP level to the albumin level. Results: There were 21 (18.4%) males and 93 (81.5%) females in Group 1 and 7 males and 29 females in Group 2. Mean age of the patients were similar in both groups (48.02 +/- 12.20 years in Group 1 vs. 44.9 +/- 8.92 years in Group 2, p = 0.44). Mean BMI of the patients did not differ significantly (Group 1: 26.4 +/- 3.7 kg/m2 vs. Group 2: 25.7 +/- 4.2 kg/m2, p = 0.13). The mean diameter of VSM was measured 5.70 +/- 0.29 mm in Group 1 whereas 3.21 +/- 0.34 mm in Group 2 (p = 0.0023). Mean CRP and albumin values in Group 1 were 6.18 +/- 4.99 mg/L and 4.45 +/- 0.27 g/dL whereas 4.25 +/- 2.46 mg/L and 6.18 +/- 1.14 g/dL in Group 2, respectively (p value for CRP = 0.049, p value for albumin = 0.074). CRP/albumin was 1.28 +/- 1.34 in Group 1 and 1.11 +/- 1.21 in Group 2, which was not statistically significant (p = 0.58). There was a positive moderately strong correlation between VSM diameter and CRP/albumin ratio as well as superficial venous reflux disease (r: 0.48). Conclusion: CRP/albumin ratio is associated with increased incidence of varicose veins and increased diame-ter of greater saphenous vein; hence, superficial venous reflux disease. The findings support the hypothesis that systemic inflammation may play a role in varicose vein disease.Öğe Low Oxygen Saturation Following Total Correction in a Patient with Tetralogy of Fallot and Persistant Left Superior Caval Vein-How Did We Diagnose and Manage?(Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2022) Basunlu, Mehmet Turan; Coban, Senay; Sari, Gizem; Saritas, Turkay; Erdem, Abdullah; Oztas, Didem Melis; Beyaz, Metin OnurAssociation of tetralogy of Fallot (TOF) with the other intracardiac pathologies such as atrial septal defect (ASD), atrioventricular canal defect or persistent left superior vena cava (PLSVC), absent pulmonary valve are well known pathologies. The associated pathologies require specific attention during surgical treatment. In this manuscript, we present management of a four-month-old girl who was diagnosed with TOF and PLSVC but the diagnosis of unroofed coronary sinus was missed in her. Association of unroofed coronary sinus with TOF is a very rare variant of TOF pathology.Öğe Preliminary Results of a New Illuminated Radiofrequency Ablation Catheter for the Treatment of Great Saphenous Vein Reflux Disease(Sage Publications Inc, 2022) Beyaz, Metin Onur; Oztas, Didem Melis; Ulukan, Mustafa Ozer; Arslan, Hasan Murat; Unal, Orcun; Ugurlucan, MuratIntroduction: In the current study, we present single surgeon experience of a new radiofrequency ablation system, the catheter, and the device. Patients and Methods: The new system, which comprises a generator and an intervally illuminated radiofrequency ablation catheter, was used for the treatment of 272 consecutive patients with chronic venous insufficiency of the great saphenous vein between November 2017 and October 2018. Mean age of the patients was 53.40 +/- 11.91 years. Mean saphenous vein diameter was 8.51 +/- 2.45 mm. Bilateral great saphenous vein reflux disease was present in 19% (51 cases) of the patients. At the end of the procedure, the closure of the great saphenous vein was confirmed with Doppler ultrasonography. Results: Procedures could be successfully performed in all, except 1 obese (BMI> 30 kg/m(2)) male patient. At the 3rd month, outpatient clinic follow-up control Doppler USG revealed successful ablation of the treated great saphenous vein in 260 patients (96%), whereas in 12 cases (4%), there was continuing reflux. The diameters of the saphenous veins in these patients ranged between 6.9 mm and 19.5 (mean: 10.68 +/- 3.41) mm. Ten patients could be treated successfully with ablation with the same device controlled both at the interventional section as well as on the 3rd month outpatient clinic follow-up. The remaining patients underwent high ligation of the great saphenous vein. Paresthesia occurred in 1 patient and had been permanent. Hematoma occurred in a male patient and resolved spontaneously. Conclusion: Preliminary results of our new radiofrequency ablation device with illumination guidance for the treatment of great saphenous vein reflux disease indicated successful results with enhanced physician utilization, comfort, and reliability.