Kardiyak Diyagnostik Kateterizasyon Sırasında Sol Ventriküler Perforasyon Olgusu: Klinik Takip ve Tedavi

Koroner arter hastalığı ön tanısı ile hastaya standart anjiografi sonrası sol ventrikülografi yapılırken, kullanılan “pigtail” sol ventrikül duvarını perfore etti. Gelişen hemoperikardium klinik ve ekokardiyografik olarak takip edildi. Bu komplikasyon, operasyon gerektiren bir durum gelişmeden spontan olarak stabilize oldu ve tamponad gelişmeden noninvaziv takip ile hasta taburcu edildi

A hybrid therapy as a third approach for type 1 proximal endoleak of thoracic endovascular aortic replacement: Caroticocarotid bypass and re-redo endovascular therapy

AbstractIntroductionIn selected cases with thoracic aortic aneurysm (TAA), thoracic endovascular aortic replacement (TEVAR) is commonly used and shall be proper therapy method. We are presenting a case of TAA previously treated twice by endovascular aortic approaches and complicated by type 1 endoleak.CaseA 67-year-old male patient was admitted to our clinic with back pain at rest. He underwent TEVAR five years ago, twice in 6month. With contrasted computed tomography of chest and abdomen, a new type 1 proximal endoleak was diagnosed, and after routine preoperative follow up, the patient was operated on. At the same session right to left caroticocarotid bypass and re-redo TEVAR were performed. The new endovascular graft was placed as the proximal landing zone to be set between left carotid artery and brachiocephalic truncus. The patient was discharged on postoperative day 4 without any problems.ConclusionAs new techniques and methods have been developed, mortality rates have decreased to 2–3% but in older and high risk patients, mortality rates still remain high [1]. TEVAR is a safe and effective treatment method in the proper and selected patients with thoracic artery aneurysm [2]. Moreover, TEVAR can also be performed as a part of hybrid procedures for arcus aortic aneurysms [3]. But it should be kept in mind that late secondary intervention rates are higher in TEVAR

In vitro effects of rabeprazole on human pylorus tone

WOS: 000352750400009PubMed ID: 25843074Background/Aims It has been reported that proton pump inhibitors induce relaxation in different types of smooth muscles. The aim of this study is to investigate in vitro effects of proton pump inhibitors on human pylorus muscle. Methods Pyloric sphincters were studied in 10 patients who were operated for stomach cancer. In isolated organ bath, control and response to rabeprazole were recorded following contraction with carbachol. During the treatment experiment, while distilled water was applied during the control experiment in every 5 minutes, rabeprazole was administered in every 5 minutes at doses of 10(-6), 10(-6), 10(-4), and 10(-3) M respectively. Contraction frequencies, maximum contraction values and muscle tones were measured. Results The contraction frequencies in the control group were greater than the rabeprazole group in the second, third and fourth intervals while the maximum contraction values in the rabeprazole group were lower in the fourth interval. Even though muscles tones were not different in both groups during all intervals, it was remarkable that the muscle tone was significantly decreased in the rabeprazole group during the fourth interval compared to the first and second intervals. Conclusions In the present study, high doses of rabeprazole reduced contraction frequencies, maximum contraction values, and muscle tone of human pylorus.Yeditepe UniversityThe present study was supported by Yeditepe University. The authors are thankful to Ece Genc, Prof. Dr. for her invaluable mentorship

The response of the myocardial metabolism to atrial pacing in patients with coronary slow flow

The pathophysiology of angina pectoris is not precisely known yet in patients who have no coronary lesion bur slow coronary how by angiography. In this study we aim to display metabolic ischemia via atrial pacing to determine the difference of lactate production and arterio-venous O-2 content difference (AVO(2)). Thirty-four patients with slow coronary flow detected by coronary angiography via the TIMI 'frame count' method were included in this study. The resting and stress images from the patients undergoing myocardial perfusion tomography were recorded, pre and postpacing lactate extraction and AVO(2) content difference values were calculated. Patients were classified according to their metabolic responses to atrial pacing stress. Group I consisted of 28 patients (18 male. 10 female, mean age 54.42 +/-9.61) who did not demonstrate metabolic ischemia and group IT consisted of six patients (four male, two female. mean age 60 +/-5.76) who had metabolic ischemia after the procedure. There was no statistically significant difference between prepacing AVO(2) content difference in group I (57.38 +/-2.05%) and group II (58.23 +/-2.11%) (P=NS). However postpacing AVO(2) content difference of group I and group II was statistically significant (respectively. 57.96 +/-2.65 vs. 68.35 +/-2.15%, P <0.001). In other words, postpacing AVO(2) content difference was unchanged from the basal AVO, content difference level in group I (respectively, 57.38 +/-2.05 vs. 57.96 +/-2.65%; P=NS) in contrast to the postpacing AVO, content difference which increased significantly in group II (58.23 +/-2.11 vs. 68.35 +/-2.15%; P <0.028). Although basal lactate extraction rates were similar in groups I and II (respectively, 0.24 +/-0.1 vs. 0.23 +/-0.18; P=NS), postpacing lactate extraction rates were decreased significantly in the two groups, prominently in group II (0.154 +/-0.15 vs. -0.471 +/-0.27; P <0.0001) which indicated that lactate extraction converted to lactate production. Metabolic ischemia was detected in only 17.6% of patients included in this study and 83.4% of these six patients with proven metabolic ischemia had perfusion defects in scintigraphy. Our data confirmed that angina pectoris was not originated from myocardial ischemia in most of the patients with slow coronary flow. We conclude that perfusion scintigraphy is a reliable and accurate method for detection of true ischemia in this group of patients. (C) 2001 Published by Elsevier Science Ireland Ltd

Advisory Board of This Issue

Relation of diabetes to coronary artery ectasia: A meta-analysis Qiao-Juan Huang et al.; Beijing, Guangxi-China Original Investigations Hormonotherapy administered concurrent radiotherapy and trastuzumab on cardiac toxicity in rats Yasemin Benderli Cihan et al.; Kayseri-Turkey Editorial Comment: The impact of radiotherapy, trastuzumab and hormonal therapy on cardiac fibrosis Alberto Farolfi; Meldola-Italy The relationship between coronary collateral artery development and inflammatory markers Didem Oğuz et al.; İstanbul-Turkey Interrelation of RDW and coronary flow reserve in patient with idiopathic dilated cardiomyopathy Mehmet Özülkü et al.; Konya-Turkey Editorial Comment: RDW and low coronary flow reserve in patients with dilated cardiomyopathy Yuji Nishizaki et al.; Tokyo-Japan Heart rate recovery may predict the presence of coronary artery disease Aydın Akyüz et al.; Tekirdağ-Turkey Homocysteine levels in patient with masked hypertension Kamile Yücel et al.; Konya-Turkey Effect of antihypertensive treatment on endothelial markers in hypertension: A randomized study Mehmet Ali Nahit Şendur et al.; Ankara-Turkey Right ventricule, exercise capacity and quality of life: associations with NT-proBNP in COPD Tuğce Şahin Özdemirel et al.; Ankara-Turkey Breast arterial calcifications, carotid intima-media thickness and hemodynamics Ramazan Büyükkaya et al.; Düzce-Turkey Aerosolized iloprost and oxygen: pulmonary vasoreactivity in children with pulmonary hypertension Özlem Elkıran et al.; Malatya-Turkey Review How to estimate left ventricular hypertrophy in hypertensive patients Dragan Lovic et al.; Nis-Serbi