Surgical treatment of giant cardiac aneurysm with pseudoaneurysm in a colon carcinoma patient

Left ventricular pseudoaneurysm is a rare and lethal condition associated with a high risk of rapid enlargement and rupture. It develops after transmural myocardial infarction (MI), cardiac surgery, trauma, or infection. When a left ventricular pseudoaneurysm is detected, surgical repair is recommended due to the high possibility of rupture. In this report, we present surgical treatment of a giant cardiac pseudoaneurysm that occurred after MI in a colon carcinoma patient

Circulating adhesion molecules and arterial stiffness

Aim: VCAM-1 and ICAM-1 are two important members of the immunoglobulin gene superfamily of adhesion molecules, and their potential role as biomarkers of diagnosis, severity and prognosis of cardiovascular disease has been investigated in a number of clinical studies. The aim of the present study was to determine the relationship between circulating ICAM-1 and VCAM-1 levels and aortic stiffness in patients referred for echocardiographic examination. Methods: Aortic distensibility was determined by echocardiography using systolic and diastolic aortic diameters in 63 consecutive patients referred for echocardiography. Venous samples were collected in the morning after a 12-hour overnight fast, and serum concentrations of ICAM-1 and VCAM-1 were measured using commercial enzyme immunoassay kits. Results: Data of a total of 63 participants (mean age 55.6 ± 10.5 years, 31 male) were included in the study. Circulating levels of adhesion molecules were VCAM-1: 12.604 ± 3.904 ng/ml and ICAM-1: 45.417 ± 31.429 ng/ml. We were unable to demonstrate any correlation between indices of aortic stiffness and VCAM-1 and ICAM-1 levels. Conclusion: The role of soluble adhesion molecules in cardiovascular disease has not been fully established and clinical studies show inconsistent results. Our results indicate that levels of circulating adhesion molecules cannot be used as markers of aortic stiffness in patients

Turkey: Coronary and structural heart interventions from 2010 to 2015

Growing populations and ageing demographics lead to an increased burden of ischaemic heart disease and related cardiovascular interventions, resulting in pressure on healthcare sys-Tems. Although the healthcare system in Turkey has undergone comprehensive remodelling over the last decade, there are many challenges to overcome, including better reimbursement for car-diovascular interventions, standardisation of interventional cardiology services and research-related activities. In this manuscript, we present an overview of coronary and structural heart interventions in Turkey, as well as providing information on current reimbursement policies and the healthcare system. © Europa Digital and Publishing 2017. All Rights Reserved

CYP2C19*1 and CYP2C19*2 Polymorphism in Turkish Patients Being Diagnosed with Stable Coronary Artery Disease and Using Clopidogrel

Objective:The CYP2C19*1 has an entirely normal activity allele whose clopidogrel metabolism is normal. CYP2C19*2 called as non-functional alleles. In this study, we aimed to establish the CYP2C19*1 and CYP2C19*2 genotype frequencies both in Turkish patients with coronary artery disease (CAD), who used clopidogrel, and in healthy Turkish population as well as to present the differences in genotypes and alleles between both groups.Method:One hundred healthy individuals and 200 patients diagnosed with CAD were included in the study. DNA was isolated and CYP2C19 gene was amplified through the polymerase chain reaction method in the genomic DNAs obtained, and the polymorphic foci in these regions were specified.Results:CYP2C19*1/1 genotype was identified in 132 patients (66%), CYP2C19*1/2 genotype in 62 patients (31%) and CYP2C19*2/2 genotype in 6 patients (3%) in the CAD group. In the control group, by contrast, 72 patients (72%) were identified with CYP2C19*1/1 genotype, 20 patients with CYP2C19*1/2 genotype and 8 patients with CYP2C19*2/2 genotype. There was a significant difference between the groups in terms of genotypes (p=0.034).Conclusion:We found CYP2C19*1/2 and CYP2C19*2/2 genotype to be higher in the CAD patients than in the control group, highlighting the importance of checking CYP2C19 gene polymorphism prior to the initiation of antiplatelet therapy in CAD patients

How Do Patients Understand Safety for Cardiac Implantable Devices? Importance of Postintervention Education

This study was designed to assess the effect of patient education on the knowledge of safety and awareness about living with cardiac implantable electronic devices (CIEDs) within the context of phase I cardiac rehabilitation. Methods. The study was conducted with 28 newly implanted CIED patients who were included in "education group (EG)". Patients were questioned with a survey about living with CIEDs and electromagnetic interference (EMI) before and 1month after an extensive constructed interview. Ninety-three patients who had been living with CIEDs were included in the "without education group (woEG)". Results. Patients in EG had improved awareness on topics related to physical and daily life activities including work, driving, sports and sexual activities, EMI of household items, harmful equipment, and some of the medical devices in the hospital setting (p<0.05). Patients in EG gave significantly different percent of correct answers for doing exercise or sports, using the arm on the side of CIEDs, EMI of some of the household appliances, medical devices, and all of the harmful equipment compared to woEG (p<0.05). Conclusion. It was demonstrated that a constructed education interview on safety of CIEDs and living with these devices within the context of phase I cardiac rehabilitation is important for improving the awareness of patients significantly. Thus, patients might achieve a faster adaptation to daily life and decrease disinformation and misperceptions and thus promote the quality of life after the device implantation

Long onlay bypass grafting using the left internal mammary artery for proximal and mid stenosis of the left anterior descending artery

Aim of the study: According to the literature, many surgeons aim to obtain complete revascularization during coronary artery surgery. This becomes an issue when the left anterior descending (LAD) artery is diffusely diseased. This study presents the results of revascularization surgery of LAD arteries with multiple stenoses and the subsequent angiographic control examinations. Material and methods: Forty-seven patients with proximal and mid-segment left anterior descending (LAD) artery disease were included in the study. Left anterior descending arteries were bypassed with left internal mammary arteries (LIMAs). Left anterior descending arteries were longitudinally opened over the mid stenotic segments 4-5 mm distally and proximally from the stenosis. The LIMAs were then anastomosed to the LAD arteries with a running suture, using 7-0 polypropylene sutures. Thirteen patients, who provided their informed consent, were angiographically evaluated at a mean of 12.5 ± 3.7 months after the operation (range 6-18 months). Results: The mean age of the patients was 64.1 ± 8.9 years. The mean number of distal anastomoses was 3.5 ± 0.9 (range 1-6). The mean length of LAD anastomoses was 1.88 ± 0.54 cm (range 1.5-4 cm). Cardiac troponin I levels were below perioperative myocardial infarction thresholds. Mean postoperative hospitalization was 6.10 ± 0.98 days (range 5-9 days). There was no mortality in the study group. Control angiography revealed patent bypass grafts in all patients. Conclusions: Long anastomosis to the LAD artery provides excellent mid-term patency. It is safe and effective in perfusing the proximal and distal non-stenotic segments of the LAD artery, as well as in perfusing the unoccluded side branches originating from the stenotic segments. © 2014 Termedia Sp. z o.o. All rights reserved

Left ventricular non-compaction in pregnancy

Left-ventricular non-compaction (LVNC) represents an arrest in the normal process of myocardial compaction, resulting in multiple, prominent, persistant trabeculations and deep inter-trabecular recesses communicating with the ventricular cavity. LVNC is a rarely encountered cardiomyopathy and few cases have been reported in pregnancy. In this case report we present a patient who referred to our clinic with symptoms of heart failure during pregnancy and whose echocardiographic examination revealed prominent trabeculations in the left ventricle