Pub Date : 2023-01-01DOI: 10.5336/cardiosci.2022-95172
Mehmet Erdem TOKER, Muharrem DAĞLI, Cüneyt ARKAN, Ömer Faruk AKARDERE
Objective: This study aims to investigate the effect of previous stent implantation on early mortality in patients undergoing elective coronary artery bypass grafting (CABG). Material and Methods: A total of 1,259 patients who underwent elective isolated CABG between January 2015 and December 2016 were included. There were 970 patients in the CABG without stent group and 289 patients in the CABG with stent group. Preoperative, intraoperative, and postoperative data of both groups were compared. Predictors of early mortality in CABG were examined using the logistic regression analysis. Results: Early mortality rates after surgery between the groups were similar (CABG without stent group vs. CABG with stent group; 2.9% vs. 3.1%, p=0.998). The length of intensive care unit stay, the use of intraaortic balloon pump, tracheotomy, new dialysis, revision and the use of extracorporeal membrane oxygenator were also comparable between the groups (p>0.05). The mean number of grafts was significantly lower in the CABG with stent group than the CABG without stent group (2.62±0.91 vs. 2.87±0.9; p<0.001 respectively). Multivariate analysis revealed that an ejection fraction of ≤40% [odds ratio (OR): 3.8; 95% confidence interval (CI): 1.9-7.7; p<0.001], preoperative renal failure (OR: 3.7; 95% CI: 1.5-8.8; p=0.003), and advanced age (OR: 1.07; 95% CI: 1.03-1.1; p<0.001) were independent predictors of early mortality. Previous stent implantation has not been found out as a risk factor for early mortality (OR: 1.08; 95% CI: 0.5-2.3; p=0.998). Conclusion: Previous stent implantation was not found to be a factor affecting early mortality in patients undergoing elective CABG operations.
{"title":"Effect of Previous Stent Implantation in Elective Coronary Artery Bypass Grafting Operation; Multivariate Analysis of 1,259 Patients: Retrospective Clinical Trial","authors":"Mehmet Erdem TOKER, Muharrem DAĞLI, Cüneyt ARKAN, Ömer Faruk AKARDERE","doi":"10.5336/cardiosci.2022-95172","DOIUrl":"https://doi.org/10.5336/cardiosci.2022-95172","url":null,"abstract":"Objective: This study aims to investigate the effect of previous stent implantation on early mortality in patients undergoing elective coronary artery bypass grafting (CABG). Material and Methods: A total of 1,259 patients who underwent elective isolated CABG between January 2015 and December 2016 were included. There were 970 patients in the CABG without stent group and 289 patients in the CABG with stent group. Preoperative, intraoperative, and postoperative data of both groups were compared. Predictors of early mortality in CABG were examined using the logistic regression analysis. Results: Early mortality rates after surgery between the groups were similar (CABG without stent group vs. CABG with stent group; 2.9% vs. 3.1%, p=0.998). The length of intensive care unit stay, the use of intraaortic balloon pump, tracheotomy, new dialysis, revision and the use of extracorporeal membrane oxygenator were also comparable between the groups (p>0.05). The mean number of grafts was significantly lower in the CABG with stent group than the CABG without stent group (2.62±0.91 vs. 2.87±0.9; p<0.001 respectively). Multivariate analysis revealed that an ejection fraction of ≤40% [odds ratio (OR): 3.8; 95% confidence interval (CI): 1.9-7.7; p<0.001], preoperative renal failure (OR: 3.7; 95% CI: 1.5-8.8; p=0.003), and advanced age (OR: 1.07; 95% CI: 1.03-1.1; p<0.001) were independent predictors of early mortality. Previous stent implantation has not been found out as a risk factor for early mortality (OR: 1.08; 95% CI: 0.5-2.3; p=0.998). Conclusion: Previous stent implantation was not found to be a factor affecting early mortality in patients undergoing elective CABG operations.","PeriodicalId":495085,"journal":{"name":"Türkiye klinikleri cardiovascular sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134888161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5336/cardiosci.2023-98476
Ömer ALYAN, Mutlu Çağan SÜMERKAN, Kudret KESKİN, Hilal ACAR DEMİR
Objective: Uncrossable coronary lesions are still challenging to treat. Several devices and techniques are introduced, including rotational atherectomy, or anchor balloon. However, these methods are expensive, not always available, and associated with lower procedural success and higher major adverse cardiac events. Our study describes a simple, effective method [patience technique (PT)] to advance a stent through uncrossable lesions that has not been described in the literature. Material and Methods: In a prospective study with 24 patients undergoing uncrossable lesion percutaneous coronary intervention with stent advancement failures, we identify PT and describe our experience with PT. The PT is the process of pushing the uncrossed same stent for a prolonged time under an optimum constant force to overcome the intraluminal friction. Results: Twenty-three (95.8%) patients had modified American College of Cardiology/ American Heart Association classification Type C, 22 (91.70%) diffuse [median length: 38 mm (quartiles 31.25-52.25)], 22 (91.70%) eccentric and 20 (83.30%) moderate-extensive calcified lesions. Respectively, 8 (27.59%) of 29 stenosis was in left anterior descending, and right coronary artery, 6 (20.69%) left circumflex coronary artery, 3 (10.35%) D1, 2 (6.90%) left main coronary artery-Cx, 1 (3.45%) LCxOM2 and saphenous vein graft-LCxOM2. The median stent advancement time was 134.00 seconds (quartiles 95.25-178.50). All procedures progressed after using the PT and finally resulted successfully without complications. Conclusion: The PT is feasible, and safe for facilitating the passage of stents through uncrossable lesions. Before advancing percutaneous cardiac intervention techniques, this method could be used advantageously in calcified, diffuse, and eccentric lesions.
{"title":"A Practical Technique to Advance Stent Through Uncrossable Coronary Lesions: A Prospective Cohort Study","authors":"Ömer ALYAN, Mutlu Çağan SÜMERKAN, Kudret KESKİN, Hilal ACAR DEMİR","doi":"10.5336/cardiosci.2023-98476","DOIUrl":"https://doi.org/10.5336/cardiosci.2023-98476","url":null,"abstract":"Objective: Uncrossable coronary lesions are still challenging to treat. Several devices and techniques are introduced, including rotational atherectomy, or anchor balloon. However, these methods are expensive, not always available, and associated with lower procedural success and higher major adverse cardiac events. Our study describes a simple, effective method [patience technique (PT)] to advance a stent through uncrossable lesions that has not been described in the literature. Material and Methods: In a prospective study with 24 patients undergoing uncrossable lesion percutaneous coronary intervention with stent advancement failures, we identify PT and describe our experience with PT. The PT is the process of pushing the uncrossed same stent for a prolonged time under an optimum constant force to overcome the intraluminal friction. Results: Twenty-three (95.8%) patients had modified American College of Cardiology/ American Heart Association classification Type C, 22 (91.70%) diffuse [median length: 38 mm (quartiles 31.25-52.25)], 22 (91.70%) eccentric and 20 (83.30%) moderate-extensive calcified lesions. Respectively, 8 (27.59%) of 29 stenosis was in left anterior descending, and right coronary artery, 6 (20.69%) left circumflex coronary artery, 3 (10.35%) D1, 2 (6.90%) left main coronary artery-Cx, 1 (3.45%) LCxOM2 and saphenous vein graft-LCxOM2. The median stent advancement time was 134.00 seconds (quartiles 95.25-178.50). All procedures progressed after using the PT and finally resulted successfully without complications. Conclusion: The PT is feasible, and safe for facilitating the passage of stents through uncrossable lesions. Before advancing percutaneous cardiac intervention techniques, this method could be used advantageously in calcified, diffuse, and eccentric lesions.","PeriodicalId":495085,"journal":{"name":"Türkiye klinikleri cardiovascular sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134888513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5336/cardiosci.2023-96729
Rengin Çetin GÜVENÇ, Abdurrahman NASER
Objective: Serum uric acid (UA), which is the final product of purine metabolism, is a predictor of left-sided heart failure (HF), as well as being a marker of outcomes and survival in patients with heart failure with reduced ejection fraction (HFrEF). Right-sided HF may or may not accompany HFrEF, but is associated with worse prognosis and increased morbidity and mortality when present. All available data for the association between RHF and UA are derived from patients with pulmonary arterial hypertension, and virtually no data is available for patients with HFrEF. Our aim was to understand the relationships between UA, echocardiographic markers of right ventricular systolic function and RHF in patients with HFrEF. Material and Methods: A total of 45 patients with an ejection fraction <40% and signs of HF were included. Patients were divided into tertiles according to serum UA concentration. RHF was defined according to the modified Interagency Registry for Mechanically Assisted Circulatory Support criteria. Results: Compared to patients within the lowest UA tertile, patients within the 3rd tertile had a significantly higher incidence of RHF (50.0% vs. 0.0%, Bonferroni-corrected p=0.009) and a significantly lower tricuspid annular plane systolic excursion (20.5±4.4 vs. 16.1±4.4, p=0.02). After adjusting for relevant clinical, demographic, laboratory and echocardiographic variables, serum UA remained a significant predictor of RHF [odds ratio: 2.89, 95% confidence interval (CI): 1.21-6.91, p=0.017]. For serum UA, the c-statistic for determination of RHF was 0.83 (95% CI: 0.71-0.96). Conclusion: Serum UA is associated with the occurrence of RHF in patients with HFrEF.
目的:血清尿酸(UA)是嘌呤代谢的最终产物，是左侧心力衰竭(HF)的预测因子，也是心力衰竭伴射血分数降低(HFrEF)患者结局和生存的标志。右侧HF可能伴随HFrEF，也可能不伴随HFrEF，但存在时预后较差，发病率和死亡率增加。所有关于RHF和UA之间关联的可用数据都来自肺动脉高压患者，几乎没有关于HFrEF患者的数据。我们的目的是了解HFrEF患者的UA、右心室收缩功能超声心动图标记物与RHF之间的关系。材料与方法:共纳入45例射血分数<40%且有HF体征的患者。根据血清UA浓度将患者分为各组。RHF是根据修改后的机械辅助循环支持机构间登记标准定义的。结果:与最低UA分位的患者相比，第3分位的患者RHF发生率显著升高(50.0% vs 0.0%， bonferroni校正p=0.009)，三尖瓣环面收缩偏移显著降低(20.5±4.4 vs 16.1±4.4,p=0.02)。在校正了相关的临床、人口学、实验室和超声心动图变量后，血清UA仍然是RHF的重要预测因子[优势比:2.89,95%可信区间(CI): 1.21-6.91, p=0.017]。血清UA检测RHF的c统计量为0.83 (95% CI: 0.71-0.96)。结论:血清UA与HFrEF患者发生RHF有关。
{"title":"Serum Uric Acid is Associated with Right Heart Failure in Patients with Heart Failure with Reduced Ejection Fraction: A Cross-Sectional Study","authors":"Rengin Çetin GÜVENÇ, Abdurrahman NASER","doi":"10.5336/cardiosci.2023-96729","DOIUrl":"https://doi.org/10.5336/cardiosci.2023-96729","url":null,"abstract":"Objective: Serum uric acid (UA), which is the final product of purine metabolism, is a predictor of left-sided heart failure (HF), as well as being a marker of outcomes and survival in patients with heart failure with reduced ejection fraction (HFrEF). Right-sided HF may or may not accompany HFrEF, but is associated with worse prognosis and increased morbidity and mortality when present. All available data for the association between RHF and UA are derived from patients with pulmonary arterial hypertension, and virtually no data is available for patients with HFrEF. Our aim was to understand the relationships between UA, echocardiographic markers of right ventricular systolic function and RHF in patients with HFrEF. Material and Methods: A total of 45 patients with an ejection fraction <40% and signs of HF were included. Patients were divided into tertiles according to serum UA concentration. RHF was defined according to the modified Interagency Registry for Mechanically Assisted Circulatory Support criteria. Results: Compared to patients within the lowest UA tertile, patients within the 3rd tertile had a significantly higher incidence of RHF (50.0% vs. 0.0%, Bonferroni-corrected p=0.009) and a significantly lower tricuspid annular plane systolic excursion (20.5±4.4 vs. 16.1±4.4, p=0.02). After adjusting for relevant clinical, demographic, laboratory and echocardiographic variables, serum UA remained a significant predictor of RHF [odds ratio: 2.89, 95% confidence interval (CI): 1.21-6.91, p=0.017]. For serum UA, the c-statistic for determination of RHF was 0.83 (95% CI: 0.71-0.96). Conclusion: Serum UA is associated with the occurrence of RHF in patients with HFrEF.","PeriodicalId":495085,"journal":{"name":"Türkiye klinikleri cardiovascular sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134887924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The aim of this study was to determine the caregiver burden and quality of life of family members who care for patients with ventricular assisted devices. Material and Methods: This cross-sectional and descriptive study was conducted in the cardiovascular surgery clinic of a university hospital with 90 caregivers caring for patients who implanted ventricular assist device at least 3 months ago. A questionnaire prepared by the researchers was used to collect data. The questionnaire comprised 2 sections. The first section included questions on sociodemographic and clinical characteristics of patients and caregivers, whereas the second section included the Family Caregiver Quality of Life Scale in Heart Failure (FAMQOL) and Zarit Caregiver Burden Scale (ZCBS). Research data were collected by face-to-face interview method. Descriptive statistics, independent samples t-test and one-way analysis of variance, and Pearson's correlation were used for data analysis. Results: The mean FAMQOL Scale score of caregivers was 47.24±14.57 and the mean ZCBS score was 58.87±19.55. Statistically significant negative correlation was determined between the mean FAMQOL Scale and ZCBS scores. Conclusion: Caregiver burden and quality of life of caregivers of patients with ventricular assist was moderate. Increase in caregiver burden decreases the caregiver's quality of life.
{"title":"Caregiver Burden and Quality of Life of Caregivers of Patients with Ventricular Assist Device: A Descriptive Study","authors":"Nihal ÇELİKTÜRK DORUKER, Fatma DEMİR KORKMAZ, Yelda CANDAN DÖNMEZ, Serpil BULUT","doi":"10.5336/cardiosci.2023-98712","DOIUrl":"https://doi.org/10.5336/cardiosci.2023-98712","url":null,"abstract":"Objective: The aim of this study was to determine the caregiver burden and quality of life of family members who care for patients with ventricular assisted devices. Material and Methods: This cross-sectional and descriptive study was conducted in the cardiovascular surgery clinic of a university hospital with 90 caregivers caring for patients who implanted ventricular assist device at least 3 months ago. A questionnaire prepared by the researchers was used to collect data. The questionnaire comprised 2 sections. The first section included questions on sociodemographic and clinical characteristics of patients and caregivers, whereas the second section included the Family Caregiver Quality of Life Scale in Heart Failure (FAMQOL) and Zarit Caregiver Burden Scale (ZCBS). Research data were collected by face-to-face interview method. Descriptive statistics, independent samples t-test and one-way analysis of variance, and Pearson's correlation were used for data analysis. Results: The mean FAMQOL Scale score of caregivers was 47.24±14.57 and the mean ZCBS score was 58.87±19.55. Statistically significant negative correlation was determined between the mean FAMQOL Scale and ZCBS scores. Conclusion: Caregiver burden and quality of life of caregivers of patients with ventricular assist was moderate. Increase in caregiver burden decreases the caregiver's quality of life.","PeriodicalId":495085,"journal":{"name":"Türkiye klinikleri cardiovascular sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134888516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.5336/cardiosci.2023-98070
Şeyma ÖZTÜRK, Çetin BORAN
Leiomyosarcoma is a mesenchymal tumor originating from smooth muscle cells and constitutes a small proportion of the primary cardiac tumors. The tumor usually tends to settle on the left side of the heart and infiltrates the pulmonary veins, causing chest pain, dyspnea, and heart failure. Since primary cardiac leiomyosarcoma is a rare entity, it is difficult to distinguish clinically from myxoma, which is the most common benign tumor of the heart. Therefore, histopathological examination is necessary. The prognosis is poor due to the high rate of postoperative recurrence and distant metastasis. In this study, a case of primary cardiac leiomyosarcoma originating from the right atrium in a 59-year-old female patient is presented.
{"title":"A Primary Right Atrial Leiomyosarcoma in a 59-Year-Old Female Patient","authors":"Şeyma ÖZTÜRK, Çetin BORAN","doi":"10.5336/cardiosci.2023-98070","DOIUrl":"https://doi.org/10.5336/cardiosci.2023-98070","url":null,"abstract":"Leiomyosarcoma is a mesenchymal tumor originating from smooth muscle cells and constitutes a small proportion of the primary cardiac tumors. The tumor usually tends to settle on the left side of the heart and infiltrates the pulmonary veins, causing chest pain, dyspnea, and heart failure. Since primary cardiac leiomyosarcoma is a rare entity, it is difficult to distinguish clinically from myxoma, which is the most common benign tumor of the heart. Therefore, histopathological examination is necessary. The prognosis is poor due to the high rate of postoperative recurrence and distant metastasis. In this study, a case of primary cardiac leiomyosarcoma originating from the right atrium in a 59-year-old female patient is presented.","PeriodicalId":495085,"journal":{"name":"Türkiye klinikleri cardiovascular sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134887931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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