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ÖZ : Amaç: Ciddi Aort Darlığı (AD) olan hastalarda TAVI , aort kapak obstrüksiyonunu ortadan kaldırarak kardiyak outputu arttırır. Sol ventrikülden çıkan akımın iyileşmesi, böbreklerin kan akımını artırarak renal perfüzyonu artırır ve bozulmuş renal fonksiyonun düzelmesini sağlayabilir. Bunun yanında, TAVI sırasında kontrast madde kullanımına bağlı ya da transfemoral kateterizasyon sırasında aterom plaklarının ve kolesterol kristallerinin saçılması sonucu alt ekstremite veya renal arter embolizasyonuna bağlı akut böbrek yetersizliği gelişebilir. Bu çalışmanın amacı; TAVI’nın böbrek fonksiyonları üzerine 1. aydaki etkisini belirlemek ve hastaların eşlik eden hastalıklarının sonuca etkisi olup olmadığını saptamaktı. Gereç ve Yöntemler: Bu çalışmaya, 2015-2019 yılları arasında ciddi AD ile takip edilip TAVI yapılan toplam 68 hasta dahil edildi. Tüm hastalarda işlem öncesi ve işlemden 1 ay sonra bakılan kreatinin ve GFR değerleri cinsiyete ve eşlik eden hastalıklara göre retrospektif olarak belirlendi ve değerlendirmeler bu temelde yapıldı. Bulgular: Hastaların ortalama yaşı 78,6+7,86, ortalama sol ventrikül ejeksiyon fraksiyonu ise (LVEF) %56,1+7,82 idi. Mevcut sonuçlar, AD’nın düzeltilmesinden sonra 1. ayda komorbiditesi bulunan hastaların böbrek fonksiyonlarında düzelme olmadığını aksine ek hastalığı olmayan hastalara göre anlamlı derecede kreatinin değerlerinde artma ve GFR değerinde düşme olduğunu göstermektedir. Diğer komorbidite durumlarının aksine işlem öncesi kronik böbrek hastalığı olanlarda ise 1. ayda kreatinin değerlerinde anlamlı bir artış saptanmamıştır. Sonuç: Çalışmamızda işlem öncesi kronik böbrek hastalığı olan hastalarda böbrek koruması açısından daha titiz olunduğunu ve bu hastalarda kronik böbrek hastalığına sebep olan majör etkenin ciddi AD olması sebebiyle ciddi AD' nın ortadan kalkması ve buna bağlı artan kardiyak debinin böbrek fonksiyonları üzerine olumlu etki yaratarak denge sağladığını düşünüyoruz., Aim: In patients with severe aortic stenosis (AS), TAVI increases cardiac output by eliminating aortic valve obstruction. Improvement of the outflow from the left ventricle increases renal perfusion by increasing blood flow to the kidneys and may improve impaired renal function. In addition, acute renal failure may develop due to lower extremity or renal artery embolization due to the use of contrast material during TAVI or as a result of scattering of atheroma plaques and cholesterol crystals during transfemoral catheterization. The aim of this study was to determine the effect of TAVI on kidney functions at 1 month and to determine whether comorbidities of the patients had an effect on the outcome. Material-methods : A total of 68 patients who were followed up with severe aortic stenosis and underwent TAVI between 2015 and 2019 were included in this study. The creatinine and GFR values measured before and 1 month after the procedure in all patients were determined retrospectively according to gender and concomitant diseases, and the evaluations were made on this basis. Results: The mean age of the patients was 78.6+7.86 years and the mean left ventricular ejection fraction (LVEF) was 56.1+7.82. Current results show that patients with comorbidity do not improve their renal function in the 1st month after AS correction, on the contrary, there is a significant increase in creatinine values and a decrease in GFR values compared to patients without comorbidity. Contrary to other comorbidities , there was no significant increase in creatinine values in the 1st month in patients with chronic kidney disease before the procedure . Conclusion: In our study, it was observed that patients with chronic kidney disease were more meticulous in terms of kidney protection before the procedure, and we think that the elimination of severe AS and the increased cardiac output due to the fact that the major factor causing chronic kidney disease in these patients was severe AS, creating a positive effect on kidney functions and providing a balance.

Aim: Signal peptide complement C1r/C1s, Uegf, and Bmp1-epidermal growth factor-like domain-containing protein 1 (SCUBE1) has been used in research as a biomarker in acute coronary syndrome (ACS). The aim of this study is to determine if SCUBE1 and routine laboratory parameters are effective in distinguishing the patients presenting with clinical symptoms of unstable angina pectoris (USAP) from the patients who have non-ST-segment elevated myocardial infarction (NSTEMI) and non-cardiac chest pain patients (NCCP).Materials and Methods: The study group consisted of patients having chest pain or those suspected of having an ACS complaint. The study consisted of 5 groups of 185 patients with USAP, NSTEMI, segment elevation myocardial infarction (STEMI), or NCCP, and a control group of 45 healthy patients (CG). The study was conducted according to the American Heart Association (AHA) guidelines.Results: There was no statistical difference between the patient groups and CG in terms of SCUBE1 (p=0.650). The Troponin I value was significantly lower in the USAP group than the STEMI and NSTEMI groups (p

Coronary artery spasm is usually defined as a focal constriction of a coronary artery segment, which is reversible, and causes myocardial ischaemia by restricting coronary blood flow. A coronary spasm may rarely compromise all three epicardial arteries simultaneously. We present a case of severe coronary spasm afflicting all coronary arteries accompanying an ST segment elevation in leads D2-D3 and aVF.

Although coronary artery pseudoaneurysm which could occur following percutaneous coronary interventions is a rare complication, it can be mortal. As soon as the pseu­doaneurysm is diagnosed, it should be treated by percu­taneous intervention or surgery. Graft stent implantation is a preferred treatment for appropriate patients. In this case report, we presented a successful treatment of coro­nary artery pseudoaneurysm by graft stent; which devel­oped after the implantation of bare metal stent into the left anterior descending coronary artery. J Clin Exp Invest 2013; 4 (1): 126-129, Koroner arter psödoanevrizması, perkütan koroner giri­şim sonrası nadir görülmesine karşın ölümcül olabilen bir komplikasyondur. Tanısı konulduğunda perkütan ya da cerrahi olarak tedavi edilmesi gerekir. Uygun vakalarda greft kaplı stent tercih edilen tedavi yöntemidir. Bu yazıda sol ön inen koroner artere çıplak metal stent implantasyo­nu sonrası gelişen koroner arter psödoanenvrizmasının greft stent ile başarılı tedavisinin yapıldığı bir olgu sunul­du.

Objective: Major setbacks with the use of stents, which are widely used in the treatment of coronary artery dis­ease, are development of acute thrombosis during early term and restenosis during the long term. No procedures have been able to completely prevent formation of early stent thrombosis (ST) and in-stent restenosis (ISR) up to now. The aim of the present study was to investigate the impact of intravascular ultrasonography (IVUS) guidance on angiographic outcomes of drug eluting stent (DES) im­plantation. Methods: In this study, we included 23 patients who re­ceived DES with the guidance of IVUS and 23 patients receiving the DES without IVUS. The patients were scru­tinized for their sixth month control angiographies. The angiographic results were compared between the groups. Results: The basic angiographic and clinical features were similar between the groups (p>0.05). The minimal luminal diameter after the percutaneous intervention was higher in Group I than Group 2 (3.2±0.3. 2.9±0.4, p=0.03). Acute ST, late lumen loss and stent restenosis rates were comparable between the groups (p>0.05). On the other hand, among the patients that did not receive IVUS three patients were presented with stent restenosis (SR) and one patient developed acute ST. Conclusion: The present results indicate that the use of IVUS for the implantation of DES can increase the suc­cess rate of the intervention. Consequently, IVUS can be considered as a complementary method during DES im­plantation. J Clin Exp Invest 2013; 4 (1): 84-89, Amaç: Koroner arter hastalığının tedavisinde yaygın olarak kullanılan stentlerle ilgili en büyük problem erken dönemde akut tromboz, geç dönemde ise restenoz geli­şimidir. Şimdiye kadar hiçbir girişim stent trombozu (ST) ve stent restenozu (SR) gelişimini tamamıyla engelleye­memiştir. Bu çalışmanın amacı ilaç kaplı stent (İKS) imp­lantasyonu sırasında intravasküler ultrasonografi (IVUS) kılavuzluğunun anjiyografik sonuçlar üzerine etkisini araştırmaktır. Yöntemler: Çalışmaya IVUS kılavuzluğunda İKS uygu­lanan 23 hasta ve IVUS yapılmaksızın direkt anjiyografi kılavuzluğunda İKS uygulanan 23 hasta alındı. Tüm has­taların altıncı ay kontrol anjiyografileri yapıldı. Anjiyografik sonuçlar gruplar arasında karşılaştırıldı. Bulgular: Gruplar arasında temel anjiyografik ve klinik özellikler benzerdi (p >0,05). İşlem sonrası stent içi mi­nimal lümen çapı (SİMLÇ) IVUS yapılanlarda, IVUS ya­pılmayanlardan daha büyüktü (3,2±03. 2,9±0,4, p=0,03). Akut ST, geç lümen kaybı ve SR oranları ise iki grup arasında benzerdi (p>0,05). İntravasküler ultrasonografi yapılanlarda bir olguda SR tespit edilirken, akut ST göz­lenmedi. IVUS yapılmayanlarda ise üç hastada SR ve bir hastada akut ST gözlendi. Sonuç: Mevcut çalışma ile gösterildi ki İKS implantasyo­nu sırasında IVUS kullanımı girişim başarısını artırabilir. İlaç salınımlı stent implantasyonu sırasında IVUS kullanı­mı işlemi tamamlayıcı bir fonksiyon görebilir.

Introduction: The aim of this study was to evaluate the effect of aging on the in-hospital outcomes and efficacy of this treatment in patients with ST elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). Materials and Method: 322 consecutive patients with acute STEMI undergoing primary PCI between December 2007 and July 2010 were included in the study. Analyses were performed retrospectively. Patients were divided into two groups according to age. The older group consisted of patients aged 65 or over and the younger group consisted of patients aged below 65 years. The baseline characteristics, primary PCI success and in-hospital outcomes (deaths, recurring infarctions, stroke and major bleeding) were compared between the two groups. Results: There were more women, more patients with hypertension, and with diabetes mellitus in the older group when compared with the younger group. Time from symptom onset to hospital admission was significantly longer in older group. Primary PCI success was similar between the two groups. In-hospital death and recurrent myocardial infarction were observed more frequently among elderly patients. Conclusion: Our results confirmed that, in the elderly there is increased risk of death and complications due to myocardial infarction. Primary PCI is a safe and effective reperfusion strategy in this high-risk population.