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Introduction and Objective: Coronary artery disease is the leading cause of mortality worldwide. Regular physical activity is part of a comprehensive management strategy for these patients. We investigated the parameters that influence physical activity in patients with a history of coronary revascularization. Methods: We included outpatients with a history of coronary revascularization at least six months prior to enrollment. Data on physical activity, demographics, and clinical characteristics were collected via a questionnaire. Results: A total of 202 consecutive outpatients (age 61.3±11.2 years, 73% male) were enrolled. One hundred and four (51%) patients had previous percutaneous coronary intervention, 67 (33%) had coronary bypass graft surgery, and 31 (15%) had both procedures. Only 46 patients (23%) engaged in regular physical activity. Patients were classified into two subgroups according to their physical activity. There were no significant differences between subgroups in terms of age, comorbid conditions or revascularization type. Multivariate regression analysis revealed that low education level (OR=3.26, 95% CI: 1.31-8.11, p=0.01), and lack of regular follow-up (OR=2.95, 95% CI: 1.01-8.61, p=0.04) were independent predictors of non-adherence to regular physical activity among study subjects. Conclusions: Regular exercise rates were lower in outpatients with previous coronary revascularization. Education level and regular follow-up visits were associated with adherence to physical activity in these patients. Resumo: Introdução e objetivos: A doença coronária é a principal causa de mortalidade em todo o mundo. A atividade física regular constitui o suporte de uma estratégia de gestão abrangente para estes doentes. Investigamos os parâmetros que influenciam a atividade física nos doentes com história de revascularização coronária. Métodos: Incluímos doentes de ambulatório com história de revascularização coronária pelo menos seis meses anterior ao registo. Foram recolhidos, através de um questionário, dados sobre os hábitos de atividade física, sobre estatística e características clínicas. Resultados: Foi registado um total de 202 doentes consecutivos de ambulatório (idade 61,3±11,2 anos, 73% homens). Cento e quatro (51%) doentes foram submetidos a intervenção coronária percutânea anterior, 67 (33%) doentes foram submetidos a cirurgia de revascularização do miocárdio e 31 (15%) foram submetidos a ambos procedimentos. De todos, 46 (23%) doentes praticavam atividade física regular. Os doentes foram classificados em dois subgrupos, de acordo com os seus hábitos de prática de atividade física. Não houve diferenças significativas relativamente à idade, às condições de comorbilidade ou ao tipo de revascularização entre os grupos. Na análise de regressão multivariada, concluiu-se que o baixo nível de instrução (OR=3,26, CI 95%: 1,31-8,11, p=0,01) e a ausência de consultas regulares de seguimento (OR=2,95, CI 95%: 1,01-8,61, p=0,04) foram fatores preditores independentes da não adesão à atividade física regular entre os indivíduos do estudo. Conclusões: Os índices de atividade física regular foram inferiores nos doentes de ambulatório com revascularização coronária anterior. O nível de instrução e as consultas de seguimento regulares foram associados à adesão à atividade física nestes doentes. Keywords: Coronary artery disease, Exercise, Physical activity, Prevention, Regression, Revascularization, Palavras-chave: Doença coronária, Exercício, Atividade física, Prevenção, Regressão, Revascularização

Introduction: Calcific aortic valve disease, a chronic progressive disorder, is the leading cause of valve replacement among elderly patients. The lymphocyte/monocyte ratio has been recently put forward as an inflammatory marker of relevance in several cancers as well as in cardiovascular disease. This study aims to assess the correlation between severity of calcific aortic stenosis and the lymphocyte/monocyte ratio. Methods: The study retrospectively included 178 patients with a diagnosis of calcific aortic stenosis and 139 age- and gender-matched controls. The patients were divided into two groups according to the severity of aortic stenosis: mild-to-moderate and severe. Results: An inverse correlation was discerned between the severity of the aortic stenosis process (mean gradient) and the lymphocyte/monocyte ratio (r=-0.232, p=0.002). The lymphocyte/monocyte ratio was observed to decrease as the severity of aortic stenosis increased (p

Background and Objectives: Lichen planus (LP) is a mucocutaneous inflammatory disease. Inflammation plays a major role in the progression of atherosclerosis. Epicardial fat tissue (EFT) has been shown to produce and secrete various proatherogenic and proinflammatory hormones and cytokines. The aim of this study was to assess EFT in patients with lichen planus. Methods: Fifty-four patients with LP and 50 controls were enrolled in the study. LP was diagnosed according to the World Health Organization criteria. EFT was measured on the free wall of the right ventricle in parasternal long-axis view, as previously described and validated. Results: There were positive correlations between EFT thickness and platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, duration of LP, and high-sensitivity C-reactive protein (hsCRP) (p

Amaç: Çalışmamızın amacı akut apandisitte nötrofil lenfosit oranının (NLR) tanısal dağerini değerlendirmektir.Gereç ve Yöntemler: Apendektomi uygulanan 310 hasta çalışmamıza dahil edildi.Hastaların yaşları, cinsiyetleri, preoperatif beyaz küre, nötrofil yüzdesi, lenfosit yüzdesi ve NLR'leri, çekilmiş olan ultrasonografi (USG) ve patoloji sonuçları retrospektif olarak elde edildi. İstatistik analizde student t test, ki-kare testi ve olasılık oranları kullanıldı.Bulgular: Çalışmamıza appendektomi ameliyatı yapılan 310 hasta dahil edildi. Çalışmaya dahil olan hastaların 176'sı (%56,8) erkek idi ve erkek kadın oranı 1,3: 1 olarak tespit edildi. Hastaların ortalama yaşı 24,5±12,2 yıl olarak bulundu. Patoloji sonuçları incelendiğinde 54 hastanın inflamasyon bulgusu olmayan appendiks vermiformis, 14 hastanın (%5,5) perfore, 5 hastanın(%2,0) gangranöz akut appendisit, 1'er hastanın karsinoid ve müsinöz kistadenom olarak rapor edildiğini görüldü. Akut appendisit çıkan hastalarda NLR ortalama değeri 7,0±5,6 idi. NLR'nin yüksek olması patolojik olarak akut appendisit arasında istatistiksel anlamlı ilişki olduğu görüldü (p

Introduction: Epicardial adipose tissue serves as a source of inflammatory cytokines and mediators. Cytokine storm is an important cause of morbidity and mortality in coronavirus disease 2019 (COVID-19). Objectives: To investigate the association between epicardial fat volume (EFV), inflammatory biomarkers and clinical severity of COVID-19. Methods: This retrospective study included 101 patients who were infected with COVID-19. Serum inflammatory biomarkers including C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT) and ferritin levels were measured. Computed tomography images were analyzed and semi-automated measurements for EFV were obtained. The primary composite endpoint was admission to the intensive care unit (ICU) or death. Results: The primary composite endpoint occurred in 25.1% (n=26) of patients (mean age 64.8±14.8 years, 14 male). A total of 10 patients died. EFV, CRP, PCT, ferritin and IL-6 levels were significantly higher in ICU patients. Moreover, a positive correlation was determined between EFV and CRP (r: 0.494, p102 cm3 were more likely to have severe complications. In multivariate logistic regression analysis, EFV independently predicted admission to the ICU at a significant level (OR: 1.02, 95% CI: 1.01-1.03, p=0.025). Conclusion: EFV and serum CRP, IL-6, PCT and ferritin levels can effectively assess disease severity and predict the outcome in patients with COVID-19. EFV is an independent predictor of admission to the ICU in hospitalized COVID-19 patients. Resumo: Introdução: O tecido adiposo epicárdico é fonte de citocinas inflamatórias e mediadores. A tempestade de citocinas é uma importante causa de morbilidade e mortalidade na doença coronavírus 2019 (COVID-19). Objetivos: Investigar a associação entre volume adiposo epicárdico (VAE), biomarcadores inflamatórios e gravidade clínica da COVID-19. Métodos: Este estudo retrospetivo incluiu 101 doentes infetados com COVID-19. Foram avaliados biomarcadores inflamatórios séricos, incluindo os níveis de proteína C-reativa (PCR), de interleucina-6 (IL-6), de procalcitonina (PCT) e de ferritina. Foram analisadas imagens de tomografia computorizada (TC) e foram obtidas medições semi-automáticas do VAE. O endpoint primário composto foi a admissão na unidade de cuidados intensivos (UCI) ou morte. Resultados: O endpoint primário ocorreu em 25,1% (n=26) dos doentes (idade média 64,8±14,8 anos, 14 homens). Um total de 10 doentes morreu. Os níveis de VAE, PCR, PCT, ferritina e IL-6 foram significativamente superiores nos doentes internados na UCI. Além disso, verificou-se uma correlação positiva entre o VAE e a PCR (r: 0,494, p102 cm3 tinham maior probabilidade de ter complicações graves. Conclusão: O VAE e os níveis séricos de PCR, IL-6, PCT e ferritina podem avaliar a gravidade da doença e prever o resultado em doentes com COVID-19. O VAE constitui um fator preditivo na admissão dos doentes hospitalizados com COVID-19 numa UCI.

Objective: Transradial access is widely used for both diagnostic and interventional cardiac procedures. The use of transradial access offers several advantages, including decreased bleeding, fewer vascular complications, and reduced length of hospital stay and cost. However, the small size of the radial artery limits the size of the equipment that can be used via this approach. In this study we sought to investigate whether preprocedural manual heating of the radial artery facilitates radial artery puncture. Methods: Patients undergoing transradial cardiac catheterization were randomized to subcutaneous nitroglycerin plus diltiazem or manual heating. The study endpoint was puncture score (score 1: easiest – puncture at first attempt; score 2: second attempt; score 3: third attempt; score 4: fourth attempt or more; score 5: puncture failed). Results: Ninety consecutive patients were enrolled in the study, 45 allocated to the drug treatment group and 45 to the heating group. Patients underwent radial artery ultrasound before catheterization. Complications were rare: one hematoma (drug treatment group) and one radial artery occlusion (heating group). Baseline demographic and clinical characteristics were similar. Baseline radial artery diameter was similar in both groups (2.41±0.46 mm and 2.29±0.48 mm in the heating and drug treatment groups, respectively). However, the median puncture score was lower in the heating group (1; interquartile range 1-2) compared to the drug treatment group (2; interquartile range 1-3; p=0.001). Conclusions: Preprocedural manual heating of the radial artery facilitates radial artery puncture in patients undergoing transradial cardiac catheterization. Resumo: Objetivo: O acesso transradial (ATR) é usado habitualmente quer para procedimentos diagnósticos quer de intervenção coronária. O uso de ATR oferece várias vantagens: redução das hemorragias, menos complicações vasculares, menor tempo de internamento e representa menos custos associados. Porém, o reduzido calibre da artéria radial limita o tamanho dos dispositivos que podem ser usados por este acesso. Neste estudo, investigamos se o prévio aquecimento da artéria radial facilita, ou não, a punção radial. Métodos: Doentes submetidos a cateterismo cardíaco por ATR foram aleatorizados para uma administração subcutânea de uma combinação de nitroglicerina e diltiazem ou, em alternativa, aquecimento manual da artéria radial. O endpoint do estudo foi o score de punção (score 1: punção simples à primeira tentativa; score 2: punção à segunda tentativa; score 3: punção à terceira tentativa; score 4: punção à quarta ou mais tentativa; score 5: punção radial falhada). Resultados: Noventa doentes consecutivos foram incluídos no estudo – 45 no grupo de tratamento farmacológico e 45 no grupo de aquecimento manual. Os doentes fizeram avaliação ecográfica da artéria radial antes do cateterismo. As complicações ocorreram de forma rara: um hematoma (grupo tratamento) e uma oclusão radial (grupo aquecimento). As caraterísticas basais demográficas e clínicas foram semelhantes. O diâmetro basal da artéria radial foi semelhante em ambos os grupos (2,41 ± 0,46 mm e 2,29 ± 0,48 mm nos grupos de aquecimento e de tratamento, respetivamente). No entanto, o score de punção foi mais baixo no grupo aquecimento (1; intervalo interquartil 1-2) comparado com o grupo tratamento (2; intervalo interquartil 1-3; p=0,001). Conclusões: O aquecimento manual da artéria radial facilita a punção radial em doentes submetidos a cateterismo cardíaco por via transradial. Keywords: Cardiac catheterization, Manual heating, Transradial access, Palavras-chave: Cateterização coronária, Aquecimento manual, Acesso transradial

Objective: Infective endocarditis (IE) carries a high risk of cardiac morbidity and mortality, despite advances in the contemporary armamentarium. Along with the development of antibiotic resistant strains, research focusing on the efficacy of novel agents other than standard antibiotic regimens continues. Daptomycin, one of these antibiotics, is approved for the treatment of Staphylococcus bacteremia and right-sided endocarditis. This retrospective study was an investigation of the effectiveness of daptomycin in patients with left-sided IE. Methods: Fourteen patients (mean age 50.9+-16.5; range 24 to 70 years) with the diagnosis of left-sided IE based on modified Duke criteria received daptomycin as monotherapy. Outcome was evaluated according to clinical improvement, microbiological eradication, and in-hospital mortality. Results: Blood culture was positive in 13 patients (92.8%) and staphylococci were isolated in all but 1 patient (92.3%). Daptomycin was administered as monotherapy at a dose of 6 or 8 mg/kg/day for mean of 40.6+-4.4 days. Clinical recovery rate was 71.4% and microbiological eradication rate was 85.7%. Mean duration of clinical recovery was 8.7+-3.2 days and duration of microbiological eradication was 11.1+-3.6 days. Side effects developed in 6 patients, but drug discontinuation was not required in any patient. Ten patients improved without complications. Two patients were lost due to heart failure and multiple-organ failure while treatment was continuing, and 2 patients died in early cardiac postoperative period. Conclusion: Daptomycin is an effective and safe alternative to standard antibiotic therapy for the treatment of left-sided IE.

Objective: Autoimmune hepatitis (AIH) is a liver disorder that affects both children and adults. It is characterized by inflammatory liver histology, elevated transaminase level, circulating nonorgan-specific autoantibodies, and increased level of immunoglobulin G in the absence of known etiology. Ventricular repolarization has been evaluated using T wave and QT interval measurements in patients with hepatic cirrhosis. Ventricular repolarization may be defined using QT interval, QT dispersion, and T wave measurements. Recently, it has been demonstrated that peak and end of the T wave (Tp-e) interval, Tp-e/QT, and Tp-e/corrected QT interval (QTc) ratios can be novel indicators for prediction of ventricular arrhythmias and mortality. In this study, an investigation of ventricular repolarization using Tp-e interval and Tp-e/QT ratio in patients with AIH was performed. Methods: Total of 31 patients with AIH and 31 controls were enrolled in the present study. Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were measured on 12-lead electrocardiogram. Results: QT interval (378.9+-41.4 vs. 350.0+-22.7; p=0.001), QTc interval (396.8+-46.7 vs. 367.3+-34.9; p=0.039), Tp-e interval (68.2+-12.3 vs. 42.5+-6.8; p

Amaç: Çok kesitli bilgisayarlı tomografi ile yapılan koroner kalsiyum skorlaması sırasında kalp dışı bulguları incelemek. Materyal ve Metod: Çalışmaya 190 çok kesitli bilgisayarlı tomografi ile koroner kalsiyum skorlaması yapılan hasta alındı. Kalp dışı bulgular Minor, Major A-B olarak tanımlandı. Bulgular: Çalışmaya alınan hastalardan 80’inde 177 kalp dışı bulgu tespit edildi (42.1%). Bu hastaların 40’ında minor bulgular (21%), 40’ında major bulgular (21%) mevcuttu. Majör B bulgular aort anevrizması, akciğerde kitle, akciğer nodülleri ve infiltrasyonları, pnömonektomi, böbrek üstü bezde nodüler kalınlaşma ve karaciğer kitle lezyonlarını içermektedir. Sonuç: Kalp dışı bulgular sık görülür. Bu bulguları raporlayan radyolog ve/veya kardiyologlar, bu bulguların sıklığı ve önemi konusunda dikkatli olmalıdırlar.

Amaç: Kronik obstruktif akciğer hastalığı (KOAH) nefes darlığıyla ortaya çıkan, hipoksi derecesinin artması sonucunda sağ ventrikül (SaV) fonksiyonlarının kötüleşmesiyle giden kronik bir hastalıktır. Yapılan çalışmalarda KOAH’da hipoksi ve sistemik inflamasyona ikincil olarak Karotis intima media kalınlığının (KİMK) arttığı gösterilmiştir. Çalışmanın amacı KOAH olan olgularda KİMK ile SaV fonksiyonları arasındaki ilişkiyi değerlendirmektir.. Gereç ve Yöntem: Daha önce KOAH tanısı konulmuş olan ve kardiyak şikayetlerle kardiyoloji polikliniğine başvuran 108 hasta çalışmaya dahil edildi. Tüm hastalara rutin olarak ekokardiyografi yapıldı ve SaV fonksiyonları değerlendirildi. Karotis ultrasonografi ile KİMK hesaplandı. Çalışmaya alınan KOAH olan olgular GOLD sınıflamasına göre alt gruplara ayrıldı. Bulgular: Çalışmaya alınan KOAH tanılı hastaların ortalama KİMK değeri 1.34±0.26 saptandı. Ortalama FEV1 (1. saniye zorlu ekspiryum volümü) (% predikte edilen) değeri 66±11 olarak saptandı. KİMK ile sistolik pulmoner arter basıncı (sPAB), triküspit kapağın anüler planda ekskürsizyonu (TAPSE), FEV1, sağ ventrikül sTDI (sistolik triküspit anulus doku doppler velositesi), SaV çapı, SaV ejeksiyon fraksiyonu korele bulundu (sırasıyla r=0.440, p lt;0.001; r=-0,555, p lt;0.001; r=-0.516, p lt;0.001; r=-0.448, p lt;0.001; r=0.205, p=0.034; 0.335, p=0.007). Yapılan çok değişkenli regresyon analizi sonrasında TAPSE’nin KİMK ile ilişkili olduğu saptandı (RR=-0.230, p=0.001). GOLD sınıflamasına göre yapılan alt gruplamada evre 3-4 olan alt grupta evre 1-2 ‘ye göre KİMK, TAPSE, sPAB, sistolik triküspit anulus doku doppler velositesi (sTDI) anlamlı olarak farklıydı (p=0.047, p=0.015, p=0.019, p=0.048, sırasıyla) Sonuç: Çalışmamızda KOAH’lı hastalarda KİMK ile SaV fonksiyonları arasında ilişki saptandı. Bu ilişkinin hipoksiye ikincil olduğu düşünüldü. KOAH hastalarındaki SaV fonksiyoları, KİMK, FEV1 ‘le ilişkili bulundu.

Objectives: This study investigated the effects of infliximab, a monoclonal antibody against TNFα, on myocardial deformation and aortic elasticity in patients with rheumatoid arthritis (RA), and the association of aortic elasticity with myocardial deformation. Study design: 38 female rheumatoid arthritis (RA) patients and 30 healthy controls were included in the study. Twenty patients received infliximab and 18 patients received prednisolone. Left ventricular (LV) longitudinal, circumferential and radial strain, systolic strain rate and early diastolic strain rate using speckletracking echocardiography, and aortic elasticity using M-mode echocardiography were assessed at baseline and post-treatment. Results: LV systolic longitudinal basal-, mid-, and apical strain, systolic mid- and apical strain rate, basal-, mid- and apical early strain rate, circumferential systolic apical strain and systolic strain rate were reduced in RA patients compared to controls. Compared to baseline, infliximab treatment increased aortic strain, aortic distensibility and decreased aortic β index. No significant aortic elastic changes were observed with prednisolone treatment. Longitudinal basal- and apical strain, basal-, mid- and apical systolic and diastolic strain rates, circumferential basal systolic strain, radial mid- and apical strain and apical strain rate were increased following infliximab treatment. Infliximab treatment improves aortic elasticity in parallel to myocardial deformation, but no significant association was observed following prednisolone treatment. Conclusion: Myocardial deformation is impaired in RA patients and is related to aortic stiffness. Chronic inhibition of TNFα improves LV deformation in association with aortic elasticity.

Coronary artery aneurysms are rare findings in patients referred for coronary angiography. Their prevalence ranges between 0.2% and 6% in different case series. We describe a male patient with a huge left main coronary artery aneurysm causing exertional angina, which was diagnosed with coronary angiography. All of the left coronary system arose from the aneurysm. He underwent coronary angiography again, followed by multislice computed tomography with a three-dimensional reconstruction. Although there is no known standard treatment modality for such aneurysms, we planned medical therapy after consultation with the cardiovascular surgery department. The patient’s first visit was in March 2013, and he was thereafter followed up until September 2016.

Objectives: In this study, we aimed to investigate the relationship between HbA1c levels and the severity of coronary artery stenosis in patients with acute coronary syndrome (ACS) without diabetes mellitus. Study design: In this study, we included 65 patients (11 females, mean age: 57+-11.42 years; 54 males, mean age: 54.56+-8.51 years) who were diagnosed as acute myocardial infarction without diabetes mellitus. During hospitalization, fasting blood glucose, postprandial blood glucose and HbA1C were measured in each patient. Gensini score was used to assess the severity of coronary artery disease. Results: Twenty patients (30.8%) had hypertension, 15 (23.1%) had impaired fasting glucose, 10 (15.3%) had combined impaired fasting and postprandial glucose, 28 had a low HDL cholesterol (45%), and 30 (46%) had abdominal obesity. Coronary angiography revealed one-vessel disease in 13 patients (20%), and two- and three-vessel disease in 52 patients (80%). There were no significant differences in terms of high-sensitive C-reactive protein (hs-CRP), total cholesterol, fasting glucose, and postprandial glucose (0.068, 0.974, 0.178, 0.677, respectively). There was no significant relation between the Gensini score and HbA1c levels (p=0.299), but there was a significant relation between the Gensini score and obesity (p=0.024). Conclusion: In our study, no significant relationship could be determined between the Gensini score and HbA1C, fasting and postprandial blood glucose levels, lipid profile, and hs-CRP levels in patients with nondiabetic ACSs

AmaçKarotis arter stent (KAS) tedavisi KEA'ye alternatif bir tedavi olarak gelişmiş olup bu gelişim teknik başarının prosedüre bağlı morbidite-mortalite ve restenoz oranlarının KEA ile karşılaştırılması ile elde edilen sonuçların büyük, geniş serilere dayanan çalışmalarla ispatlanması ile sağlanmıştır. Bu çalışmada kliniğimize başvuran ve revaskülarizasyon kararı alınan karotis arter hastalığı tanısı almış hastalarda distal emboli cihazları kullanılarak stent uygulamasının orta dönem klinik sonuçlarını sunmaya çalıştık. YöntemlerÇalışmaya 2006- 2010 yılları arasında Kardiyoloji polikliniği, Acil Servis ve Nöroloji kliniğini takiplerinde karotis arter hastalığı tanısı almış 20 hasta dahil edildi. Çalışmaya dahil edilme kriteri NASCET metodu ile angiografik olarak değerlendirilip asemptomatik hastalarda % 60-99 çap darlığı veya semptomatik hastalarda % 70-99 çap darlığı olan karotis bifurkasyon darlığı idi.BulgularHastaların hepsine telefon ile ulaşıldıktan sonra sorgulanmaları sonucunda 1 hastada işlemden 48 gün sonrasında geçici iskemik atak (%5), 3'ünde farklı hastalar olmak üzere minör kanama öyküsü olduğu (%15) ve eritrosit transfüzyon ihtiyacının olmadığı ve 1 hastada ise akut koroner sendrom/ unstabil anjina olduğu (%5) fakat medikal tedavi önerildiği öğrenildi. Geçici iskemik atak olan ve işlem sonrasında minör kanama öyküsü olan bir hasta olmak üzere 2 hastanın 1 günlük hastane yatışlarının olduğu öğrenildi (%10).SonuçKlinik çalışmalar ışığında özellikle bizim çalışma dizayn ve popülasyonumuza en yakın parametrelere sahip CREST çalışması ışığında, kliniğimizde yapılan karotis arter stentleme işlemlerinin başarısını ölçmeye çalıştık. Çalışmaya alınan hastalara emboli koruma cihazlarını kullanmaya çalıştık. Takip dönemi sonucunda cerrahi açısından yüksek riskli hasta grubunda karotis arter stentlemenin iyi bir alternatif olabileceğini düşünüyoruz.

Primer intrakardiyak tümörler klinik pratikte nadir görülür ve otopsi serilerinde sıklığının %0.3’ten daha az olduğu bildirilmiştir. Bunların yaklaşık %50’si kardiyak miksomalardır. Papiller fibroelastomlar, kardiyak miksomalardan sonra ikinci en sık görülen primer kardiyak tümörlerdir ve genellikle kalp kapaklarını tutar ve onlara zarar verir. Bu tümörler asemptomatik seyredebileceği gibi ani kardiyak ölüm gibi ciddi sonuçlarla da ilişkili olabilirler. Biz bu vakada, tekrarlayan akut pulmoner ödem ile prezente olan ve mitral arka kapakta papiller fibroelastom tanısı alan 77 yaşında bir erkek hastayı sunduk.Anahtar Kelimeler: Papiller fibroelastom, mitral arka kapak, tekrarlayan akut pulmoner ödem