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Kılıç S, Çelik A, Çekirdekçi E, Altay S, Elçik D, Akboğa MK, Durukan M, Yayla Ç, Zoghi M. The Prevalence and Risks of Inappropriate Combination of Aspirin and Warfarin in Clinical Practice: Results From WARFARIN-TR Study. Balkan Med J 2018; 36:17-22. [PMID: 30079702 PMCID: PMC6335934 DOI: 10.4274/balkanmedj.2017.1472] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background The use of warfarin and aspirin in combination is restricted to limited patients under relevant guidelines. Aims To evaluate the prevalence of the inappropriate combination of aspirin and warfarin therapy in daily practice and its risks. Study Design Cross-sectional study. Methods The awareness, efficacy, safety, and time in the therapeutic range of warfarin in the Turkish population study is a multi-center observational study that includes 4987 patients using warfarin for any reason between January 1, 2014, and December 31, 2014. To determine the prevalence of inappropriate combination use in daily practice, all patients who had a history of atherosclerotic disease (ischemic heart disease, peripheral artery disease) or cerebrovascular disease (n=1498) were excluded. The data of 3489 patients were analyzed. We defined inappropriate combination as all patients who received aspirin and warfarin regardless of the indication for warfarin use, under the direction of the European Society of Cardiology guideline recommendation. Results The mean age of patients was 59.2±13.8 years (41.8% male). The prevalence of the inappropriate use of warfarin and aspirin combination was 20.0%. The prevalence of combination therapy in patients with a primary indication for mechanical heart valve, non-valvular atrial fibrillation, and other reasons was 20.5%, 18.7%, and 21.0%, respectively. Multivariate logistic regression analysis revealed that age (odds ratio, 1.009; 95% confidence interval, 1.002-1.015; p=0.010), heart failure (odds ratio, 1.765; 95% confidence interval, 1.448-2.151; p<0.001), smoking (odds ratio, 1.762; 95% confidence interval, 1.441-1.153; p<0.010), chronic kidney disease (odds ratio, 2.057; 95% confidence interval, 1.494-2.833; p<0.001), and deep vein thrombosis (odds ratio, 0.463; 95% confidence interval, 0.229-0.718; p=0.001) were independent predictors of combination therapy (r2=0.66). The mean time in therapeutic range of patients receiving combination therapy was significantly lower than in those on warfarin monotherapy (51.6±27.05 vs. 54.7±23.93; p=0.006). Overall, 19.4% (n=677) of patients had a bleeding event (major bleeding 13.0%, n=88) within a year. Percentages of patients with combination therapy were significantly higher in patients with major bleeding than in patients without major bleeding (29.5% vs. 19.7%; p=0.023). Conclusion Our study demonstrated that 20.0% of patients taking warfarin use concomitant aspirin inappropriately in daily practice. Patients receiving aspirin with warfarin were demonstrated to have more comorbidities, lower time in therapeutic range levels, and higher bleeding rates.
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Affiliation(s)
- Salih Kılıç
- Department of Cardiology, Ege University School of Medicine, İzmir, Turkey
| | - Ahmet Çelik
- Department of Cardiology, Mersin University School of Medicine, Mersin, Turkey
| | - Elif Çekirdekçi
- Clinic of Cardiology, Tekirdağ Çorlu District State Hospital, Tekirdağ, Turkey
| | - Servet Altay
- Clinic of Cardiology, Edirne Sultan Murat 1. State Hospital, Edirne, Turkey
| | - Deniz Elçik
- Clinic of Cardiology, Ankara Research and Training Hospital, Ankara, Turkey
| | | | - Mine Durukan
- Clinic of Cardiology, Mersin City Research and Training Hospital, Mersin, Turkey
| | - Çağrı Yayla
- Clinic of Cardiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
| | - Mehdi Zoghi
- Department of Cardiology, Ege University School of Medicine, İzmir, Turkey
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Ballı M, Çetin M, Taşolar H, Uysal OK, Yılmaz M, Durukan M, Elbasan Z, Çaylı M. The relationship between serum thyroid hormone levels, subclinical hypothyroidism, and coronary collateral circulation in patients with stable coronary artery disease. Turk Kardiyol Dern Ars 2016; 44:130-6. [PMID: 27111311 DOI: 10.5543/tkda.2015.00905] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Thyroid disease is a common endocrine disease with important effects on the cardiovascular system. As an adaptive response to myocardial ischemia, coronary collateral circulation (CCC) plays an important role in obstructive coronary artery disease (CAD). The association between serum thyroid hormone levels and development of CCC was investigated in the present study. METHODS In total, 430 consecutive patients who underwent coronary angiography procedure and had documented total occlusion in at least 1 major coronary artery were investigated retrospectively. Degree of CCC was classified according to Cohen-Rentrop method. Serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were assessed by the chemiluminescence immunoassay technique. RESULTS In spite of diabetes mellitus (p=0.019), smoking (p<0.001), and TSH (p<0.001), FT3 (p<0.001), FT4 (p=0.015), and subclinical hypothyroidism (SCH) (p<0.001) ratios were significantly different between groups. In regression analysis, SCH (p=0.024), DM (p=0.021), smoking (p<0.001), and heart failure (p=0.029) were independent predictors of poor CCC development in multivariate model 1. When regression analyses were performed based on multivariate model 2, TSH (p<0.001), FT3 (p<0.001), heart failure (p=0.022), smoking (p<0.001), and hyperlipidemia (HPL) (p=0.046) were independent predictors of poor CCC development. CONCLUSION In addition to traditional risk factors, SCH, higher serum TSH, and lower FT3 levels were associated with development of poor CCC in patients with obstructive CA.
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Affiliation(s)
- Mehmet Ballı
- Department of Cardiology, Mersin Toros State Hospital, Mersin, Turkey.
| | - Mustafa Çetin
- Department of Cardiology, Adıyaman University Training and Research Hospital, Adıyaman, Turkey
| | - Hakan Taşolar
- Department of Cardiology, Adıyaman University Training and Research Hospital, Adıyaman, Turkey
| | - Onur Kadir Uysal
- Department of Cardiology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Mahmut Yılmaz
- Department of Cardiology, Mersin Toros State Hospital, Mersin, Turkey
| | - Mine Durukan
- Department of Cardiology, Mersin Toros State Hospital, Mersin, Turkey
| | - Zafer Elbasan
- Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Murat Çaylı
- Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey
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3
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Ertaş F, Kaya H, Yıldız A, Davutoğlu V, Kiriş A, Dinç L, Kafes H, Avcı A, Calapkorur B, Ertaş G, Gül M, Kahraman Ay N, Bulur S, Durukan M, Eren M, İlhan İ, Küçük M, Özpelit E, Şimşek H, Uçar FM, Yıldız A, Şahin DY, Ayhan E, Çağlayan CE, Güngör H, Özyurtlu F, Şen N, Vatan B, Vatansever F, Kobat MA, Temiz A, Taylan G, Dönmez İ, Erkuş ME, Söylemez S, Zengin H, Gündüz M, Tuncez A, Karavelioğlu Y, Gökdeniz T, Koza Y, Aktop Z, Katlandur H, Karaca Özer P, Yüksel M, Acet H, Çil H, Alan S, Toprak N. An epidemiological study to evaluate the use of vitamin K antagonists and new oral anticoagulants among non-valvular atrial fibrillation patients in Turkey- AFTER-2 study design. Turk Kardiyol Dern Ars 2015; 43:169-77. [PMID: 25782122 DOI: 10.5543/tkda.2015.35984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is related to increased cardiovascular morbidity and mortality. There is a lack of data in Turkey on the use of new oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modality. In this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients. STUDY DESIGN Four thousand one hundred consecutive adult patients from 42 centers with at least one AF attack identified on electrocardiography will be included in the study. Patients with rheumatic mitral valve stenosis and prosthetic valve disease will be excluded from the study. At the end of one year, the patients will be evaluated in terms of major cardiac end points (death, transient ischemic attack, stroke, systemic thromboembolism, major bleeding and hospitalization). RESULTS First results are expected in June 2015. Data about major cardiovascular end-points will be available in January 2016. CONCLUSION The rates and kind of oral anticoagulant use, TTR in vitamin K antagonist users and main management modality applied in non-valvular AF patients will be determined by AFTER-2 study. In addition, the rate of major adverse events (MACEs) and the independent predictors of these MACEs will be detected (AFTER-2 Study ClinicalTrials.gov number, NCT02354456.).
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Affiliation(s)
- Faruk Ertaş
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Hasan Kaya
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Abdulkadir Yıldız
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Vedat Davutoğlu
- Department of Cardiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Abdulkadir Kiriş
- Department of Cardiology, Karadeniz Technique University Faculty of Medicine, Trabzon, Turkey
| | - Lale Dinç
- Department of Cardiology, Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Habibe Kafes
- Department of Cardiology, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
| | - Anıl Avcı
- Department of Cardiology, Koşuyolu Training and Research Hospital, İstanbul, Turkey
| | - Bekir Calapkorur
- Department of Cardiology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Gökhan Ertaş
- Department of Cardiology, Siyami Ersek Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Gül
- Department of Cardiology, Mehmet Akif Ersoy Training and Research Hospital, İstanbul, Turkey
| | - Nuray Kahraman Ay
- Department of Cardiology, Bezmialem Foundation University Faculty of Medicine, İstanbul, Turkey
| | - Serkan Bulur
- Department of Cardiology, Medeniyet University Faculty of Medicine, İstanbul, Turkey
| | - Mine Durukan
- Department of Cardiology, Mersin State Hospital, Mersin, Turkey
| | - Murat Eren
- Department of Cardiology, Bozyaka Training and Research Hospital, İzmir, Turkey
| | - İbrahim İlhan
- Department of Cardiology, Mardin State Hospital, Mardin, Turkey
| | - Murathan Küçük
- Department of Cardiology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Ebru Özpelit
- Department of Cardiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Hakkı Şimşek
- Department of Cardiology, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
| | - F Mehmet Uçar
- Department of Cardiology, Denizli State Hospital, Denizli, Turkey
| | - Ahmet Yıldız
- Department of Cardiology, Cardiology Institute, İstanbul, Turkey
| | - D Yıldıray Şahin
- Department of Cardiology, Numune Training and Research Hospital, Adana, Turkey
| | - Erkan Ayhan
- Department of Cardiology, Medical Park Hospital, Bursa, Turkey
| | - C Emre Çağlayan
- Department of Cardiology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Hasan Güngör
- Department of Cardiology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Ferhat Özyurtlu
- Department of Cardiology, Grand Medical Hospital, Manisa, Turkey
| | - Nihat Şen
- Department of Cardiology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
| | - Bülent Vatan
- Department of Cardiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Fahriye Vatansever
- Department of Cardiology, Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Mehmet Ali Kobat
- Department of Cardiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Ahmet Temiz
- Department of Cardiology, Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Gökay Taylan
- Department of Cardiology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - İbrahim Dönmez
- Department of Cardiology, Abant İzzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - M Emre Erkuş
- Department of Cardiology, Harran University Faculty of Medicine, Şanlıurfa, Turkey
| | - Selami Söylemez
- Department of Cardiology, Kırıkkale University Faculty of Medicine, Kırıkkale, Turkey
| | - Halit Zengin
- Department of Cardiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Mahmut Gündüz
- Department of Cardiology, Fatih University Faculty of Medicine, İstanbul, Turkey
| | - Abdullah Tuncez
- Department of Cardiology, Selçuk University Faculty of Medicine, Konya, Turkey
| | - Yusuf Karavelioğlu
- Department of Cardiology, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Tayyar Gökdeniz
- Department of Cardiology, Kafkas University Faculty of Medicine, Kars, Turkey
| | - Yavuzer Koza
- Department of Cardiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Ziyaeddin Aktop
- Department of Cardiology, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | - Hüseyin Katlandur
- Department of Cardiology, Mevlana University Faculty of Medicine, Konya, Turkey
| | - Pelin Karaca Özer
- Department of Cardiology, Kastamonu State Hospital, Kastamonu, Turkey
| | - Murat Yüksel
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Halit Acet
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Habib Çil
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Sait Alan
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Nizamettin Toprak
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
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Aksu T, Guler TE, Colak A, Baysal E, Durukan M, Sen T, Guray U. Intracoronary epinephrine in the treatment of refractory no-reflow after primary percutaneous coronary intervention: a retrospective study. BMC Cardiovasc Disord 2015; 15:10. [PMID: 25885120 PMCID: PMC4353473 DOI: 10.1186/s12872-015-0004-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 02/12/2015] [Indexed: 11/25/2022] Open
Abstract
Background Despite the advances in medical and interventional treatment modalities, some patients develop epicardial coronary artery reperfusion but not myocardial reperfusion after primary percutaneous coronary intervention (PCI), known as no-reflow. The goal of this study was to evaluate the safety and efficacy of intracoronary epinephrine in reversing refractory no-reflow during primary PCI. Methods A total of 248 consecutive STEMI patients who had undergone primary PCI were retrospectively evaluated. Among those, 12 patients which received intracoronary epinephrine to treat a refractory no-reflow phenomenon were evaluated. Refractory no-reflow was defined as persistent TIMI flow grade (TFG) ≤2 despite intracoronary administration of at least one other pharmacologic intervention. TFG, TIMI frame count (TFC), and TIMI myocardial perfusion grade (TMPG) were recorded before and after intracoronary epinephrine administration. Results A mean of 333 ± 123 mcg of intracoronary epinephrine was administered. No-reflow was successfully reversed with complete restoration of TIMI 3 flow in 9 of 12 patients (75%). TFG improved from 1.33 ± 0.49 prior to epinephrine to 2.66 ± 0.65 after the treatment (p < 0.001). There was an improvement in coronary flow of at least one TFG in 11 (93%) patients, two TFG in 5 (42%) cases. TFC decreased from 56 ± 10 at the time of no-reflow to 19 ± 11 (p < 0.001). A reduction of TMPG from 0.83 ± 0.71 to 2.58 ± 0.66 was detected after epinephrine bolus (p < 0.001). Epinephrine administration was well tolerated without serious adverse hemodynamic or chronotropic effects. Intracoronary epinephrine resulted in significant but tolerable increase in heart rate (68 ± 13 to 95 ± 16 beats/min; p < 0.001) and systolic blood pressure (94 ± 18 to 140 ± 20; p < 0.001). Hypotension associated with no-reflow developed in 5 (42%) patients. During the procedure, intra-aortic balloon pump counterpulsation was required in two (17%) patients, transvenous pacing in 2 (17%) cases, and both intra-aortic balloon counterpulsation and transvenous pacing in one (8%) patients. One patient (8%) died despite all therapeutic measures. Conclusion Intracoronary epinephrine may become an effective alternative in patients suffering refractory no-reflow following primary PCI.
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Affiliation(s)
- Tolga Aksu
- Department of Cardiology, Derince Education and Research Hospital, Derince, Turkey.
| | - Tumer Erdem Guler
- Department of Cardiology, Derince Education and Research Hospital, Derince, Turkey.
| | - Ayse Colak
- Department of Cardiology, Ankara Yuksek Ihtisas Hospital, Ankara, Turkey.
| | - Erkan Baysal
- Department of Cardiology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey.
| | - Mine Durukan
- Department of Cardiology, Mersin State Hospital, Mersin, Turkey.
| | - Taner Sen
- Department of Cardiology, Kutahya Evliya Celebi Education and Research Hospital, Kutahya, Turkey.
| | - Umit Guray
- Department of Cardiology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
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Durukan M, Guray U, Aksu T, Guray Y, Demirkan B, Korkmaz S. Low plasma renin activity and high aldosterone/renin ratio are associated with untreated isolated systolic hypertension. Blood Press 2012; 21:320-5. [PMID: 22587638 DOI: 10.3109/08037051.2012.686167] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Isolated systolic hypertension (ISH) is generally encountered in elderly patients and there are scarce data regarding the renin-angiotensin-aldosterone system (RAAS) activity in patients with ISH. We aimed to determine the plasma renin activity (PRA), plasma aldosterone levels (PAL) and aldosterone/PRA ratio (PAL/PRA) in patients (age >50 years) with ISH and to compare these values with patients with essential hypertension (EH) as well as subjects with normal blood pressure values (control) who have similar age and cardiovascular risk profile. METHODS Consecutively, 42 untreated ISH patients, 30 patients with EH and 29 normal subjects were included in the study. Parameters were presented as median (interquartile range). RESULTS There were no significant differences regarding age, gender and other cardiovascular risk factors among groups. As expected, systolic, diastolic blood pressure and pulse pressure values were significantly different among groups. Besides, PRA values were found to be significantly lower in patients with ISH (0.4 [0.2-1.1] ng/ml/h) compared with the EH (0.95 [0.5-2.6] ng/ml/h, p =0.024) and control (1.3 [0.7-2.1] ng/ml/h, p =0.001) groups. Although, PAL were similar among groups, PAL/PRA ratio was significantly higher in ISH group (134.1 [73-224]) compared with those with EH (42.2 [35-84], p <0.001) and the control group (53.3 [30-106], p =0.001). No significant difference was present with respect to PAL/PRA ratio between EH and control groups. CONCLUSIONS Our findings suggested that in patients with ISH, despite lower PRA levels, PAL/PRA ratio is significantly higher compared with the patients with EH and subjects with normal blood pressure. Since higher PAL/PRA levels is an indicator of relative aldosterone excess, medications blocking RAAS activity including aldosterone antagonists may have useful cardiovascular consequences in addition to their antihypertensive effects in ISH.
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Affiliation(s)
- Mine Durukan
- Toros Hospital, Department of Cardiology, Mersin, Turkey
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Durukan M, Aksu T, Çolak A, Güray Ü. [Augmentation of vessel narrowing by nitroglycerine in a case with myocardial bridge]. Anadolu Kardiyol Derg 2011; 11:464-466. [PMID: 21733785 DOI: 10.5152/akd.2011.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Mine Durukan
- Türkiye Yüksek İhtisas Hastanesi, Kardiyoloji Kliniği, Ankara-Türkiye
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Aksu T, Durukan M, Güray U, Colak A. [Extraction of a large vegetation and ICD lead using the Evolution Mechanical Dilator Sheath]. Turk Kardiyol Dern Ars 2011; 39:403-6. [PMID: 21743264 DOI: 10.5543/tkda.2011.01356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 74-year-old male patient presented with complaints of fatigue, fever, and worsening health status. He had a 34-month history of cardioverter-defibrillator (ICD) implantation due to ischemic cardiomyopathy. Transthoracic and transesophageal echocardiography showed a mobile mass, 24 x 11 mm in size, consistent with a vegetation attached to the right ventricular ICD lead. Surgical removal of the electrode was considered to be highly risky for the patient, thus percutaneous removal was decided. Due to adhesions, manual traction of the lead with a standard stylet was ineffective. Complete lead extraction was accomplished using the Evolution Mechanical Dilator Sheath, which is a new mechanical sheath with a stainless steel bladed tip. No complications occurred during or after the procedure. Following a histopathologic diagnosis of vegetation, the patient received a six-week antibiotic therapy, after which a new ICD was implanted on the contralateral side. To our knowledge, this case represents the largest lead vegetation extracted by this new device. Although its safety should be validated by increasing number of cases, it seems that its simple use would make this device a new interesting tool among the instruments available for lead extraction.
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Affiliation(s)
- Tolga Aksu
- Department of Cardiology, Türkiye Yüksek İhtisas Heart-Education and Research Hospital, Ankara, Turkey.
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8
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Baser K, Guray U, Durukan M, Demirkan B. High ventricular lead impedance of a DDD pacemaker after cranial magnetic resonance imaging. Pacing Clin Electrophysiol 2011; 35:e251-3. [PMID: 21303387 DOI: 10.1111/j.1540-8159.2011.03027.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Management of electromagnetic interference in the form of magnetic resonance imaging (MRI) in patients with pacemakers (PMs) may be challenging. Serious consequences, especially in PM-dependent patients, may be encountered. Changes in device programming, asynchronous pacing, heating of the lead tip(s), and increased thresholds or even device dislocation may be experienced. We report of a patient with a DDD PM who underwent an emergent MRI, after which there was an increase in ventricular impedance as well as increased cardiac biomarkers.
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Affiliation(s)
- Kazim Baser
- Cardiology Department, Turkiye Yuksek Ihtisas Hastanesi, Ankara, Turkey.
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Kervan Ü, Altintas G, Ozen A, Durukan M, Guray Ü, Özatik MA. Implantable cardioverter defibrillator lead endocarditis causing diffuse right atrial abscess and pulmonary artery embolism. Pacing Clin Electrophysiol 2010; 34:e115-7. [PMID: 20636317 DOI: 10.1111/j.1540-8159.2010.02829.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Implantation of electrophysiological cardiac devices such as pacemakers and implantable cardioverter defibrillators has become a widely available and routine procedure in cardiovascular medicine. One of the most feared complications of device implementation is infection. Infection rates for these devices are reported to vary between 0.7% and 7.0%. Cardiac thromboembolic event is a recognized complication of permanent cardiac rhythm devices with an incidence of 0.6%-3.5%, unrelated to lead size or number. These complications are associated with high morbidity and mortality rates. In this case report, right atrial mass, right atrial abscess, perforation of tricuspid septal leaflet, and pulmonary embolism secondary to ICD lead endocarditis is presented.
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Affiliation(s)
- Ümit Kervan
- Cardiovascular Surgery, Yuksek Ihtisas Hospital of Turkey, Ankara, Turkey.
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Aksu T, Durukan M, Kaya V, Tufekcioglu O, Arat N, Guray U, Kisacik H. PP-115 PREDICTIVE VALUE OF DIRECT RADIOGRAPHIC MEASUREMENT AS A MARKER OF SEVERITY OF VALVULAR REGURGITATION. Int J Cardiol 2010. [DOI: 10.1016/s0167-5273(10)70260-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Durukan M, Baser K, Guray U, Guray Y, Demirkan B, Aksu T, Korkmaz S. PP-159 VENTRICULAR LEAD MICROFRACTURE AFTER AN INADVERTENT CRANIAL MAGNETIC RESONANCE IMAGING IN A PATIENT WITH PERMANENT DDD PACEMAKER. Int J Cardiol 2010. [DOI: 10.1016/s0167-5273(10)70304-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Aksu T, Guler E, Durukan M, Arat N, Tufekcioglu O, Guray U, Demirkan B, Kisacik H. OP-110 HEART RATE VARIABILITY AND QT DISPERSION IN PATIENTS WITH BEHCET'S DISEASE. Int J Cardiol 2010. [DOI: 10.1016/s0167-5273(10)70111-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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