Browsing by Author "Güney, Murat Can"
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Article Incidence and Predictors of Permanent Pacemaker Implantation After Transcatheter Aortic Valve Implantation With a Balloon-Expandable Biosprosthesis in Patients With Bicuspid Aortic Valves(Termedia Publishing House Ltd, 2024) Suygun, Hakan; Kasapkara, Haci Ahmet; Guney, Murat Can; Polat, Melike; Bozkurt, EnginIntroduction:
There are few data on permanent pacemaker implantation (PPMI) in patients who have undergone transcatheter aortic valve implantation (TAVI) for bicuspid aortic valve (BAV) stenosis.
Aim:
The purpose of this study was to evaluate the predictors and incidence of PPMI in bicuspid patients using a balloon-expandable (BE) TAVI device.
Material and methods:
A total of 62 patients with bicuspid morphology who had undergone successful TAVI using a BE device without previous PPMI were included (retrospectively). Their baseline clinical, electrocardiographic (ECG), echocardiographic, and multislice computed tomography (MSCT) details were collected.
Results:
The incidence of PPMI after TAVI in this BAV cohort was 12.9%. All eight patients with PPMs were found to have type 1 left-right (LR) fusion morphology. In univariate analysis, the presence of right bundle branch block (RBBB) in preprocedural ECG ( p < 0.0001), short membraneous septum (MS) evaluated in MSCT ( p < 0.0001), and increased annulus-left main coronary artery distance ( p = 0.02) were statistically significant for PPMI. Among these parameters included in the model using multivariate Firth logistic regression analysis, the presence of preprocedural RBBB ( p = 0.001) and shortness of the MS in MSCT ( p = 0.004) were independent risk factors for predicting postprocedural PPMI in patients who underwent TAVI among those with BAV.
Conclusions:
Preprocedural RBBB on ECG and shorter MS are independent risk factors for PPMI after TAVI in BAV patients and these parameters should be considered before the procedure to guide clinical decision making. Type 1 LR patients may be considered at increased risk of PPMI.Article Outcomes of Transcatheter Aortic Valve Implantation in Patients With and Without Diabetes Mellitus(Soc Brasil Cirurgia Cardiovasc, 2024) Ayhan, Huseyin; Guney, Murat Can; Keles, Telat; Bozkurt, EnginIntroduction: Diabetes mellitus (DM) in patients undergoing cardiac transcatheter or surgical interventions usually is correlated with poor outcomes. Transcatheter aortic valve implantation (TAVI) has been developed as a therapy choice for inoperable, high-, or intermediate-risk surgical patients with severe aortic stenosis (AS). Objective: To evaluate the impact of DM and hemoglobin A1c (HbA1c) on outcomes and survival after TAVI. Methods: Five hundred and fifty-two symptomatic severe AS patients who underwent TAVI, of whom 164 (29.7%) had DM, were included in this retrospective study. Follow-up was performed after 30 days, six months, and annually. Results: The device success and risks of procedural-related complications were similar between patients with and without DM, except for acute kidney injury, which was more frequent in the DM group (2.4% vs. 0%, P=0.021). In-hospital and first-year mortality were similar between the groups (4.9% vs. 3.6%, P=0.490 and 15.0% vs. 11.2%, P=0.282, respectively). There was a statistical difference between HbA1c >= 6.5 and HbA1c <= 6.49 groups in total mortality (34.4% vs. 15.8%, P<0.001, respectively). The only independent predictors were Society of Thoracic Surgeons score (hazard ratio [HR] 1.28, 95% confidence interval [CI] 1.09-1.51; P=0.003) and HbA1c level >= 6.5 (HR 10.78, 95% CI 2.58-21.50; P=0.003) in multivariable logistic regression analysis. Conclusion: In this study, we conclude that DM was not correlated with an increased mortality risk or complication rates after TAVI. Also, it was shown that mortality was higher in patients with HbA1c >= 6.5, and it was an independent predictor for long-term mortality.Article Predictors and Prognostic Implications of Myocardial Injury After Transcatheter Aortic Valve Replacement(Texas Heart inst, 2022) Guney, Murat Can; Keles, Telat; Karaduman, Bilge Duran; Ayhan, Huseyin; Suygun, Hakan; Kahyaoglu, Muzaffer; Bozkurt, EnginMyocardial injury (MI) is not unusual after transcatheter aortic valve replacement (TAVR). To determine precipitating factors and prognostic outcomes of MI after TAVR, we retrospectively investigated relationships between MI after TAVR and aortic root dimensions, baseline patient characteristics, echocardiographic findings, and procedural features. Of 474 patients who underwent transfemoral TAVR for severe aortic stenosis in our tertiary center from June 2011 through June 2018, 188 (mean age, 77.7 +/- 7.7 yr; 96 women [51%]) met the study inclusion criteria. Patients were divided into postprocedural MI (PMI) (n=74) and no-PMI (n=114) groups, in accordance with high-sensitivity troponin T levels. We found that MI risk was associated with older age (odds ratio [OR]=1.054; 95% CI, 1.013-1.098; P=0.01), transcatheter heart valve type (OR=10.207; 95% CI, 2.861-36.463; P=0.001), distances from the aortic annulus to the right coronary artery ostium (OR=0.853; 95% CI, 0.731-0.995; P=0.04) and the left main coronary artery ostium (OR=0.747; 95% CI, 0.616-0.906; P=0.003), and baseline glomerular filtration rate (OR=0.985; 95% CI, 0.970-1.000; P= 0.04). Moreover, the PMI group had a longer time to hospital discharge (P=0.001) and a higher permanent pacemaker implantation rate (P=0.04) than did the noPMI group. Our findings may enable better estimation of which patients are at higher risk of MI after TAVR and thus improve the planning and course of clinical care.Editorial Transcatheter Aortic Valve Implantation in Bicuspid Aortic Valve Patients With Coagulation Factor 7 and 11 Deficiency and Atrial Fibrillation(Kare Publ, 2023) Guney, Murat Can; Karaduman, Bilge Duran; Ayhan, Huseyin; Keles, Telat; Bozkurt, Engin[No Abstract Available]
