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Article Citation - WoS: 13Citation - Scopus: 13Evaluation of procedural and clinical outcomes of transcatheter aortic valve implantation: A single-center experience(Kare Publ, 2020) Karaduman, Bilge Duran; Kayaoğlu, Hüseyin Ayhan; Keleş, Telat; Bozkurt, EnginObjective: Transcatheter aortic valve implantation (TAVI) is an established alternative to surgical aortic valve replacement. Our study aimed to evaluate the implementation of TAVI at our large-volume center, having an all-comer patient population with short and long-term follow-ups. Methods: This retrospective, single-center analysis included 556 consecutive patients with symptomatic severe aortic stenosis (AS) who underwent TAVI between July 2011 and December 2019. Results: The mean age of the entire population was 77.6±7.9 years, and 54.9% were women. The Society of Thoracic Surgeons (STS) mean score of the cohort was 6.0%±3.5%. The balloon-expandable valve (Sapien XT, Sapien 3; Edwards Lifesciences, Irvine, California) was the most frequently used valves in this cohort (94.6%). Transfemoral access was used in 96.3% of patients. Implantation success was achieved in 96.6% of cases. During the TAVI procedure, 7.2% of patients required permanent pacemaker implantation, with 37.5% in the Lotus valve group needing the most permanent pacemakers. The mean length of hospital stay for the entire cohort was 4.5±2.3 days. Overall, 22 (3.9%) in-hospital deaths occurred before hospital discharge. The mean follow-up period was 15.1±14.9 months for all patients, and a significant improvement was noted in all echocardiographic parameters and functional capacity. Paravalvular leak (PVL) was documented in 18.9% patients, mild in 17.9%, and moderate in 1% at discharge. No cases with severe PVL, necessitating additional procedures. The multiple logistic regression analysis revealed that sex, STS score, baseline SYNTAX score, bicuspid valve morphology, common femoral artery diameter, and post-TAVI PVL were independent predictors of overall mortality. Conclusion: To our knowledge, this study, which is the largest single-center real-world experience of TAVI in Turkey, demonstrated low complication rates with favorable short- and mid-term THV performance in patients undergoing TAVI.Article Citation - WoS: 1Citation - Scopus: 1Outcomes 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 Citation - WoS: 4Citation - Scopus: 4Semptomatik Çok Ciddi Aort Darlıklı Hastalarda Transkateter Aort Kapak İmplantasyonun Etkisi(Kare Publ, 2021) Karaduman, Bilge Duran; Ayhan, Hüseyin; Keles, Telat; Bozkurt, EnginAmaç: Aort darlığı (AD) ilerleyici bir hastalıktır ve tek tedavi seçeneği olan kapak replasmanı semptomatik hale geldikten sonra ve geri dönüşümsüz miyokardiyal hasar gelişmeden önce yapılmalıdır. Çok ciddi aort darlığı (ÇCAD) hastalarında cerrahi kapak replasmanı asemptomatik olsa bile önerilmektedir. Ancak ÇCAD hastalarında transkateter aortik kapak implantasyonunun (TAVI) etkisi hakkında ayrıntılı bir çalışma yoktur. Bu çalışmada amacımız, semptomatik ÇCAD hastalarında TAVI’nin uygulanabilirliğini ve güvenilirliğini göstermektir. Yöntemler: Merkezimizde TAVI uygulanan toplam 505 ardışık semptomatik AD hastası retrospektif olarak incelendi. Hastaların ortalama yaşı 77.8±7.6 yıl ve %56.4 kadın idi. Hastalar ÇCAD grubu (n: 134 hasta) ve yüksek gradyentli AD grubu (YGAD, n: 371 hasta) olarak iki gruba ayrıldı. Bulgular: ÇCAD grubunda daha fazla kadın cinsiyet, daha yüksek sol ventrikül ejeksiyon (SV) fraksiyonu, daha fazla küçük SV, hipertrofik SV, daha fazla normal koronerler ve daha az koroner arter hastalığı, bypas cerrahisi, miyokard enfarktüsü ve atriyal fibrilasyon öyküsü vardı. Predilatasyon ve Edwards SAPIEN 3 ÇCAD grubunda olarak daha az kullanıldı. VARC-2 kriterlerine göre majör komplikasyonlar ve hastane içi mortalitede (ÇCAD grubu; 5 hasta, YG AD grubu; 16 hasta, p: 0.769) istatistiksel fark saptanmadı. İki grup arasında Cox regresyon modeli sağ kalım eğrisinde ÇCAD lehine istatistiksel olarak anlamlı fark vardı (p<0.001). Sonuç: Bu çalışmamız ile semptomatik çok ciddi aort darlığında TAVI’nin kabul edilebilir komplikasyon ve daha yüksek sağ kalım oranları ile uygulanabilir ve güvenli olduğu gösterilmiştir. Hâlihazırda cerrahi kapak replasmanı endikasyonu olan asemptomatik ÇCAD hastalarında TAVI uygulanabilmesi için daha fazla randomize büyük çalışma gereklidir.Editorial Citation - WoS: 5Citation - Scopus: 6Transcatheter Treatment Tricuspid Regurgitation by Valve-In Implantation With a Novel Balloon-Expandable Myval® Thv(Polish Cardiac Soc-polskie Towarzystwo Kardiologiczne, 2022) Ayhan, Huseyin; Karaduman, Bilge Duran; Keles, Telat; Bozkurt, Engin[No Abstract Available]Article Citation - WoS: 1Citation - Scopus: 1Left Ventricular Geometry as a Predictor of Carotid Artery Stenosis Severity in Patients Undergoing Carotid Artery Stenting(Wiley, 2020) Karaduman, Bilge Duran; Ayhan, Huseyin; Keles, Telat; Bozkurt, EnginBackground and Aim Cerebrovascular diseases are the second most common cause of death worldwide. Moderate and severe carotid artery stenosis causes nearly 10% of all strokes. LV geometry is a familiar prognostic and diagnostic factor in several populations; yet, data on its role in carotid artery stenosis are unknown. In our study, we investigated the prognostic value of LV geometry in predicting carotid artery stenosis severity in patients undergoing carotid artery stenting. Methods Patients who underwent carotid artery stenting between January 2012 and January 2016 at our tertiary care center were evaluated retrospectively. Two hundred fifty-five patients who underwent carotid artery stenting were included in the study. Accessible echocardiographic documentation of ninety-eight patients was accessed and evaluated. Results LV normal geometry was detected in 37 (37.7%) of the 98 carotid artery stenting (CAS) patients, concentric hypertrophy in 13 (13.2%), eccentric hypertrophy in 9 (9.1%), and concentric remodeling in 39 (39.7%). By a majority, distal filter was used in normal geometry and eccentric hypertrophy groups (82.9% vs 100%, P: .017). Considering the relationship between carotid artery stenosis severity and LV geometry, we determined that the stenosis severity was statistically significantly higher in the concentric hypertrophy group (p:0.012). However, although no complications were detected in the concentric hypertrophy group, it did not reach statistical significance between the groups (P: .058). LVMi and as expected, Doppler velocity showed a significant correlation with stenosis severity (r = .23 vs .54; P: .021, <.001, respectively). Conclusion Echocardiographic evaluation of LV geometry provided prognostic information in the development of carotid artery stenosis. Abnormal LV geometry is an independent predictor in detecting the severity of carotid artery stenosis undergoing carotid artery stenting.Editorial Citation - Scopus: 1The Playmaker of the Mitral Valve Disease: Mitral Annulus(Elsevier Ireland Ltd, 2020) Karaduman, Bilge Duran; Ayhan, Huseyin; Keles, Telat; Bozkurt, Engin[No Abstract Available]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]Article Transcatheter Aortic Valve Implantation in Nonagenarians: A Comparative Analysis of Baseline Characteristics and 1-Year Outcomes(MDPI, 2025) Guney, Murat Can; Bozkurt, EnginBackground: Transcatheter aortic valve implantation (TAVI) is increasingly used in elderly patients with severe aortic stenosis, yet data on nonagenarians remain limited. This study aimed to compare clinical characteristics and outcomes of patients aged >= 90 years with those aged <90 years undergoing TAVI. Methods: We retrospectively analyzed 620 patients who underwent transfemoral TAVI. Patients were divided into two groups: <90 years (n = 545) and >= 90 years (n = 75). Baseline clinical, procedural, and outcome data were compared. Results: Nonagenarians had lower body mass index (BMI) and a lower prevalence of comorbidities such as diabetes, hyperlipidemia, and prior coronary artery bypass grafting CABG (all p < 0.05). All-cause mortality was higher in nonagenarians at 1 month (8.0% vs. 5.5%, p = 0.425), 6 months (9.3% vs. 7.9%, p = 0.838), and 1 year (21.3% vs. 16.7%, p = 0.405), though these differences were not statistically significant. In-hospital stroke occurred more frequently in patients >= 90 years (6.7% vs. 2.2%, p = 0.044). Conclusions: Despite a higher rate of in-hospital stroke, nonagenarians undergoing TAVI had comparable mortality outcomes to younger patients. These findings support the feasibility of TAVI in selected very elderly patients, while highlighting the need for tailored stroke prevention strategies. Trial Registration: The trial is retrospectively registered, and a clinical trial number is not applicable.Article Citation - WoS: 1Citation - Scopus: 1Karotis Arter Stentlemesinin Etkinliği ve Güvenliği: Tek Merkez Deneyimi(Kare Publ, 2020) Karaduman, Bilge Duran; Karaduman, Bilge Duran; Ayhan, Hüseyin; Ayhan, Hüseyin; Keles, Telat; Bozkurt, Engin; Karaduman, Bilge Duran; Ayhan, HüseyinAmaç: İnternal karotis arterdeki orta ve şiddetli darlıklar tüm inmelerin %10–15’ine neden olmaktadır. Bu çalışmada, üçüncü basamak bir referans merkezde karotis arter stentlemesinin (KAS) güvenliğini ve kısa dönem etkinliğini değerlendirmeyi amaçladık. Yöntemler: Üçüncü basamak merkezimizde Ocak 2017 ile Mayıs 2018 arasında KAS uygulanan hastalar geriye dönük olarak değerlendirildi. KAS uygulanan 145 hasta çalışmaya dahil edildi. Bulgular: Hastaların ortalama yaşı 70.1±8.6 yıl idi ve tüm grubun %75.2’si erkek olup %37.9’unda hipertansiyon mevcuttu. Hastaların 81’i (%55.9) semptomatik, 64’ü (%44.1) asemptomatik olarak gruplandırıldı. Semptomatik hastalarda koroner girişimler daha çok KAS sonrası (%38.9) yapılırken, asemptomatik grupta ise KAS öncesi (%25.9) ve sonrasında (%25.9) benzer oranlarda yapıldığı görüldü ama gruplar arasında istatistiksel fark yoktu. Semptomatik hastalarda (%59.2), asemptomatik hastalarda (%78.7) olduğu gibi distal emboli koruyucu cihaz (EKC), proksimal EKC’ye göre daha fazla kullanıldı. Ancak proksimal EKC, semptomatik hastalarda asemptomatik hastalara kıyasla anlamlı olarak daha fazla kullanıldı. Hastane içi ölüm görülmedi ve tüm popülasyonda 5 (%3.4) hastada inme veya geçici iskemik atak (GİA) gözlendi. Asemptomatik grupta GİA veya inme gözlenmedi, semptomatik grupta 2 hastada (%2.4) inme ve 3 hastada (%3.7) GİA görüldü. Sonuç: Bu çalışma kabul edilebilir komplikasyon oranları ile KAS’ın güvenirliğini ve uygulanabilirliğini ortaya koymuştur. KAS prosedürü, deneyimli girişimciler tarafından optimal tıbbi tedavi altında, agresif risk modifikasyonu ile EKC kullanılarak, uygun hastalarda en az komplikasyonla gerçekleştirilmelidir.Article Citation - Scopus: 1Stenotic Double-Orifice Mitral Valve After Surgical Repaired Partial Atrioventricular Septal Defect(Wiley, 2020) Duran Karaduman, Bilge; Torun, Ayse Nur; Ayhan, Huseyin; Keles, Telat; Bozkurt, EnginDouble-orifice mitral valve (DOMV) is an uncommon congenital anomaly account for 1% of congenital heart disease. However, accurate diagnosis and evaluation of valve stenosis or regurgitation and other concomitant congenital anomalies due to DOMV are required to obtain suitable treatment. Two- and three-dimensional echocardiography can contribute valuable functional and anatomic information that can support to reach this goal. Here, we present a case of complete bridge-type DOMV that causes mitral stenosis after surgical repair of the partial atrioventricular septal defect in childhood.
