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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 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.Article Citation - WoS: 2Citation - Scopus: 2Transcatheter valve-in-valve implantation Edwards Sapien XT in a direct flow valve after early degeneration(Wiley-hindawi, 2020) Duran Karaduman, Bilge; Ayhan, Huseyin; Bulguroglu, Serkan; Keles, Telat; Bozkurt, EnginIn recent years, the use of bioprosthetic valve (BPV) has increased significantly with both surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) due to reasons such as the advantage of not using anticoagulants. Nevertheless, major disadvantage of all BPV is the risk of early structural valve deterioration, leading to valve dysfunction, and requires reoperation, which significantly increases the risk of mortality or major morbidity especially after SAVR. There are a limited number of TAV-in-TAV case reports due to TAVI BPV degeneration. In our knowledge, this is the second report of TAV-in-TAV implantation wherein a previously implanted transfemoral 25-mm nonmetallic Direct Flow SVD valve treated with ViV TAVI via Edwards Sapien XT.Article Citation - WoS: 3Citation - Scopus: 2Transcatheter Aortic Valve Implantation in Patients With Connective Tissue Disease(Taiwan Soc Cardiology, 2021) Ayhan, Huseyin; Karaduman, Bilge Duran; Keles, Telat; Bozkurt, EnginBackground: There is still no consensus on the treatment of patients with connective tissue disease (CTD) with severe symptomatic aortic stenosis (AS). The aim of this study was to evaluate the feasibility and safety of transcatheter aortic valve implantation (TAVI) in patients with CTD. Methods: Five hundred and fifty consecutive symptomatic severe AS patients who underwent TAVI between 2011 and 2019 were included in this retrospective study, of whom 14 had CTD. Follow-up was performed 30 days, 6 months, and 1 year after the procedure. Results: Of the 14 (2.5%) patients who had CTD, most had rheumatoid arthritis (n = 10), followed by lupus erythematosus (n = 2), scleroderma (n = 1) and mixed (n = 1) CTD. The mean age was 77.6 +/- 7.9 years, and there was no statistical difference between the CTD and no-CTD groups. In addition, significantly more of the CTD patients (85.7%) were female compared to the no-CTD group (p = 0.018). None of the patients in the CTD group had acute kidney injury, stroke, major bleeding, or pericardial effusion. However, significantly more patients in the CTD group (n = 4) needed permanent pacemaker implantation than in the no-CTD group (p = 0.008). There were no significant differences between the two groups in terms of mean discharge time (CTD 4.6 +/- 2.0, no-CTD 4.5 +/- 2.3 days, p = 0.926) and in-hospital mortality [CTD 1 (7.1%), no-CTD 21 (3.9%); p = 0.542]. Conclusions: In this study, we presented the results of TAVI in patients with and without CTD. The TAVI procedure had similar mid-term outcomes in the two groups, and the CTD group had numerically lower rates of major complications at the cost of a higher incidence of pacemaker implantation.
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