Ventriküler septumun sağlam olduğu valvüler Pul moner Stenoz (PS) vakaları, tüm kongenital kalp h... more Ventriküler septumun sağlam olduğu valvüler Pul moner Stenoz (PS) vakaları, tüm kongenital kalp has talıkları arasında %10'a varan sıklıkta görülür (1). PS'un tedavisinde önceleri sadece cerrahi tedavi uygu lanmakta idi ve elde edilen sonuçlar başarılı idi (2).
Aim: Whether measurement of left ventricular outflow tract diameter (LVOTd) using color Doppler (... more Aim: Whether measurement of left ventricular outflow tract diameter (LVOTd) using color Doppler (CD) in order to more accurately define LVOTd is more accurate for determination of stroke volume (SV) than gray scale and compare it with direct measurement of LVOT area (a) using three‐dimensional echocardiography (3DE) for SV determination. Methods and Results: Twenty‐one volunteers were examined. LVOTa was calculated by two‐dimensional echocardiography (2DE) using the following formula: π× (d/2)2, d = LVOT diameter by gray scale and CD, respectively. Planimetry of LVOTa was performed in parasternal long axis using 3DE. Eccentricity Index was calculated using the lateral and anterior‐posterior LVOTd. SV was obtained by four different methods: (1) 2D gray scale, (2) 2D color, (3) LVOTa × LVOT velocity time integral, and (4) SV by Simpson's biplane method. Gray scale LVOTd was significantly smaller compared to LVOTd obtained with CD (P < 0.05). Significant differences occurred bet...
Objectives: In this study, we present the use of case specific three- dimensional (3D) printed pl... more Objectives: In this study, we present the use of case specific three- dimensional (3D) printed plastic models and custom-made acetabular implants in orthopedic surgery. Materials and methods: Between March 2018 and September 2020, surgeries were simulated using plastic models manufactured by 3D printers on the two patients with pilon fractures. Also, custom-made acetabular implants were used on two patients with an acetabular bone defect for the revision of total hip arthroplasty (THA). Results: More comfortable surgeries were experienced in pilon fractures using preoperative plastic models. Similarly, during the follow-up period, the patients that applied custom-made acetabular implants showed a fixed and well-positioning in radiographic examination. These patients did not experience any surgical complications and achieved an excellent recovery. Conclusion: Preoperative surgical simulation with 3D printed models can increase the comfort of fracture surgeries. Also, custom-made 3D p...
The aim of the study was to investigate the effects of a long term (1 year) hormone replacement t... more The aim of the study was to investigate the effects of a long term (1 year) hormone replacement therapy (HRT) on QT interval, QT dispersion (QTd) frequencies of arrhythmia and heart rate variability (HRV) parameters. Forty-six healthy postmenopausal women (mean age; 55.34+/-4.21) as a hormone replacement therapy group and 25 healthy premenopausal women (mean age; 35.36+/-6.06) as a control group were prospectively enrolled to the study. Hormone replacement therapy group was divided into two groups; estrogen replacement therapy (ERT) group (n=23) and progestin-estrogen replacement therapy (PERT) group (n=23). Standard 12 lead electrocardiograms and 24-h ambulatory Holter recording were obtained to evaluate the effects of one year of ERT and PERT on QT intervals, QTd, frequencies of arrhythmias and HRV parameters. Long term use of ERT increases QT interval, QTd, in the frequencies of arrhythmia and HRV indexes of parasympathetic activity; however, the increase in frequencies of arrhythmia was not statistically significant (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Long term use of PERT did not effected QT interval, QTd, frequencies of ventricular arrhythmia and HRV parameters (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Frequency of supraventricular tachycardia increased in post-treatment PERT group was compared with pre-treatment PERT group. These findings supported the hypothesis that estrogen may directly modulate ventricular repolarization. But progestin do not effect the ventricular repolarization. However, these findings must be supported with a large-scale study.
Objective: To assess cardiac function in patients with hypogonadotropic hypogonadism. Study desig... more Objective: To assess cardiac function in patients with hypogonadotropic hypogonadism. Study design: We studied heart structure and left ventricular systolic and diastolic function by echocardiography in 38 patients with hypogonadotropic hypogonadism (34 men and 4 women, mean age 24 +/- 4 years) and in 30 healthy subjects (25 men and 5 women, mean age 22 +/- 3 years). Left ventricular end-diastolic diameter, end-systolic diameter, left ventricular septal wall thickness, posterior wall thickness and ejection fractions were measured by M-mode echocardiography. Parameters of mitral flow were measured by pulsed wave Doppler echocardiography. Results: Between patients with and without hypogonadotropic hypogonadism, there were no significant differences in echocardiographic measurements. Conclusion: Cardiac function is normal in patients with hypogonadotropic hypogonadism.
Coronary artery aneurysm (CAA) is a relatively rare disease that may cause angina, myocardial inf... more Coronary artery aneurysm (CAA) is a relatively rare disease that may cause angina, myocardial infarction, sudden death due to thrombosis, embolisation, or rupture. This report describes the case of a man aged 65 years old who had an anterior myocardial infarction due to left anterior descending artery (LAD) aneurysm. We attempted early percutaneous transluminal coronary angioplasty (PTCA) for treatment of acute myocardial infarction, but were not successful. He was then treated with intracoronary streptokinase. Serial coronary angiographies showed recanalisation and aneurysm on the LAD. The patient was operated on with coronary bypass surgery, and treated with an oral anticoagulant, nitrate, and blocker. He was well after one year of follow-up.
We report a 16-year-old girl with acute rupture of the sinus of Valsalva. This case is unique in ... more We report a 16-year-old girl with acute rupture of the sinus of Valsalva. This case is unique in that the right coronary sinus of Valsalva ruptured into both the right and left ventricles, producing severe aortic insufficiency. The diagnosis was made with two-dimensional and color Doppler echocardiography which showed an abnormal jet flow from the aortic root into both ventricles. The diagnosis was confirmed by magnetic resonance imaging and aortic root angiography. Early diagnosis is important so that urgent surgical treatment can be taken.
3D printing and additive manufacturing, Aug 1, 2020
During epidemics or pandemics affecting the respiratory systems, hospital equipment such as venti... more During epidemics or pandemics affecting the respiratory systems, hospital equipment such as ventilators may become insufficient and different solutions can be considered. In fast spreading respiratory illnesses such as COVID-19 due to the rapidly increasing number of patients, ventilatory machine insufficiencies may appear. It may be considered to use one hospital ventilator for more than one patient by dividing the airway of the machine with a specially designed splitter. The aim of this study was to determine whether a ventilator can be modified to provide ventilation of two or more patients simultaneously by using 3D designed and manufactured splitters. A two-port and four-port splitter were designed in Autodesk Fusion 360 computer program and manufactured by 3D printer using PolyJet technology (Stratasys J750). Two sets of splitters were used to adapt to the ventilator during trial process: one for inspiratory and one for expiratory outputs. Two intensive care specialists voluntarily tried this study on themselves. It was concluded from the study that 3D designed and manufactured two-port splitter can be used to separate the airway of a single ventilator to multiple patients within a very limited indication and time interval.
Journal of The American Society of Echocardiography, Oct 1, 2003
Background: The 320-row area detector computed tomography (ADCT) for the evaluation of left ventr... more Background: The 320-row area detector computed tomography (ADCT) for the evaluation of left ventricular (LV) systolic function has been reported, but reporting of ADCT for the evaluation of LV diastolic function (LVDF) cannot be found. The purpose of this study was to examine the usefulness of ADCT in the assessment of LV systolic and diastolic function compared to ultrasound echocardiography (Echo) as the standard of reference. Materials and methods: We evaluated 60 consecutive patients (mean age 62.4±13.2 years, male/female 36/24) who underwent ADCT (retrospective electrocardiogram triggered) and Echo. All patients were classified into three groups (A, B, C) according to LVDF evaluated by Echo. We examined peak filling rate (PFR) and time to peak filling (TPF) as indicator of LVDF using ADCT. Results: Good correlations between ADCT and Echo were demonstrated for the assessment of LVSF. PFR of group B (mild diastolic dysfunction) patients (1.92±0.69) and group C (moderate severe diastolic dysfunction) patients (1.90±0.75) were significantly lower than that of group A (normal diastolic function) patients (2.50±0.43). TPF of group B (191.6±54.4 ms) and group C patients (197.5±64.0 ms) were significantly higher than that of group A patients (149.5±34.1 ms). Conclusions: ADCT is useful method for the evaluation of LVSF and LV diastolic dysfunction.
Objective: Factor V Leiden mutation, the genetic defect underlying resistance to activated protei... more Objective: Factor V Leiden mutation, the genetic defect underlying resistance to activated protein C, is the most common risk factor for venous thrombosis. Factor V Leiden mutation and its relation to post-myocardial infarction (MI) complications including angina pectoris, heart failure, reinfarction and cardiac mortality has not been investigated. We aimed to investigate this relation. Methods: The prevalence of factor V Leiden mutation was investigated in 122 patients with first acute myocardial infarction (aged 56 +/- 11, 82 men/40 women). These patients were divided into two groups according to whether the patients had factor V Leiden mutation (Group I) or not (Group II). Post MI complications were evaluated during 18 months. Blood samples from the patients were analyzed for factor V Leiden mutation by DNA analysis, using the polymerase chain reaction (PCR). Results: Factor V Leiden was detected in 11 (9%) patients (aged; 54 +/- 10, 5 women/men) and was not detected in 111(90%) patients (aged; 56 +/- 11; 35 women/76 men) of the 122 patients. There were no significant differences between Group I and Group II in terms of post MI complications, including reinfarction (27% vs. 29%; p > 0.05, respectively), angina pectoris (45% vs. 38%; p > 0.05, respectively), heart failure (27% vs. 23%; p > 0.05, respectively) and cardiac mortality (18% vs. 14%; p > 0.05, respectively). Conclusion: Post MI complications, including reinfarction, heart failure, angina pectoris and cardiac mortality were not increased in patients with factor V Leiden.
Ventriküler septumun sağlam olduğu valvüler Pul moner Stenoz (PS) vakaları, tüm kongenital kalp h... more Ventriküler septumun sağlam olduğu valvüler Pul moner Stenoz (PS) vakaları, tüm kongenital kalp has talıkları arasında %10'a varan sıklıkta görülür (1). PS'un tedavisinde önceleri sadece cerrahi tedavi uygu lanmakta idi ve elde edilen sonuçlar başarılı idi (2).
Aim: Whether measurement of left ventricular outflow tract diameter (LVOTd) using color Doppler (... more Aim: Whether measurement of left ventricular outflow tract diameter (LVOTd) using color Doppler (CD) in order to more accurately define LVOTd is more accurate for determination of stroke volume (SV) than gray scale and compare it with direct measurement of LVOT area (a) using three‐dimensional echocardiography (3DE) for SV determination. Methods and Results: Twenty‐one volunteers were examined. LVOTa was calculated by two‐dimensional echocardiography (2DE) using the following formula: π× (d/2)2, d = LVOT diameter by gray scale and CD, respectively. Planimetry of LVOTa was performed in parasternal long axis using 3DE. Eccentricity Index was calculated using the lateral and anterior‐posterior LVOTd. SV was obtained by four different methods: (1) 2D gray scale, (2) 2D color, (3) LVOTa × LVOT velocity time integral, and (4) SV by Simpson's biplane method. Gray scale LVOTd was significantly smaller compared to LVOTd obtained with CD (P < 0.05). Significant differences occurred bet...
Objectives: In this study, we present the use of case specific three- dimensional (3D) printed pl... more Objectives: In this study, we present the use of case specific three- dimensional (3D) printed plastic models and custom-made acetabular implants in orthopedic surgery. Materials and methods: Between March 2018 and September 2020, surgeries were simulated using plastic models manufactured by 3D printers on the two patients with pilon fractures. Also, custom-made acetabular implants were used on two patients with an acetabular bone defect for the revision of total hip arthroplasty (THA). Results: More comfortable surgeries were experienced in pilon fractures using preoperative plastic models. Similarly, during the follow-up period, the patients that applied custom-made acetabular implants showed a fixed and well-positioning in radiographic examination. These patients did not experience any surgical complications and achieved an excellent recovery. Conclusion: Preoperative surgical simulation with 3D printed models can increase the comfort of fracture surgeries. Also, custom-made 3D p...
The aim of the study was to investigate the effects of a long term (1 year) hormone replacement t... more The aim of the study was to investigate the effects of a long term (1 year) hormone replacement therapy (HRT) on QT interval, QT dispersion (QTd) frequencies of arrhythmia and heart rate variability (HRV) parameters. Forty-six healthy postmenopausal women (mean age; 55.34+/-4.21) as a hormone replacement therapy group and 25 healthy premenopausal women (mean age; 35.36+/-6.06) as a control group were prospectively enrolled to the study. Hormone replacement therapy group was divided into two groups; estrogen replacement therapy (ERT) group (n=23) and progestin-estrogen replacement therapy (PERT) group (n=23). Standard 12 lead electrocardiograms and 24-h ambulatory Holter recording were obtained to evaluate the effects of one year of ERT and PERT on QT intervals, QTd, frequencies of arrhythmias and HRV parameters. Long term use of ERT increases QT interval, QTd, in the frequencies of arrhythmia and HRV indexes of parasympathetic activity; however, the increase in frequencies of arrhythmia was not statistically significant (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Long term use of PERT did not effected QT interval, QTd, frequencies of ventricular arrhythmia and HRV parameters (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Frequency of supraventricular tachycardia increased in post-treatment PERT group was compared with pre-treatment PERT group. These findings supported the hypothesis that estrogen may directly modulate ventricular repolarization. But progestin do not effect the ventricular repolarization. However, these findings must be supported with a large-scale study.
Objective: To assess cardiac function in patients with hypogonadotropic hypogonadism. Study desig... more Objective: To assess cardiac function in patients with hypogonadotropic hypogonadism. Study design: We studied heart structure and left ventricular systolic and diastolic function by echocardiography in 38 patients with hypogonadotropic hypogonadism (34 men and 4 women, mean age 24 +/- 4 years) and in 30 healthy subjects (25 men and 5 women, mean age 22 +/- 3 years). Left ventricular end-diastolic diameter, end-systolic diameter, left ventricular septal wall thickness, posterior wall thickness and ejection fractions were measured by M-mode echocardiography. Parameters of mitral flow were measured by pulsed wave Doppler echocardiography. Results: Between patients with and without hypogonadotropic hypogonadism, there were no significant differences in echocardiographic measurements. Conclusion: Cardiac function is normal in patients with hypogonadotropic hypogonadism.
Coronary artery aneurysm (CAA) is a relatively rare disease that may cause angina, myocardial inf... more Coronary artery aneurysm (CAA) is a relatively rare disease that may cause angina, myocardial infarction, sudden death due to thrombosis, embolisation, or rupture. This report describes the case of a man aged 65 years old who had an anterior myocardial infarction due to left anterior descending artery (LAD) aneurysm. We attempted early percutaneous transluminal coronary angioplasty (PTCA) for treatment of acute myocardial infarction, but were not successful. He was then treated with intracoronary streptokinase. Serial coronary angiographies showed recanalisation and aneurysm on the LAD. The patient was operated on with coronary bypass surgery, and treated with an oral anticoagulant, nitrate, and blocker. He was well after one year of follow-up.
We report a 16-year-old girl with acute rupture of the sinus of Valsalva. This case is unique in ... more We report a 16-year-old girl with acute rupture of the sinus of Valsalva. This case is unique in that the right coronary sinus of Valsalva ruptured into both the right and left ventricles, producing severe aortic insufficiency. The diagnosis was made with two-dimensional and color Doppler echocardiography which showed an abnormal jet flow from the aortic root into both ventricles. The diagnosis was confirmed by magnetic resonance imaging and aortic root angiography. Early diagnosis is important so that urgent surgical treatment can be taken.
3D printing and additive manufacturing, Aug 1, 2020
During epidemics or pandemics affecting the respiratory systems, hospital equipment such as venti... more During epidemics or pandemics affecting the respiratory systems, hospital equipment such as ventilators may become insufficient and different solutions can be considered. In fast spreading respiratory illnesses such as COVID-19 due to the rapidly increasing number of patients, ventilatory machine insufficiencies may appear. It may be considered to use one hospital ventilator for more than one patient by dividing the airway of the machine with a specially designed splitter. The aim of this study was to determine whether a ventilator can be modified to provide ventilation of two or more patients simultaneously by using 3D designed and manufactured splitters. A two-port and four-port splitter were designed in Autodesk Fusion 360 computer program and manufactured by 3D printer using PolyJet technology (Stratasys J750). Two sets of splitters were used to adapt to the ventilator during trial process: one for inspiratory and one for expiratory outputs. Two intensive care specialists voluntarily tried this study on themselves. It was concluded from the study that 3D designed and manufactured two-port splitter can be used to separate the airway of a single ventilator to multiple patients within a very limited indication and time interval.
Journal of The American Society of Echocardiography, Oct 1, 2003
Background: The 320-row area detector computed tomography (ADCT) for the evaluation of left ventr... more Background: The 320-row area detector computed tomography (ADCT) for the evaluation of left ventricular (LV) systolic function has been reported, but reporting of ADCT for the evaluation of LV diastolic function (LVDF) cannot be found. The purpose of this study was to examine the usefulness of ADCT in the assessment of LV systolic and diastolic function compared to ultrasound echocardiography (Echo) as the standard of reference. Materials and methods: We evaluated 60 consecutive patients (mean age 62.4±13.2 years, male/female 36/24) who underwent ADCT (retrospective electrocardiogram triggered) and Echo. All patients were classified into three groups (A, B, C) according to LVDF evaluated by Echo. We examined peak filling rate (PFR) and time to peak filling (TPF) as indicator of LVDF using ADCT. Results: Good correlations between ADCT and Echo were demonstrated for the assessment of LVSF. PFR of group B (mild diastolic dysfunction) patients (1.92±0.69) and group C (moderate severe diastolic dysfunction) patients (1.90±0.75) were significantly lower than that of group A (normal diastolic function) patients (2.50±0.43). TPF of group B (191.6±54.4 ms) and group C patients (197.5±64.0 ms) were significantly higher than that of group A patients (149.5±34.1 ms). Conclusions: ADCT is useful method for the evaluation of LVSF and LV diastolic dysfunction.
Objective: Factor V Leiden mutation, the genetic defect underlying resistance to activated protei... more Objective: Factor V Leiden mutation, the genetic defect underlying resistance to activated protein C, is the most common risk factor for venous thrombosis. Factor V Leiden mutation and its relation to post-myocardial infarction (MI) complications including angina pectoris, heart failure, reinfarction and cardiac mortality has not been investigated. We aimed to investigate this relation. Methods: The prevalence of factor V Leiden mutation was investigated in 122 patients with first acute myocardial infarction (aged 56 +/- 11, 82 men/40 women). These patients were divided into two groups according to whether the patients had factor V Leiden mutation (Group I) or not (Group II). Post MI complications were evaluated during 18 months. Blood samples from the patients were analyzed for factor V Leiden mutation by DNA analysis, using the polymerase chain reaction (PCR). Results: Factor V Leiden was detected in 11 (9%) patients (aged; 54 +/- 10, 5 women/men) and was not detected in 111(90%) patients (aged; 56 +/- 11; 35 women/76 men) of the 122 patients. There were no significant differences between Group I and Group II in terms of post MI complications, including reinfarction (27% vs. 29%; p > 0.05, respectively), angina pectoris (45% vs. 38%; p > 0.05, respectively), heart failure (27% vs. 23%; p > 0.05, respectively) and cardiac mortality (18% vs. 14%; p > 0.05, respectively). Conclusion: Post MI complications, including reinfarction, heart failure, angina pectoris and cardiac mortality were not increased in patients with factor V Leiden.
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