Mehmet Cengiz Çolak

Left atrial volume and function in patients with white-coat hypertension assessed by real-time three-dimensional echocardiography.

BackgroundWhite-coat hypertension (WCH) is a disease based on the disparity of a patient’s blood pressure measurements between the physician’s office and the patient’s home environment. The aim of the present study is to evaluate the left atrial (LA) volume and functions in WCH. MethodsIn total, this study included 37 WCH (17 women, 20 men, mean age 48.4±5.7 years) and 30 healthy individuals (18 women, 20 men, mean age 47.9±7.5 years). All patients underwent real-time three-dimensional and comprehensive two-dimensional echocardiography (2DE) with tissue Doppler evaluation to estimate left atrial volumes and mechanical functions. ResultsLA diameters were significantly higher in the patients compared with the controls (37±2.8 vs. 35±3.1 mm, P=0.017). LA total systolic volume and LA maximal volume were significantly higher in the patients. (41.1±6.9 vs. 35.5±3.7 ml, P<0.001; 25.8±5.4 vs. 21.3±3.3 ml, P<0.001, respectively). LA volume before LA contraction and LA active stroke volume were significantly higher in the patients with WCH than in the normotensives (24.4±6.3 vs. 20.9±2 ml, P=0.002; 9.1±4.8 vs. 6.7±2.5 ml, P=0.007, respectively). Moreover, the LA expansion index was significantly higher in the patients with WCH than in the normotensives (178.7±53.6 vs. 155.3±36.3, P=0.037). However, the total emptying volume fraction of the LA was similar between the two groups. ConclusionWe showed that LA structural functions and volumes were increased in the WCH group. Although increased LA volume has been observed in many diseases, structural changes in LA may be accepted as an early sign for clinical cardiac remodeling in patients with WCH, suggesting the necessity of early intervention for preventing clinical cardiovascular disease.

Interrupted inferior vena cava and partial anomalous pulmonary venous return with atrial septal defect in a 38-year-old adult: a case report

We present a woman having congenital anomalies of the inferior vena cava and partial anomalous pulmonary venous return from the right lung with atrial septal defect in a 38-year-old. Congenital anomalies of inferior vena cava are rare. They are seen more often in young males. If there are not other anomalies, they are latent for a long time. Peripheral venous thrombosis, chronic venous insufficiency, dyspnea and fatigue are often the first symptoms of these anomalies. Surgical repair of atrial septal defect with partial anomalous pulmonary venous return include provision of durably unobstructed systemic and pulmonary venous pathways, closure of the atrial septal defect, and avoidance of arrhythmias. The diagnosis has been determined by compression ultrasonography with color doppler assessment, multidetector computed tomography angiography and echocardiography.

Successful Surgical Treatment of a Ruptured Giant Atherosclerotic Aneurysm of Arcus Aorta

Background: Due to its high mortality and morbidity rates, the surgical treatment for ruptured aortic arch aneurysms is challenging. There is no consensus on the optimal treatment modality in this patient group. Herein, we present a case of a ruptured giant atherosclerotic aortic arch aneurysm treated successfully with emergency surgical intervention. Case Report: A 74-year-old female patient was admitted to our emergency clinic with complaints of blurred consciousness, chest pain, and dyspnea. In physical examination arterial blood pressure, pulse, oxygen saturation was 80/40 mmHg, 122 beats/min, 85-90% respectively. In oscultation of left hemithorax breath sounds was decreased. Chest X-ray revealed a giant aortic aneurysm and opacity at left hemithorax which was suggestive of pleural effusion. A ruptured saccular aortic arch aneurysm with a size of 8x6 cm2 was detected in the contrasted tomography. Emergency surgery with right selective antergrade cerebral perfusion performed uneventfully. Because of pulmonary complications she wasnÂ’t tolerate extubation and re-intubated. After appropriate therapy in anesthesiology and reanimation clinic she was discharged in the postoperative 15th day. Conclusion: Recent outcomes of open arch repair and hybrid TEVAR demonstrate acceptable results, particularly early after the procedure, open arch repair provides more reliable outcomes during follow-up. These two surgical strategies, when properly selected according to the individual risk, can improve the surgical outcomes in patients with aortic arch aneurysms

The effects of pulmonary hypertension on early outcomes inpatients undergoing coronary artery bypass surgery.

BACKGROUND/AIM To investigate the effects of pulmonary hypertension on early clinical variables in patients undergoing coronary artery bypass grafting surgery. MATERIALS AND METHODS The preoperative echocardiographic data of patients who underwent isolated coronary artery bypass surgery were evaluated retrospectively. A total of 1244 patients were included in the study. The patients were divided into two groups: one group consisted of patients with systolic pulmonary artery pressure (SPAP) values equal to or greater than 30 mmHg (Group 1, n = 184), while the other group consisted of patients with SPAP values below 30 mmHg (Group 2, n = 1060). RESULTS Early mortality was similar in both groups (0% in Group 1 and 1.2% in Group 2; P > 0.05). Comparison of postoperative data indicated that Group 1 had a higher need for inotropic agent treatment, a longer average duration of ventilation, and a longer average duration of stay in the intensive care unit (P < 0.05). For the other variables, no significant differences were identified between patients with and without pulmonary hypertension (P > 0.05). CONCLUSION Mild pulmonary hypertension (mean SPAP = 37.7 ± 8.4 mmHg) was not associated with a significant difference in the mortality of patients undergoing coronary artery bypass grafting. For patients undergoing this type of coronary bypass surgery, lower morbidity and mortality rates can be achieved through comprehensive preoperative examinations and effective perioperative medical procedures.