Mehmet Serdar Küçükoğlu

Pulmonary Artery Sarcoma Masquerading as Chronic Pulmonary Thromboembolism

We describe the case of a 60-year-old woman who presented with pulmonary artery sarcoma, a very rare tumor of the cardiovascular system. Her tumor was initially misdiagnosed as chronic pulmonary thromboembolism, and she underwent pulmonary endarterectomy. Early diagnosis of primary pulmonary artery sarcoma is crucial. That alternative should always be considered before settling on a diagnosis of pulmonary embolism. Suspicion should be aroused by the failure of anticoagulant treatment to alleviate pulmonary perfusion abnormalities and systemic symptoms. Surgical resection of the tumor-preferably by pulmonary endarterectomy, followed by reconstruction as needed-is currently the most promising treatment for pulmonary artery sarcoma.

A case difficult to diagnose in adults: High sinus venous atrial septal defect

Sinus venous atrial septal defect (SVD) is highly difficult to diagnose because of its location. Below, we report a case of SVD which is misdiagnosed as pulmonary hypertension and anomalous pulmonary venous return. A 57-year-old female patient was referred to congenital disease outpatient clinic of a tertiary center. She was admitted to the hospital with complaints of fatigue and exercise dyspnea which had started a year ago. She had transthoracic echocardiography (TTE) examination done in another hospital which showed dilated right heart chambers and pulmonary hypertension. She underwent transesophageal echocardiography (TEE) examination with the suspicion of atrial septal defect (ASD), but no defect was seen. As her symptoms persisted, we repeated the TTE and TEE examination in our center. TEE revealed 0.6 cm ASD on the upper side of the interatrial septum. All four pulmonary veins were draining into the left atrium. Right heart catheterization (RHC) confirmed the diagnosis. A left-to-right shunt was detected and localized by a significant step-up in blood oxygen saturation found between mid and upper segments of the right atrium. According to our TEE and RHC results, we planned the surgical closure of the defect. Sinus venous ASD is deficiency of the superior portion of atrial septum adjacent to superior vena cava. Diagnosis of SVD is often more difficult than other forms of ASD and may require special imaging such as TEE, magnetic resonance imaging, or computed tomographic scanning. In conclusion, cardiologists must be aware about the possibility of SVD patients who have unexplained exertional dyspnea and fatigue, dilated right atrium and ventricle, pulmonary hypertension, paradoxical embolism, or atrial arrhythmias in their respective populations.

SURVIVAL ANALYSIS FROM THALES STUDY, A LARGE NATION-WIDE REGISTRY ON PULMONARY ARTERIAL HYPERTENSION ASSOCIATED WITH CONGENITAL HEART DISEASE

Background: Baseline data from the national, multicenter, prospective, observational THALES Registry providing information regarding demographic and clinical characteristics and treatment patterns had previously reported. In this analysis, we aim to assess survival in association with clinical,

Endarteritis of coarctation of the aorta diagnosed with PET-CT

Infective endocarditis (IE) is an infectious disease that affects the endothelium of the large intrathoracic vessels, heart valves, and intra-cardiac foreign body material. A 20-year-old woman was admitted to the cardiology department with complaints of fever and palpitations. Transthoracic echocardiography revealed a bicuspid aortic valve, aortic root enlargement, and aortic coarctation. Transesophageal echocardiography revealed a bicuspid aortic valve, but there was no vegetation. Methicillin-sensitive Staphylococcus aureus was identified on a blood culture. 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) revealed increased intensive glucose uptake on the dilated aortic segment adjacent to the distal coarctation zone. Several reports have shown promising results for radio-labelled white blood cell single-photon emission computed tomography and 18F-FDG PET-CT imaging in IE. To our knowledge, this is the first described case in which PET-CT revealed endarteritis of the descending aorta in a patient without prosthetic material.

The new insights of 2015 ESC Pulmonary Hypertension Guidelines

Geliş tarihi: 17.11.2015 Kabul tarihi: 09.12.2015 Yazışma adresi: Dr. Mehmet Serdar Küçükoğlu. İstanbul Üniversitesi Kardiyoloji Enstitüsü, Kardiyoloji Anabilim Dalı, İstanbul. Tel: +90 212 459 20 00 e-posta: kucukoglu3@yahoo.com

Obstruction of mechanical mitral valves by preserved posterior leaflet remnants.

We report two cases of mechanical prosthetic mitral valve obstruction caused by remnants of the mitral valve posterior leaflet tissue preserved from the previous surgery. Both patients had rheumatic mitral stenosis causing New York Heart Association class III symptoms prior to mitral valve replacement.

Cardiac Tamponade due to Left Ventricular Pseudoaneurysm After Aortic Valve Replacement

Left ventricular outflow tract pseudoaneurysm is a rare but a potentially lethal complication, mainly after aortic root endocarditis or surgery. Usually, it originates from a dehiscence in the mitral-aortic intervalvular fibrosa and arises posteriorly to the aortic root. We report a rare case of a patient with cardiac tamponade due to left ventricular pseudoaneurysm after aortic valve replacement. The subsequent surgical resection was performed successfully.

Atypical Chest X-Ray Calcification in an Idiopathic Constrictive Pericarditis Case

Constrictive pericarditis is an uncommon cause of heart failure. It is a clinical entity caused by thickening, fibrosis, and/or calcification of the pericardium. We present a 50-year-old female patient who was admitted to our institution with a 6-month history of progressive dyspnea on exertion, abdominal swelling, and lower extremity edema. Her chest X-ray revealed an oblique linear calcification in the cardiac silhouette. Transthoracic echocardiography revealed biatrial enlargement. Left ventricular size and systolic function were normal. Cardiac computed tomography revealed the pericardial thickening (>5 mm) and heavy calcification in left atrioventricular groove. Simultaneous right and left heart catheterization showed elevation and equalization of right-sided and left-sided diastolic filling pressures, with characteristic dip, and plateau. Pericardiectomy was performed which revealed a thick, fibrous, calcified, and densely adherent pericardium constricting the heart. The postoperative period was uneventful and was in NYHA functional class I after 3 months.