Ömer Tetik

Giant cardiac hydatid cyst in the interventricular septum protruding to right ventricular epicardium.

Cardiac hydatid cyst is a rare condition, and the location of a hydatid cyst in the interventricular septum is exceptional. A 54-year-old female was admitted to our hospital with complaints of chest pain, shortness of breath and malaise. Transthoracic echocardiography defined a cystic mass lesion of 50 × 59 mm originating from apex of the heart protruding into and compressing the interventricular septum. The cyst was excised surgically and the patient was discharged on the 8th postoperative day without symptoms. In our case, localization of the cystic mass was within interventricular septum which is an uncommon site. It limited both ventricular volumes significantly. In addition, this cyst was extensively protruding to the right ventricular epicardium.

Management of a patient with giant aneurysms in the popliteal and coronary arteries

Coexistence of multiple peripheric arterial and coronary artery aneurysms of different sizes is extremely rare in young adults. We present a case of rare giant coronary aneurysm and concurrent giant left popliteal aneurysm treated with classical open repair.

Identification and characterization of a novel FBN1 gene variant in an extended family with variable clinical phenotype of Marfan syndrome

ABSTRACT Marfan syndrome (MFS) is a multi-systemic autosomal dominant condition caused by mutations in the gene (FBN1) coding for fibrillin-1. Mutations have been associated with a wide range of overlapping phenotypes. Here, we report on an extended family presenting with skeletal, ocular and cardiovascular clinical features. The 37-year-old male propositus, who had chest pain, dyspnea and shortness of breath, was first diagnosed based on the revised Ghent criteria and then subjected to molecular genetic analyses. FBN1 sequencing of the proband as well as available affected family members revealed the presence of a novel variant, c.7828G>C (p.Glu2610Gln), which was not present in any of the unaffected family members. In silico analyses demonstrated that the Glu2610 residue is part of the conserved DINE motif found at the beginning of each cbEGF domain of FBN1. The substitution of Glu2610 with Gln decreased fibrillin-1 production accordingly. Despite the fact that this variation appears to be primarily responsible for the etiology of MFS in the present family, our findings suggest that variable clinical expressions of the disease phenotype should be considered critically by the physicians.

Combined system usage for large neck anatomy in a high risk abdominal aortic aneurysm patient

Nowadays, endovascular aneurysm repair (EVAR) is the first line approach in abdominal aortic aneurysm (AAA) repair. A sufficient infrarenal aortic neck is one of the key points for successful outcome after EVAR. Proximal neck characteristics remain a challenge in endovascular treatments. In these case report, we present you a 75-year-old, male patient with a large neck AAA. He was unsuitable to standard EVAR therapy and open surgery because of his comorbidities. Funnel technique in which a thoracic stent-graft is placed through the main body of a bifurcated or uni-iliac endograft could be a feasible and succesfull treatment in such cases.

Bentall Operation in a Patient With Severe Hemophilia A and Marfan Syndrome by Use of a Biologic Composite Graft

We describe a patient with severe hemophilia A and Marfan syndrome who underwent an elective Bentall operation. Because of the severe hemophilia, anticoagulation could not be given postoperatively; thus, a biologic Valsalva conduit graft was used. During the procedure, factor VIII was given as a bolus dose just before incision, then by continous infusion intraoperatively to maintain the factor VIII activity level between 200% and 300%. Minimal postoperative bleeding occurred. The infusion was continued postoperatively at a lower dose until all chest tubes, pacing wires, and invasive catheters were removed. The patient was discharged on postoperative day 7 without adverse events.

Endovascular therapy in iliac artery and lower extremity peripheral arterial diseases

Methods Twenty-four of patients were treated with endovascular method. Nineteen of the patients had intermittent claudication, 4 had rest pain and one patient with bilateral popliteal artery aneurysms had pain at the back of bilateral knee joints. Twenty patients were male and 3 were female. The mean age was 64,05 (range 40-82 years) years. Nine of the patients who underwent endovascular therapy had a lesion in TASC-A group, 5 had a TASC-B lesion, and TASC-COPD lesions were present in 9 patients. Subintimal balloon angioplasty failed with TASC-C lesions of 2 patients who were excluded from the study. One of these patients underwent urgent infragenual femoropopliteal bypass using a saphenous graft and the other supragenual femoropopliteal bypass using a PTFE graft.

Treatment of bilateral popliteal artery and right anterior tibial artery aneurysm with endovascular stent grafting

Methods A 67-year-old woman presented to our clinic with pain at the back of bilateral knee joints. Physical examination showed manually palpable distal arterial pulses and a pulsatile mass at bilateral popliteal fossae. Arterial Doppler ultrasonography revealed bilateral popliteal arterial aneurysms. Multislice computerized tomography showed an aneurysm starting from distal femoral artery and involving entire popliteal artery at the left side and aneurysmal dilatation in both popliteal artery and proximal segment of the anterior tibial artery at the right side. Screening tests failed to show any additional aneurysms at other sites.

Coexistence of persistent left superior vena cava which is drained directly to left atrium and aortic stenosis with low gradient and low ejection fraction

Methods 46-year-old male patient was hospitalized because of shortness of breath. The patient’s general condition was very bad and he was confined to a wheelchair. The patient was in New York Heart Association Functional Classification (NYHA FC) Class IV. Severe aortic stenosis, EF 20%, Left ventricular end-systolic diameter 65 mm, end-diastolic diameter 50mm, global hypokinesia, gradient 51/13 mm Hg, normal mitral valve, pulmonary hypertension (75 / 24mmHg) were determined on transthoracic echocardiography. Basal gradient increased from 51/ 13mm Hg to 72/40 mmHg on dobutamine stress echocardiography.