Browsing by Author "Asker, M"

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Aneurysm of Sinus of Valsalva Dissecting Into Interventricular Septum
(Blackwell Futura Publishing, inc, 2004) Güler, N; Eryonucu, B; Tuncer, M; Asker, M
A 43-year-old man who had a Carbomedics prosthetic aortic valve replacement in 1997 was admitted to our hospital with complaints of shortness of breath and dyspnea on exertion in 2000. The patient was hospitalized due to atrioventricular (AV) complete block and a permanent pacemaker was implanted. At that time echocardiography indicated an aneurysm at the left sinus of Valsalva. In 2003, the patient was re-admitted to our clinic with complaints of shortness of breath and fatigue. Echocardiography showed a sinus of Valsalva aneurysm dissecting into interventricular septum. Operation confirmed dissection of the interventricular septum and communication between this cavity and the aneurysm of the left sinus of Valsalva. The postoperative course was uneventful and the patient was discharged in a satisfactory condition. This is the first reported case of aneurysm of the sinus of Valsalva dissecting into interventricular septum late and complicating aortic valve replacement.
Evaluation of Right Atrial Appendage Blood Flow by Transesophageal Echocardiography in Subjects With a Normal Heart
(Japan Heart Journal, Second dept of internal Med, 1999) Bilge, M; Eryonucu, B; Güler, N; Asker, M
Right atrial appendage (RAA) blood flow pattern was analyzed in 42 normal subjects without cardiovascular disease (aged 30 to 48 years, mean 40 +/- 6) who underwent transesophageal echocardiography. RAA flow pattern was demonstrated to be bi-, tri- or quadriphasic and heart rate dependent (p < 0.01) in this study. In 15 subjects (36%), a biphasic pattern was observed. A triphasic pattern was observed in 12 subjects (28%). Fifteen subjects (36%) had a quadriphasic pattern. In these subjects, we observed a pattern consisting of two diastolic forward flow waves, each followed by a backward flow wave. Mean heart rates among subjects with bi-, tri- and quadriphasic patterns were 110 +/- 6, 91 +/- 4 and 72 +/- 13 beats/min, respectively. In the triphasic pattern, the onset of superior vena cava diastolic forward flow began 18 +/- 4 ms after the onset of tricuspid E wave, whereas the first diastolic forward flow wave in the RAA began 40 +/- 7 ms after onset of the tricuspid E wave. A similar relation was also noted in the quadriphasic pattern. This sequence was constant and independent of heart rate (p < 0.05), suggesting a temporal relation between right ventricular relaxation and the first diastolic forward flow wave in the RAA. In normal subjects, the RAA flow pattern is heart rate dependent and three distinct flow patterns can be differentiated. Right ventricular relaxation appears to induce both the superior vena cava diastolic forward flow wave and the first diastolic forward flow wave of the RAA. These results can be used for comparison with patterns found in disease states.
Frequency of Left Atrial Thrombus and Spontaneous Echocardiographic Contrast in Acute Myocardial Infarction
(Excerpta Medica inc-elsevier Science inc, 1999) Bilge, M; Güler, N; Eryonucu, B; Asker, M
Left ventricular systolic dysfunction may precipitate blood stasis as well as thrombus formation in the left atrial appendage of patients with acute myocardial infarction, even in the presence of sinus rhythm. Thus, left atrial thrombi may be an alternative source for systemic embolism in acute myocardial infarction.
Transesophageal Echocardiography Assessment of Left Atrial Appendage Function in Untreated Systemic Hypertensive Patients in Sinus Rhythm
(Mosby-elsevier, 2000) Bilge, M; Eryonucu, B; Güler, N; Akdemir, I; Asker, M
To assess left atrial appendage (LAA) function in hypertensive patients without treatment, transesophageal echocardiography (TEE) was performed in 46 hypertensive patients in sinus rhythm, aged 40 to 55 years, and in 16 control subjects (group I) without cardiovascular disease, aged 41 to 54 years. The hypertensive patients were divided into 2 groups according to left ventricular (LV) systolic function: group II, the group with normal LV systolic function (ejection fraction 0.63 +/- 0.08), and group III, the group with LV systolic dysfunction (ejection fraction 0.39 +/- 0.05). The LAA late emptying velocities (EVs) were significantly reduced in the hypertensive subgroups compared with the control group (P < .001), but no significant difference in the LAAEV was found between groups Il and III. The LAAEV in the hypertensive patients had a significant negative correlation with diastolic blood pressure, systolic blood pressure, and left atrial (LA) diameter. The maximal LAA areas were significantly larger in the hypertensive subgroups than in the control group (P < .05). No significant difference in LAA maximal area existed between groups II and III. The maximal LAA area in the hypertensive patients had a significant positive correlation with diastolic blood pressure, systolic blood pressure, and LA diameter, but a significant negative correlation with LV ejection fraction. With TEE, LA spontaneous echocardiographic contrast (SEC) was present in 6 (43%) of 14 patients in group III (P < .01) and in 7 (22%) of 32 patients in group II (P < .05). No significant difference in the occurrence of LASEC was found between groups II and III. Left atrial appendage thrombi by TEE were observed in 4 (29%) of 14 patients in group III (P < .05) and in 4 (13%) of 32 patients in group II (P = not significant). No significant difference in the occurrence of LAA thrombus existed between groups II and III. In conclusion, in patients with untreated hypertension, marked elevation of afterload imposed on the left atrium may involve both the left atrium and the LAA, resulting in impairment of LAA function. This condition may worsen with subsequent occurrence of SEC and later, thrombus formation. Therefore assessment of LAA function may be important even in the hypertensive patient in sinus rhythm.