Browsing by Author "Tuncer, M."

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Aortic Valve Rupture Due To High-Voltage Electrical Injury: Case Report
(2004) Güler, N.; Özkara, C.; Tuncer, M.; Güntekin, Ü.; Kocabas, S.
In the heart, the most common sequelae after electrical injury are myocardial contusion and arrhythmias. A case is presented of segmental ventricular dysfunction and severe aortic regurgitation due to laceration of the right coronary cusp of the aortic valve caused by electrical injury. To the authors' knowledge, this is the first reported case of valvular rupture due to electrical injury. © Copyright by ICR Publishers 2004.
Clinical and Laboratory Features of Patients With Pericardial Effusion
(2010) Gümrükçüoǧlu, H.A.; Akyol, A.; Tuncer, M.; Güneş, Y.; Beǧenik, H.; Akdaǧ, S.; Aǧirbaşli, M.
Objectives: We reviewed patients who were diagnosed to have pericardial effusion (PE) over a four-year period to determine the causes of PE, clinical and laboratory features, and treatment modalities. Study design: Medical records of 136 patients (81 women, 55 men; mean age 55.8±18.7 years; range 8 to 90 years) admitted to our department with PE from August 2005 to August 2009 were reviewed. The diagnosis of PE was made by transthoracic echocardiography. Medical history, physical examination, electrocardiography, echocardiography, and laboratory findings and treatment methods were recorded. Results: The most frequent complaint was dyspnea (86.8%) and the most common physical examination finding was jugular venous distension (47.1%). The most common electrocardiographic and echocardiographic findings were tachycardia (47.8%) and mild PE (<1 cm) (63.2%), respectively. Chronic renal failure and malignant diseases were the primary causes of PE (25% and 22.8% respectively), followed by idiopathic cases (14%). Pericardial tamponade was detected in 34 patients (25%), of which the majority had malignant diseases (53%). Thirty-eight patients (27.9%) underwent interventional treatment (pericardiocentesis in 27, surgical drainage in 11), while 98 patients (72.1%) were followed-up with medical treatment. Mortality occurred in three patients with pericardial tamponade. Conclusion: The most common causes of PE in our cases were chronic renal failure and malignancies. The incidence of malignant PE is on the incline owing to increased life expectancy. Echocardiography is the primary imaging modality for the evaluation of PE.
Comparison of Effects of Nebivolol and Atenolol on P-Wave Dispersion in Patients With Hypertension
(Russian Heart Failure Soc, 2008) Tuncer, M.; Fettser, D.; Gunes, Y.; Batyraliev, T. A.; Guntekin, U.; Gumrukcuoglu, H. A.; Sidorenko, B. A.
Background. P-wave dispersion has been shown to be a noninvasive electrocardiographic predictor for development of atrial fibrillation. Thus it may be possible to attenuate atrial fibrillation risk through normalization of P-wave variables and improvement in P-wave dispersion may be an important goal in treatment of hypertension. Objective. To compare the effects of nebivolol, a new P-blocker that have additional vasodilating activity via acting on endothelium and nitric oxide release, and atenolol on P-wave duration and dispersion in patients with mild-to-moderate hypertension. Methods. A total of 34 newly-diagnosed hypertensive patients were enrolled in the study. The patients were randomly assigned to receive treatment with either nebivolol (5 mg) or atenolol (50 mg). P-wave durations (Pmin and Pmax) and P-wave dispersion were measured before and one month after treatment. Results. While Pmin increased (50,6 +/- 11,2 ms to 54,7 +/- 9,1 ms, p=0,05), Pmax decreased (111,9 +/- 9,1 ms to 104,0 +/- 12,4 ms, p=0,003) and P-wave dispersion decreased (62,5 +/- 10,6 ms to 51,3 +/- 8,9 ms, p<0,001) with nebivolol, Pmin increased (44,4 +/- 9,8 ms to 58,0 +/- 15,5 ms, p=0,02), Pmax didn't change (106,1 +/- 13,8 ms to 107,0 +/- 11,6 ms, p=NS) and P-wave dispersion decreased (61,7 +/- 15,0 ms to 49,0 +/- 13,7 ms, p<0.001) with atenolol. However, there was no statistical difference between pre- and post-treatment values of two groups. Conclusions. Both nebivolol and atenolol are effective in improvement of P-wave dispersion in patients with hypertension and there's no significant difference between them.
Effects of Illness Activity on Electrocardiographic Parameters in Patients With Multiple Sclerosis
(Elsevier Ireland Ltd, 2011) Gumrukcuoglu, H. A.; Tuncer, M.; Simsek, H.; Sahin, M.; Akdag, S.; Gunes, Y.; Tombul, T.
Evaluation of Cardiology Consultations During the Covid-19 Pandemic Period
(Yuzuncu Yil Universitesi Tip Fakultesi, 2021) Babat, N.; Duz, R.; Karaduman, M.; Tuncer, M.
In this study, we scientifically examined the consultations of the patients being hospitalized from the other departments to the cardiology department during Coronavirus Disease 2019 (COVID-19) pandemia. Consultations to the cardiology department between 01 April-31 May 2020 and 01 April-31 May 2019 were discussed. Demographic characteristics and reasons of consultations were compared. A different approach was f ollowed in COVID-19 patients diagnosed with compared to patients in other clinics. The rate of consulted patients in 2019 year was 14.4% (866/5989). Its rate in 2020 year was found as 18.5% (462/2486) (p: <0.001). A statistically significant difference was obtained in both groups. The use of drugs prolonging the Qt, preoperative and increase in cardiac enzymes were found statistically significant in terms of the consultations (p: <0.001-<0.001-0.003-0.016, respectively). Face to face interviews were made in 29% (33/114) of the patients who were consulted from COVİD-19 clinics. In 71% (81/114) patients, electrocardiography (ECG) s were evaluated digitally. In this study, although there was a decrease in the number of hospitalized patients during the COVİD-19 pandemia, we observed an increase in the number of patients being consulted to cardiology clinic. The relationship between COVİD-19 disease and cardiovascular diseases and drugs being used in the treatment increased the workload of the cardiology clinic during the pandemic period. © 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Impaired Heart Rate Variability as a Marker of Cardiovascular Autonomic Dysfunction in Multiple Sclerosis
(Blackwell Publishing, 2004) Tombul, T.; Anlar, O.; Tuncer, M.; Huseyinoglu, N.; Eryonucu, B.
Interrupted Aortic Arch in an Old Woman With Aortic Stenosis
(2010) Gümrükcüoǧlu, H.A.; Şimşek, H.; Şahin, M.; Tuncer, M.; Güneş, Y.; Güntekin, U.
Interrupted aortic arch (IAA) is a rare and usually lethal congenital malformation. Without previous surgical intervention to reach adult age is very rare in patients with complete IAA. The present report describes a 70-year-old hyptertensive women who was incidentally diagnosed to have IAA and aortic stenosis. Aortography showed a complete IAA below the origin of left subclavian artery and gadolinium contrast-enhanced magnetic resonance angiogram (1.5 T scanners) clearly reaffirmed a complete interruption of the arcus aorta, with markedly developed collateral circulation.
Left Main Aneurysm
(Elsevier Ireland Ltd, 2011) Tuzun, N.; Tuncer, M.; Yilmaz, H. A.
Levels of Serum Α-Tocopherol, Retinol and Colecalciferol in Coronary Heart Disease Patients
(Blackwell Publishing, 2007) Cebi, A.; Kaya, Y.; Yoruk, I. H.; Demir, H.; Tuncer, M.
Maintenance of Sinus Rhythm and Treatment of Atrial Fibrillation in Mitral Stenosis
(2011) Sahin, M.; Simsek, H.; Ekici, B.; Akdag, S.; Tuncer, M.
Rheumatic fever is the most common cause of mitral stenosis. The most common complication of mitral stenosis is atrial fibrillation (AF). AF precipitates symptoms, greatly increases the risk of systemic embolisation, and reduces cardiac output and exercise capacity. Systemic embolization most often occurs in patients with both AF and mitral stenosis. Maintenance of the sinus rhythm in patients with mitral stenosis is very important because of reduce the risk of cerebral embolism, conservation of cardiac output and exercise capacity, and reduction of symptoms.
Maternal, Fetal Outcome, and Anticoagulant Management in Pregnant Women With Prosthetic Heart Valves
(Imr Press, 2018) Akyol, A.; Yuman, M.; Sabin, M.; Simsek, H.; Akdag, S.; Gumrukcuoglu, H. A.; Tuncer, M.
Introduction: Cardiac disease in maternity is a great problem particularly in developing countries. Pregnant patients with prosthetic heart valves (PHV) may suffer therapeutic difficulty, as the need for anticoagulation is fraught with risk of hemorrhagic or thromboembolic complications and structural valve deterioration. The present study aimed to evaluate the maternal, fetal outcome, and anticoagulant management in pregnant women with PHV. Materials and Methods: This study is prospective observational research. The medical archives of pregnant patients with PHV from September 2010 to January 2015 were scanned. Data collected from Yuzuncu Yil University Hospital Cardiology clinics archives included demographic characteristics, anticoagulant, presence or absence of obstructive or non-obstructive thrombus, and maternal-fetal outcome. Results: The authors evaluated the outcomes of 56 pregnant patients with PHV. The age at the time of pregnancy ranged between 19 and 37 (mean 28.7 +/- 8.4) years. Most common preferred anticoagulation therapy was heparin during the first trimester, followed by oral anticoagulation up to the 36th week, with subsequent replacement by heparin until delivery. Most common encountered complication was preterm birth. Death occurred in one patient due to obstructive valve thrombosis. Conclusion: Ideal PHV is not accessible for women during childbearing age. The risk of adverse event during pregnancy depends on valve position, symptoms, valve type, cardiac function, and functional capacity in patients with PHV. The active collaboration among an obstetrician, a cardiologist, and a cardiothoracic surgeon is required for optimal outcome patient with PHV.
Obstructive Sleep Apnea Syndrome in Turkish Adults
(Elsevier Ireland Ltd, 2007) Hergenc, G.; Onat, A.; Uyarel, H.; Yazici, M.; Tuncer, M.; Dogan, Y.; Rasche, K.
P Wave Dispersion in Covid-19
(Yuzuncu Yil Universitesi Tip Fakultesi, 2022) Tuncer, M.; Öztürk, F.; Çoldur, R.; Karaduman, M.; Güneş, Y.
The effects of COVID-19 on the heart are still not fully known. In this study, we investigated how COVID-19 affects the P interval. Electrocardiographies (ECG) of 30 COVID-19 patients and the control group consisting of 23 healthy volunteers were examined and dispersion (Pd) of the P wave was calculated. Compared to control group mean Pd ( 40,1±6,6 vs. 49,6±11,5, p=0,006) values were significantly higher in Covid19 patients. Increased Pd was observed as an indication that COVID-19 affects the atriums. © 2022, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
P Wave Dispersion in Hypertensive Urgency
(Russian Heart Failure Soc, 2008) Tuncer, M.; Fettser, D.; Gunes, Y.; Batyraliev, T.; Guntekin, U.; Gumrukcuoglu, H. A.; Guler, N.
Background and purpose: P wave dispersion (PWD) has been accepted as a predictor for atrial fibrillation (AF) in hypertension and some other cardiac diseases. The aim of this study was to compare the P wave parameters between patients with mild-moderate hypertension and those with hypertensive crises. Methods: A total of 48 patients, 24 of who presented to the emergency department with hypertensive urgency and 24 patients who were followed in the cardiology clinic with mild-moderate essential hypertension were included in this study. P wave durations were measured manually by two investigators blinded to data of patients. Results: The maximal duration of P wave (P-max) and the PWD were found to be significantly different between groups, being longer in patients with hypertensive urgency (p=0,05 and 0,02; respectively). Conclusions: PWD increases in hypertensive urgency states. Clinical implication of this finding should be addressed with further, prospective studies conducted on larger samples.
P Wave Duration and Dispersion in Patients With Hyperthyroidism and the Short-Term Effects of Antithyroid Treatment
(2009) Guntekin, U.; Gunes, Y.; Simsek, H.; Tuncer, M.; Arslan, S.
Background: Prolonged P wave duration and P wave dispersion (PWD) have been associated with an increased risk for atrial fibrillation (AF). Hyperthytodism is a frequent cause of atrial fibrillation (AF). Methods: Forty-two patients with newly diagnosed overt hyperthyroidism and 20 healthy people were enrolled in the study. Transthoracic echocardiography, 12 lead surface ECG and thyroid hormone levels were studied at the time of enrollment and after achievement of euthyroid state with propylthiouracil treatment. Results: Maximum P wave duration (Pmax) (97.4±14.6 vs. 84.2±9.5 msec, p<0.001), PWD (42.9±10.7 vs. 31.0±6.2 msec, p<0.001), deceleration (DT) (190.7±22.6 vs. 177.0±10.2 msec, p=0.013) and isovolumetric relaxation times (IVRT) (90.9±11.2 vs. 79.6±10.5 msec, p<0.001) were significantly higher in hyperthyroid patients compared to control group. Pmax and PWD were significantly correlated with the presence of hyperthyroidism. Pmax (97.4±14.6 to 84.3±8.6 msec, p<0,001) Pmin (54.1±8.6 to 48.1±8.5 msec, p=0.002), PWD (42.9±10.7 to 35.9±8.1 msec, p=0.002) and DT (190.7±22.6 to 185.5±18.3, p=0.036) were significantly decreased after achievement of euthyroid state in patients with hyperthyroidism. Diastolic dyfunction was seen in 5 patients at hyperthroid state but only in one patient at euthyroid state. Conclusions: Hyperthyroidism is associated with prolonged P wave duration and dispersion. Achievement of euthyroid state with propylthiouracil treatment results in shortening of P wave variables. Diastolic function may have a partial effect for the increased Pmax and PWD. Shortening of Pmax and PWD may be a marker for the prevention of AF with the anti-thyroid treatment.
Penetrating Cardiac Injury: Report of Three Cases and Review of the Literature
(2007) Ekim, H.; Tuncer, M.
Background: Penetrating wound of the heart should be suspected in any patient with penetrating wound of the chest, upper abdomen or neck and particularly of the anterior aspect of the left chest wall in proximity to the heart. Case Report: In this paper, we present 3 cases of penetrating heart injury associated with pulmonary injury, which were successfully operated on. All patients were young males. Postoperatively, 2 patients requiring cardiopulmonary bypass (CPB) underwent revision operation due to bleeding. Early recognition of cardiac injury is the precondition of success. Hemodynamically unstable patients with penetrating cardiac wound should be taken to the operating room immediately without performing time-consuming procedures. Because of their small size and protected location, selective penetrating injuries to the coronary arteries are uncommon. Conclusions: The present cases of severe left ventricular injury associated with pulmonary injury, which might have had a disastrous outcome if delayed, underline the value of emergent surgery in unstable penetrating thoracic injury. Additionally, coronary revascularization may provide a safe alternative therapy to primary ligation for management of proximal left anterior descending artery (LAD) injuries.
Percutaneous Transluminal Angioplasty in Haemodialysis Patients With Central or Peripheral Venous Stenosis
(Ondokuz Mayis Universitesi, 2016) Yaman, M.; Sahin, M.; Simsek, H.; Gumrukcuoglu, H.A.; Tuncer, M.; Gunes, Y.; Akdag, S.
Dysfunction of arteriovenous fistulae (AVF), which result from peripheral or central venous occlusive illness, occurs very often in haemodialysis patients. In therapy, endovascular open procedures are prefered. Our study illustrated the clinical success of percutaneous transluminal angioplasty (PTA) for the treatment of these patient. A retrospective analysis was applied on patients presenting during a 2-years term with haemodialysis failure and ipsilateral arm swelling coherant with peripheral and/or central venous stenosis. PTA was performed as clinically and angiografically indicated. Technical success of PTA was defined less than 30% residual stenosis and clinical success was illustrated by resolution of pain and edema along with preservation of the AVF. Our study shows a subgroup of 26 patients that presented with symptomatic peripheral or central venous occlusive disease. Mean follow-up was 12.4 months (range, 3-24 months). PTA was successful in 26 patients 11 of whom were with central lesions and 15 of whom were with peripheral lesions. We were stated for central lesions PTA had a priority patency rates of 81.8%, 60%, 37.5% and supported primary patency rates of 90.9%, 70%, 62.5% at 3, 6, 12 months. For peripheral lesions, primary patency rates of 86.7%, 78.5%, 66.6% at 3, 6 and 12 months and assisted primary patency rates of 93.3%, 85.7% and 75%, separately. PTA for central and peripheral venous stenosis is be a successful and safe procedure in hemodialysis patients. In patients with lesions that are responsible for dilation, continuous functional access in the affected extremity is sustained, especially for patients with peripheral venous stenosis. © 2016 OMU.
Recurrence of Primary Cardiac Rhabdomyosarcoma Without Methastasis Two Years After Surgery
(TIP ARASTIRMALARI DERNEGI, 2012) Simsek, H.; Sahin, M.; Gumrukcuoglu, H.A.; Tuncer, M.; Gunes, Y.
Primary malignant cardiac tumors are rare. Rhabdomyosarcoma is the most common of these lesions. These tumors usually arise from the ventricular walls. They sometimes arise from the atrial walls and mimic atrioventricular valve stenosis. A case of recurrence of primary cardiac rhabdomyosarcoma without metastasis to other organs in a 34 year old woman is presented. The tumor arose from the posterior wall of the left atrium and extended to the posterior mitral valve leaflet. Histopathology confirmed recurrence of the cardiac rhabdomyosarcoma. Although cardiac rhabdomyosarcomas are highly lethal, operation indicated. Clarify diagnosis, relieve symptoms and improve survive intracardiac mass must be excision as as extensively as possible in these cases in order to prevent recurrence of tumor.
Regional Functions of the Left Ventricle in Patients With Coronary Slow Flow and the Effects of Nebivolol
(2009) Gunes, Y.; Tuncer, M.; Guntekin, U.; Ceylan, Y.; Sahin, M.; Simsek, H.
Background: Microvascular and endothelial dysfunction have been implicated for coronary slow flow (CSF). Nebivolol, besides its beta-receptor blocking activity, causes an endothelium-dependent vasodilatation through increased nitric oxide release. Methods: This study included 27 patients with CSF and 27 subjects with normal coronary arteries. Segmental functions of the left ventricle (LV) were assessed using myocardial tissue Doppler velocities before and 3 months after treatment with nebivolol 5 mg/day. Results: Compared with the control group, mitral deceleration time (DT) was significantly longer, and E/A ratio, systolic velocity of lateral mitral annulus (Sm) and regional myocardial peak systolic and early diastolic velocities (Vs, Vd) were significantly lower in patients with CSF. The reason for coronary angiography was typical angina in 21 (77.8%) and positive treadmill test in six (22.2%) CSF patients. There were significant correlations between presence of CSF in left anterior descending artery (LAD) with Sm (r =-0.404, p =0.002) and Vs in anterior (r =-0.531, p < 0.001 ) and lateral (r =-0.495, p < 0.001 ) segments and between presence of CSF in RCA and Vs in posterior segments (r =-0.501, p < 0.001). Treatment with nebivolol significantly decreased blood pressures (128.5±12.5/82.5±8.8 to 119.8± 12.6/76.4± 7.4 mmHg, p < 0.001), DT (252.3±53.6 to 222.0±41.0 ms, p < 0.001 ) and IVRT (115.7±19.9 to 103.3±17.0 ms, p <0.001), and increased exercise capacity (8.7±1.3 to 10.4±0.9 METs, p < 0.001), E/A ratio (0.87±0.26 to 1.08±0.23, p <0.001) and myocardial velocities (p < 0.001). All the patients were free of angina after treatment. Patients with CSF had impaired diastolic and regional LV functions. Conclusions: Nebivolol may therefore be useful in improving angina, exercise capacity and LV functions in patients with CSF. © 2009, SAGE Publications. All rights reserved.
Repair of Ventricle Free Wall Rupture After Acute Myocardial Infarction: a Case Report
(2009) Ekim, H.; Tuncer, M.; Basel, H.
Introduction: Acute myocardial infarction (AMI) may culminate in sudden death by ventricular fibrillation, cardiogenic shock, and cardiac rupture. We present a case of postinfarction rupture treated by direct closure and coronary artery bypass grafting after thrombolytic therapy. Case report: A 67-year-old woman with cardiac risk factors of hypertension, diabetes mellitus, and being post-menopausal was admitted complaining of chest pain and sweating. Thrombolytic therapy with streptokinase was started due to acute myocardial infarction. But, reperfusion criteria were not achieved. Echocardiography revealed a moderate pericardial effusion with mild right chamber collapse and pericardial thrombus. Cardiac catheterization revealed totally occluded left anterior descending (LAD) and circumflex coronary arteries. She was taken to the operating-room immediately. The pericardium was opened and a large amount of blood with thrombus was removed. Her hemodynamic indices improved immediately. There was active bleeding from multiple sites with a 4 mm rupture. Cardiopulmonary bypass was established. Direct closure of rupture was carried out. Reversed autogenous saphenous vein bypass grafts were placed to the LAD and second obtuse margin coronary arteries. Postoperative recovery was uneventful and she was discharged from hospital in good condition. She remained asymptomatic during first year following the surgery. Conclusion: This case demonstrates that left ventricular free wall rupture is not always fatal and that early diagnosis and emergency surgical therapy may be successful. The combination of surgical repair with revascularization should be considered, because 80% of patients who experience LVFWR have multivessel coronary artery disease. © 2009 Ekim et al; licensee BioMed Central Ltd.