Browsing by Author "Muderrisoglu, I. Haldun"

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A case of primer angiosarcoma in a young woman: lessons from multi-modality imaging
(2022) Coskun, Mehmet; Hasirci, Senem Has; Ozdemir, Handan; Coskun, Mehmet; Sezgin, Atilla; Muderrisoglu, I. Haldun; Sade, Leyla Elif; 0000-0002-7528-3557; X-8540-2019
MELD-XI Score in Hospitalized Heart Failure Patients with Cardiac Electronic Devices
(2019) Ciftci, Orcun; Celik, Casit Olgun; Yilmaz, Kerem Can; Karacaglar, Emir; Sezenoz, Burak; Ozin, Bulent; Muderrisoglu, I. Haldun
Objective: MELD-XI (Model for End-Stage Liver Disease Excluding INR) score predicts mortality in patients with heart failure. Herein, we assessed the role of MELD- XI score in predicting in-hospital mortality among heart failure patients having intracardiac cardioverter defibrillator (ICD) or cardiac resynchronization therapy with defibrillator backup (CRT-D) who presented with appropriate device shock or acute decompensated heart failure. Methods: We reviewed the medical records of patients with implantable cardioverter defibrillator or cardiac resynchronization therapy with defibrillator backup admitted to coronary care unit with acute decompensated heart failure or appropriate implantable device shocks between 01 January 2013 and 01 November 2018. MELD-XI score was compared between the deceased and surviving patients. The correlation of MELD-XI score with in-hospital mortality was sought. Results: There were 106 coronary care unit admissions of 67 patients (52 (77.6%) males and 15 (22.4%) females), who had a mean age of 64.8 (range 19-93) years. Eighty-eight (83.0%) admissions were for acute decompensated heart failure and 18 (17.0%) for appropriate device shock and/or electrical storm. A total of 16 (15.1%) patients died at hospital. The median MELD-XI score of the patients who died at hospital was significantly greater than that of the survivors (11.80 (0.59-28.98) vs 15.24 (9.11-24.64); p<0.05). A binary logistic regression analysis showed that MELD-XI score was a significant independent predictor of in-hospital mortality (X-2=1.229 (%95 CI 1.06-1.43); p<0.05). Conclusion: MELD-XI score successfully predicts in-hospital mortality among patients with ICD or CRT-D admitted with acute decompensated heart failure or appropriate implantable electronic device shocks.
Posttransplant Pulmonary Hypertension Is Correlated With Acute Rejection and Death Among Cardiac Transplant Recipients: A Single Center Study
(2018) Ciftci, Orcun; Akgun, Neslihan Arzu; Yilmaz, Kerem Can; Karacaglar, Emir; Aydinalp, Alp; Sezgin, Atilla; Muderrisoglu, I. Haldun; Haberal, Mehmet; 0000-0001-8926-9142; 0000-0002-2538-1642; 0000-0002-3761-8782; 0000-0002-3462-7632; 29527998; W-5233-2018; AAJ-1331-2021; ABI-6723-2020; AAD-5841-2021; AAJ-8097-2021
Objectives: Endomyocardial biopsy sampling is used to check acute rejection after cardiac transplant. However, it may lead to tricuspid valve injury and cardiac perforation; therefore, less invasive tools may be useful. Right heart catheterization provides valuable information about cardiac hemodynamics. Herein, we aimed to determine the correlation of right heart catheterization parameters with acute rejection and death during cardiac transplant follow-up. Materials and Methods: We retrospectively evaluated follow-up right heart catheterization and endomyocardial biopsy results from 47 adult patients who underwent cardiac transplant at Baskent University Faculty of Medicine between 2004 and 2016. Right heart catheterization parameters were compared between deceased and surviving patients and were correlated with acute cellular and humoral rejection. Averaged right heart catheterization parameters were correlated with death. We used Cox regression analysis to determine risk of death and acute cellular rejection and Kaplan-Meier survival analysis to determine any survival differences associated with pulmonary hypertension. Results: There were 47 patients (38 males, 9 females) with a mean age of 44 +/- 10 years at transplant. In our patient group, 18 patients (38.3%) died at a median time of 11.2 months. Ninety endomyocardial biopsy samples (22.1%) showed cellular rejection, and 61 samples (4.5%) showed humoral rejection. The deceased patients had significantly greater mean and systolic pulmonary artery pressures, which were significantly correlated with acute cellular rejection. Death was significantly correlated with averaged values of mean and systolic pulmonary artery pressures. Our Cox regression analysis revealed that pulmonary hypertension was significantly associated with risk of death and acute cellular rejection. A Kaplan-Meier survival analysis revealed that pulmonary hypertension was associated with a significantly lower median survival. Conclusions: Pulmonary artery pressures are significantly correlated with acute cellular rejection and death after cardiac transplant. Pulmonary hypertension significantly increases the risk of death and shortens survival after cardiac transplant.
Prevalence and Angiographic Characteristics of Coronary Vasospasm Detected at Surveillance Coronary Angiograms Among Patients With Heart Transplants
(2018) Akgun, Arzu Neslihan; Ciftci, Orcun; Yilmaz, Kerem Can; Karacaglar, Emir; Aydinalp, Alp; Sezgin, Atilla; Muderrisoglu, I. Haldun; Haberal, Mehmet; 0000-0002-1752-4877; 0000-0001-8926-9142; 0000-0002-2538-1642; 0000-0002-3761-8782; 0000-0002-3462-7632; 29527999; HJP-8792-2023; W-5233-2018; AAJ-1331-2021; ABI-6723-2020; AAD-5841-2021; AAJ-8097-2021
Objectives: Coronary vasospasm in heart transplant recipients occurs through various mechanisms. It has been linked to allograft rejection and coronary vasculopathy, which can result in mortality during follow-up. Here, we investigated the prevalence of coronary vasospasm among heart transplant recipients undergoing surveillance coronary angiography procedures. Materials and Methods: This study was prospectively performed at Baskent University Faculty of Medicine by retrospectively analyzing medical information of patients who underwent bicaval heart transplant between 2003 and 2016 and subsequently had coronary angiography to rule out allograft vasculopathy. We analyzed prevalence of coronary vasospasm, affected vessels, underlying vessel properties, and treatment modalities. Coronary vasospasm was defined as transient diffuse or localized lumina! narrowing, either spontaneously or catheter-induced, relieved spontaneously or with nitroglycerine. Results: Forty-one coronary angiography procedures were performed using the standard Judkins technique. Among these, 5 patients showed coronary vasospasm a mean of 2 years after cardiac transplant. All vasospasm episodes involved the left anterior descending artery, with 2 also involving the circumflex artery and 1 involving the right coronary artery. The degree of luminal narrowing ranged from mild to severe. Episodes that involved the left anterior descending artery more often diffusely involved most of the vessel. In 3 patients, vasospasms were recurrent. Three patients had underlying coronary artery disease, which was relieved in 2 patients who progressed by stent implant. Neither ischemic events nor reduction of ejection fraction was observed during follow-up. There were also no occurrences of cellular or humoral rejection or death in any of the patients with vasospasm. Conclusions: Coronary vasospasm is common in heart transplant recipients. It may be diffuse or localized and occur spontaneously or because of underlying coronary artery disease. Factors, including allograft vasculopathy, associated with coronary vasospasm remain to be determined, and further related research is needed.