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  • Küçük Resim
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    Concomitant right atrial hemangioma resection with lvad implantation first-in-human experience
    (2024) Dursun, Atakan; Hakgör, Aykun; Kenger, Melike Zeynep; Karaca, Oğuz
    Cardiac hemangiomas are exceedingly rare, comprising only 5% to 10% of benign cardiac tumors. We report a patient with a large right atrial mass and end-stage heart failure with severe left ventricular dysfunction. Echocardiography revealed a mass obstructing tricuspid inflow. Contrast-enhanced computed tomography and cardiac magnetic resonance confirmed a 100 mm × 96.5 mm × 104 mm lobulated mass. Simultaneous tumor resection and left ventricular assist device implantation were performed. Histopathologic examination confirmed a cardiac hemangioma. The patient showed significant improvement and remained alive at 3-year follow-up, with only minor gastrointestinal bleeding episodes.
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    Prognostic implications of baseline and new-onset fragmented qrs complex in patients undergoing transcatheter aortic valve implantation
    (2024) Hakgör, Aykun; Dursun, Atakan; Akhundova, Aysel; Kenger, Melike Zeynep; Savur, Ümeyir; Derviş, Emir; Çeleğen, Muhammed Furkan; Boztosun, Bilal
    Fragmented QRS complex (fQRS), which can be easily detected by electrocardiography (ECG), is an indicator of myocardial fibrosis and has adverse prognostic impact in cardiovascular diseases. The aim of this study was to investigate the effect of the presence of both pre-and post-operative fQRS on short-and long-term prognosis in patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS). Data of 615 patients who underwent TAVI from different risk categories in a single-center were retrospectively screened and 289 patients were included after exclusion criteria. The presence of fQRS was recorded on pre-and postoperative ECGs and the effect of the fQRS on in-hospital and 2-year all-cause mortality was investigated. fQRS was detected in 85 (29.4%) patients before TAVI and also 24 (11.8%) patients had new-onset fQRS after TAVI. The presence of preop fQRS was found to be an independent predictor of in-hospital mortality. Postop fQRS, moderate or severe paravalvular aortic regurgitation and high systolic pulmonary artery pressure were associated with long-term mortality. In addition, patients with preop fQRS were more likely to need permanent pacemaker implantation after TAVI (14.1% vs. 2.9%). fQRS, which can be considered an indicator of subclinical left ventricular dysfunction due to myocardial fibrosis, is associated with decreased short-and long-term survival in patients undergoing TAVI. The presence of preop fQRS and postop new-onset fQRS is associated with a 3.8-and 3.2-fold increased cumulative mortality risk, respectively, at 24-month follow-up compared to patients without fQRS.
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    Sodium glucose cotransporter 2 inhibitors improve long-term atrial fibrillation-free survival after catheter ablation
    (2025) Hakgör, Aykun; Dursun, Atakan; Çatalbaş Kahraman, Başak; Akhundova, Aysel; Beşiroğlu, Mehmet; Kenger, Melike Zeynep; Derviş, Emir; Kılıçaslan, Fethi
    Abstract:Although sodium-glucose cotransporter 2 inhibitors (SGLT2i) are known to reduce the incidence of atrial fibrillation (AF) and AF-related adverse events, evidence on their prognostic effect in patients undergoing catheter ablation (CA) for AF is limited. In a single center, 614 patients (mean age 58.1 ± 9.9 years, 42.2% female) who underwent CA for AF were retrospectively divided into 2 groups according to SGLT2i treatment after the index procedure and followed up for 24 months. The primary outcome of the study was AF recurrence after the first 90-day blanking period after CA. Two separate Cox regression models were constructed to determine the predictors of AF recurrence. Rates of the primary outcome were 19.4% and 35.7% in the SGLT2i and non-SGLT2i groups, respectively. According to the multivariable model 1, which was established among the clinically relevant variables that were found to be statistically significant in univariable analysis, left atrial diameter (adjusted HR: 1.087, 95% CI, 1.054-1.122, P < 0.001), SGLT2i therapy (adjusted HR: 0.436, 95% CI, 0.286-0.665, P < 0.001), and nonparoxysmal AF (adjusted HR: 1.549, 95% CI, 1.039-2.309, P = 0.032) were independent predictors of recurrence after ablation. In model 2, SGLT2i treatment remained an independent predictor of AF recurrence along with significant variables such as age, heart failure with reduced ejection fraction, and previous stroke (adjusted HR: 0.315, 95% CI, 0.214-0.461, P < 0.001). The favorable efficacy of SGLT2i on the primary outcome was maintained in subgroup analyses. SGLT2i treatment is associated with lower recurrence after CA for AF in subgroups with and without diabetes or heart failure with reduced ejection fraction and in the overall patient population, independent of AF phenotype.