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  • Küçük Resim
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    Pocket haematoma after cardiac electronic device implantation in patients receiving antiplatelet and anticoagulant treatment: A single-centre experience
    (Taylor and Francis, 2017) Demir, Gültekin Günhan; Babur Güler, Gamze; Güler, Ekrem; Güneş, Hacı Murat; Kızılırmak, Filiz; Karaca, İbrahim Oğuz; Omaygenç, Mehmet Onur; Çakal, Beytullah; Olgun, Erkam; Savur, Umeyr; İbişoğlu, Ersin; Barutçu, İrfan; Kılıçaslan, Fethi
    Objective In modern cardiology practice, implantation of cardiac electronic devices in patients taking anticoagulant or antiplatelet therapy is a common clinical scenario. Bleeding complications are of particular concern in this patient population and pocket haematoma is one of the most frequent complications. We sought to determine the relationship between periprocedural antiplatelet/anticoagulant therapy and pocket haematoma formation in patients undergoing cardiac implantable electronic device (CIED) implantation. Methods We conducted a retrospective study including 232 consecutive patients undergoing CIED implantation in the department of cardiology of the Medipol University Hospital. Patients were divided into six groups: clopidogrel group (n = 12), acetylsalicylic acid (ASA) group (n = 73), ASA + clopidogrel group (n = 29), warfarin group (n = 34), warfarin + ASA group (n = 21) and no antiplatelet-anticoagulant therapy group as the control group (n = 63). CIED implantations were stratified under four subtitles including implantable cardioverter/defibrillator (ICD), cardiac resynchronization therapy (CRT), permanent pacemaker and the last group as either device upgrade or generator replacement. Results The mean age of the patients was 63 ± 14 years and 140 patients were male (60.3%). A pocket haematoma was documented in 6 of 232 patients (2.6%). None of the patients with pocket haematoma needed pocket exploration or blood transfusion. The type of the device did not have a significant effect on pocket haematoma incidence (P = 0.250). Univariate logistic regression showed that platelet level and ASA plus clopidogrel use were significantly associated with haematoma frequency after CIED implantations, respectively (OR: 0.977, CI 95% [0.958-0.996]; OR: 16.080, CI 95% [2.801-92.306]). Multivariate analysis revealed that dual antiplatelet treatment (ß = 3.016, P = 0.002, OR: 2.410, 95% CI [3.042-136.943]) and baseline platelet level (ß = –0.027, p:0.025, OR: 0.974, 95% CI [0.951-0.997]) were independent risk factors for pocket haematoma formation. Conclusion Dual antiplatelet therapy and low platelet levels significantly increased the risk of pocket haematoma formation in patients undergoing CIED implantations.
  • Küçük Resim Yok
    Öğe
    The effect of CRT on mitral valve geometry: Incidence and predictors of reversed mitral remodeling
    (Wiley, 2017) Karaca, Oğuz; Çakal, Beytullah; Omaygenç, Mehmet Onur; Güneş, Hacı Murat; Çakal, Sinem Deniz; Kızılırmak, Filiz; İbişoğlu, Ersin; Savur, Umeyr; Çelebi, Fener; Naki, Deniz Dilan; Kılıçaslan, Fethi
    [Abstract Not Available]