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Item Association between serum vitamin D levels and subclinical coronary atherosclerosis and plaque burden/composition in young adult population(ASSOC BASIC MEDICAL SCI FEDERATION BOSNIA \& HERZEGOVINA SARAJEVO, 2015-01-01) Satilmis, Seckin; Celik, Omer; Biyik, Ismail; Ozturk, Derya; Celik, Kubra Asik; Akin, Fatih; Ayca, Burak; Yalcin, Burce; Dagdelen, SinanEvidence suggests that low 25-OH vitamin D (25)(OH)D concentrations may increase the risk of several cardiovascular diseases such as hypertension, peripheral vascular disease, diabetes mellitus, obesity, myocardial infarction, heart failure and cardiovascular mortality. Recent studies suggested a possible relationship between vitamin I) deficiency and increased carotid intima-media wall thickness and vascular calcification. We hypothesized that low 25(OH)D may be associated with coronary atherosclerosis and coronary plaque burden and composition, and investigated the relationship between serum vitamin I) levels and coronary atherosclerosis, plaque burden or structure, in young adult patients by using dual-source 128x2 slice coronary computed tomography angiography (CCTA). We included 98 patients with coronary atherosclerosis and 110, age and gender matched, subjects with normal findings on CCTA examinations. Patients with subclinical atherosclerosis had significantly higher serum total cholesterol, triglycerides, hs-CRP, uric acid, HbA1c and creatinine levels and lower serum 25(OH)l) levels in comparison with controls. There was no significant correlation between 25(OH)D and plaque morphology. There was also a positive relationship between 25(OH)D and plaque burden of coronary atherosclerosis. In multivariate analysis, coronary atherosclerosis was associated high hs-CRP (adjusted OR: 2.832), uric acid (adjusted OR: 3.671) and low 25(OH)D (adjusted OR: 0.689). Low levels of 25(OH)D were associated with coronary atherosclerosis and plaque burden, but there was no significant correlation between 25(OH)D and plaque morphology.Item Transcatheter aortic valve implantation in a patient with bicuspid aortic stenosis and a borderline-sized annulus(OXFORD UNIV PRESS, 2015-01-01) Colkesen, Yucel; Baykan, Oytun; Dagdelen, Sinan; Cayli, MuratBicuspid aortic valve (BAV) is currently considered an exclusion criterion for transcatheter aortic valve implantation (TAVI). The risk of adverse aortic events such as incomplete sealing, severe paravalvular regurgitation or dislocation due to elliptic shape and asymmetric calcifications in annulus are higher in TAVI. In this case report, we detailed a case of successful trans-femoral TAVI in a 51-year old male with BAV and its management without in-hospital and 30-day complications. The challenge in this case was the patient's anatomy with a 27-mm annulus for balloon expandable device. The applied strategy was balloon sizing and overdilating the 29-mm stented valve with additional volume that obviated re-ballooning. Trans-femoral TAVI was performed uneventfully under fluoroscopic and transoesophageal echocardiography guidance. A multidetector computed tomography (MDCT) evaluation at 1 month did not show device dislodgement or any other complications. Evidence for evaluation post-TAVI is not sufficient in BAV. We believe patients with BAV should undergo a comprehensive assessment after TAVI including MDCT evaluation.Item A hybrid therapy as a third approach for type 1 proximal endoleak of thoracic endovascular aortic replacement: Caroticocarotid bypass and re-redo endovascular therapy(ELSEVIER SCIENCE BV, 2013-01-01) Ariturk, Cem; Okten, Murat; Dagdelen, Sinan; Toraman, Fevzi; Karabulut, HasanIntroduction: In selected cases with thoracic aortic aneurysm (TAA), thoracic endovascular aortic replacement (TEVAR) is commonly used and shall be proper therapy method. We are presenting a case of TAA previously treated twice by endovascular aortic approaches and complicated by type 1 endoleak. Case: A 67-year-old male patient was admitted to our clinic with back pain at rest. He underwent TEVAR five years ago, twice in 6 month. With contrasted computed tomography of chest and abdomen, a new type 1 proximal endoleak was diagnosed, and after routine preoperative follow up, the patient was operated on. At the same session right to left caroticocarotid bypass and re-redo TEVAR were performed. The new endovascular graft was placed as the proximal landing zone to be set between left carotid artery and brachiocephalic truncus. The patient was discharged on postoperative day 4 without any problems. Conclusion: As new techniques and methods have been developed, mortality rates have decreased to 2-3\% but in older and high risk patients, mortality rates still remain high {[}1]. TEVAR is a safe and effective treatment method in the proper and selected patients with thoracic artery aneurysm {[}2]. Moreover, TEVAR can also be performed as a part of hybrid procedures for arcus aortic aneurysms {[}3]. But it should be kept in mind that late secondary intervention rates are higher in TEVAR. (C) 2013 Production and hosting by Elsevier B.V. on behalf of King Saud University.Item The Long Term Incidence and Predictors of Radial Artery Occlusion Following a Transradial Coronary Procedure(2013-01-01) Buturak, Ali; Gorgulu, Sevket; Norgaz, Tugrul; Voyvoda, Nuray; Sahingoz, Yusuf; Degirmencioglu, Alex; Demirci, Yasemin; Dagdelen, SinanItem Simultaneous endovascular stent and renal stent placement for acute type B aortic dissection with malperfusion of kidney(ELSEVIER SCIENCE BV, 2012-01-01) Dagdelen, Sinan; Aydin, Ebuzer; Karabulut, HasanAcute aortic dissection frequently causes life-threatening organ ischemia. The optimal therapy for acute type-B aortic dissection is still controversial. Surgery for acute dissection with organ malperfusion is known to carry a high morbidity and mortality