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The Anatolian Journal of Cardiology - Anatol J Cardiol: 13 (6)
Volume: 13  Issue: 6 - September 2013
1.International Scientific Summer Schools 2013

doi: 10.5152/akd.2013.178  Page 
Abstract

EDITORIAL
2.Discussion on Turkish scientific language and facts-rightness
Bilgin Timuralp
PMID: 24091147  doi: 10.5152/akd.2013.226  Page 515
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
3.Factors influencing the use of ambulance among patients with acute coronary syndrome: results of two centers in Turkey
Burcu Demirkan, Meltem Refiker Ege, Pınar Doğan, Esra Gücük İpek, Ümit Güray, Yeşim Güray
PMID: 23835296  doi: 10.5152/akd.2013.171  Pages 516 - 522
Objective: In this study, we aimed to identify the factors influencing the use of ambulance among patients admitted to two Turkish hospitals with acute coronary syndrome (ACS).
Methods: Overall, 330 with a mean age of 55±13 years, hospitalized patients with ACS at 2 different hospitals were included in this prospective cohort study. The factors influencing the use of ambulance hospital were investigated through a questionnaire. The comparisons were made between two groups regarding use of ambulance. The predictors of the use of ambulance were determined using multiple logistic regression analysis.
Results: Despite the high rate of knowing the emergency service number of “112”, of the 330 patents, only 96 (29%) used ambulance. Ambulance users had shorter arrival duration with median of 60 min vs 120 min (p=0.03). Presenting with ST elevation myocardial infarction (OR=3.127, 95% CI: 1.555-6.2877, p<0.001), severity of chest pain (OR=2.665, 95% CI: 1.938-3.665, p<0.001), presence of accompanying symptoms such as dyspnea (OR= 5.510, 95% CI: 2.614-11.614, p<0.001), dizziness (OR=4.172, 95% CI: 1.901-9.154, p<0.001) and vomiting (OR=3.756, 95% CI: 1.521-9.272, p=0.004), knowledge of cardiac risk factors (OR=10.512, 95% CI: 4.497-24.572, p<0.001) or chest pain related to heart attack and the importance of quickly seeking for medical care by calling ambulance (OR= 4.184, 95% CI: 2.528-6.926, p<0.001) are the factors associated with ambulance use.
Conclusion: Using ambulance was in a very low rate among our study patients with ACS. Severity of symptoms, type of ACS and knowledge are seemed to be related with increased ambulance use. Informative health educational programs can be organized to achieve a behavioral change in using of ambulance. (Anadolu Kardiyol Derg 2013; 13: 516-22)

4.A multicenter study on experience of 13 tertiary hospitals in Turkey in patients with infective endocarditis
Mehmet Ali Elbey, Serkan Akdağ, Mehmet Emin Kalkan, Mehmet G. Kaya, M. Raşit Sayin, Hekim Karapınar, Serkan Bulur, Taner Ulus, M. Ata Akıl, Hatice Köprü Elbey, Abdurrahman Akyüz
PMID: 23835297  doi: 10.5152/akd.2013.172  Pages 523 - 527
Objective: The aim of this retrospective multicenter study was to investigate the clinical manifestations, microbiological profile, echocardiographic findings and management strategies of infective endocarditis (IE) in Turkey. Methods: The study population consisted of 248 Turkish patients with IE treated at 13 major hospitals in Turkey from 2005 to 2012 retrospectively. All hospitals are tertiary referral centers, which receive patients from surrounding hospitals. Data were collected from the medical files of all patients hospitalized with IE diagnosed according to modified Duke Criteria. Results: One hundred thirty seven of the patients were males. Native valves were involved in 158 patients while in 75 participants there was prosthetic valve endocarditis. Vegetations were detected in 223 patients (89%) and 52 patients had multiple vegetations. Mitral valve was the most common site of vegetation (43%). The most common valvular pathology was mitral regurgitation. The most common predisposing factor was rheumatic valvular disease (28%). Positive culture rate was 65%. Staphylococci were the most frequent causative microorganisms isolated (29%) followed by enterococci (11%). In-hospital mortality rate was 33%. Conclusions: Compared to IE in developed countries younger age, higher prevalence of rheumatic heart disease, more frequent enterococci infection and higher rates of culture negativity were other important aspects of IE epidemiology in Turkey.

5.Management of right heart thrombi associated with acute pulmonary embolism: a retrospective, single-center experience
Hakan Akıllı, Enes Elvin Gül, Alpay Arıbaş, Kurtuluş Özdemir, Mehmet Kayrak, Halil İbrahim Erdoğan
PMID: 23835298  doi: 10.5152/akd.2013.173  Pages 528 - 533
Objective: The mortality of right heart thrombi (RHT) associated with pulmonary embolism (PE) is increased about three to four times. The most devastating scenario is fragmentation of RHT and occurrence of recurrent PE. The reports regarding the management of RHT complicated with PE are very scarce in the current literature. Therefore, we report a single-center experience in this paper. Methods: From January 2006 to December 2011, data of all patients diagnosed with acute PE were analyzed retrospectively. Of the 312 acute PE cases confirmed with computed tomography, total 35 patients who were diagnosed with concomitant RHT (prevalence of 11%) by echocardiography were recruited. After excluding of six patients with metastatic malignancy a total 29 patients were accepted eligible for the analysis. In addition, catheter -induced thrombus (type B) were not included to the study. The difference between categorical variables was analyzed with Chi-square test and continuous variables were analyzed with Mann-Whitney U test. A p value of <0.05 was considered statistically significant. Results: Overall mortality was high (34%) in study population: among undergoing surgery-100%, therapy with thrombolytics -18%, and heparin -27%. Troponin levels were found significantly higher in died patients than that in survived patients (p=0.03). There was no significant difference regarding to clinical and echocardiographic characteristics of patients received heparin versus thrombolytic except for shock index (p=0.02). In addition, patients treated with heparin had increased duration of hospitalization compared to subjects treated with thrombolytic (median: 8 vs 3 days p<0.01). Conclusion: Despite of the low incidence of RHT, a mortal course is still an important problem during PE. The decision on treatment modality should be performed based on the hemodynamic parameters, laboratory findings, and bleeding risk of the patients.

EDITORIAL COMMENT
6.Management of right heart thrombi associated with acute pulmonary embolism: is there no room for surgical embolectomy?
Ikuo Fukuda, Satoshi Taniguchi, Wakako Fukuda
PMID: 24064079  doi: 10.5152/akd.2013.197  Pages 534 - 535
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
7.Doppler-derived strain and strain rate imaging assessment of right ventricular systolic function in adults late after tetralogy of Fallot repair: an observational study
Anita Sadeghpour, Majid Kyavar, Shabnam Madadi, Leili Ebrahimi, Zahra Khajali, Zahra Alizadeh Sani
PMID: 23835299  doi: 10.5152/akd.2013.174  Pages 536 - 542
Objective: Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. Today, we are faced with an increasing number of patients with residual pulmonary regurgitation (PR) late after TOF repair. The right ventricular (RV) volumes and function are among the most important factors influencing clinical decision-making. Cardiac magnetic resonance (CMR) is the gold standard method for the quantitative assessment of the RV function; it is, however, expensive for routine clinical follow-up and sometimes is contraindicated. We sought to evaluate the RV systolic function via CMR and compare it with Doppler-derived strain(S) and strain rate (SR) imaging in patients with repaired TOF. Methods: In an observational cross-sectional study, 70 patients (22 women, mean age=22±4.9 years) late after TOF repair with severe PR were evaluated. Peak systolic strain and SR in the basal, mid, and apical segments of RV free wall (RVFW) were measured and compared with the RV function measured in the short-axis cine MR. Associations between RVEF and S/SR, investigated by ordinal logistic regression models. Results: Significant association was observed between RV function and mean S of all the three segments of the RVFW segments [OR (CI95%): 1.17 (1.05-1.31)]. Association between RV function and mean SR of all the three segments of the RVFW segments was borderline significant [OR (CI95%): 1.7 (0.97-2.93)]. Conclusion: There was a significant correlation between the Doppler-derived mean strain of RVFW and the RV function measured by CMR in adults late after TOF repair. These quantitative methods improved the assessment of the RV function and served as an additional method to follow up patients with contraindications to CMR.

8.Aggregation of lipoprotein(a) to apolipoprotein A-I underlying HDL dysfunction as a major coronary risk factor
Altan Onat, Günay Can, Sani Murat, Gökhan Çiçek, Ender Örnek, Hüsniye Yüksel
PMID: 23835300  doi: 10.5152/akd.2013.175  Pages 543 - 551
Objective: Dysfunction of high-density lipoprotein (HDL) may contribute to coronary heart disease (CHD) risk. We determined whether aggregation to lipoprotein (Lp)(a) of apolipoprotein (apo) A-I underlies HDL dysfunction conferring incident CHD risk. Methods: A representative sample of 1509 middle-aged Turkish adults was studied at 4.9-years’ follow-up yielding 198 incident CHD cases. Statistical analysis was performed using multiple linear regression and Cox proportional regression analyses. Results: In women, not age or apoA-I, rather complement C3, apoE levels and statin use were linearly related to log-Lp(a). Individuals in the low Lp(a) tertile (<6.4 mg/dL) displayed high mean triglyceride and apoE values, and geometric mean Lp(a) values increased moderately in subjects having low and mid tertiles of apoE or triglycerides, only to be lower in the high tertiles (p≤0.002). These two findings indicated the unexpected fall in Lp(a) under circumstances of high apo E (>4.5 mg/dL) and/or triglycerides (>2.0 mmol/L). Levels actually represent aggregation of Lp(a) to apoA-I in an immune complex, rendering apoA-I atherogenic. Lp(a) did not, but apoA-I did significantly predict incident CHD (HR 1.21 [95%CI 1.07; 1.37]) in Cox regression analyses after adjustment for conventional risk factors and statin use. This adverse action of apoA-I was independent of prevalent metabolic syndrome (MetS), existed in individuals in whom ATPIII-defined MetS was not identified, and was similar in magnitude to that of conventional risk factors. Conclusion: Beyond being atherogenic, Lp(a) may aggregate in a pro-inflammatory milieu to apoA-I, rendering apoA-I atherogenic. This process is independent of ATPIII-defined MetS and exhibits risk magnitude similar to that of conventional risk factors.

9.Traditional coronary risk factors in healthy Turkish military personnel between 20 and 50 years old: focus on high-density lipoprotein cholesterol
Cem Barçın, Hasan Kutsi Kabul, Serkan Tapan, Uğur Küçük, Meltem Çöl
PMID: 23835301  doi: 10.5152/akd.2013.176  Pages 552 - 558
Objective: Previous studies presented the Turkish population as a typical example of nations with low levels of high-density lipoprotein cholesterol (HDL-c). Nevertheless, some recent studies opposed this suggestion. We aimed to examine the traditional cardiovascular risk factors in young-middle age male military professionals, focusing especially on HDL-c. Methods: In this observational and cross-sectional study, the data of 820 male military personnel between 20-50 years old (mean age: 35.3±6.9) who applied to the hospital for routine health examination were included. Blood biochemistry, arterial blood pressure and anthropometric measurements were noted. Statistical analysis was performed using Kruskal-Wallis test and ANCOVA. Results: The mean age was 35.3±6.9, body mass index was 25.8±3.4 kg/m2 and waist circumference was 93.1±8.7 cm. HDL-c, low-density cholesterol, triglyceride and fasting blood glucose levels were 47.6±11.3, 120.4±33.2, 150.4±86.4 and 96,6±13.0 mg/dL, respectively. Only 23.2% of the participants had HDL-c level less than 40 mg/dL. The ratio of current smokers was 40.7%. Almost 66% of the participants (n=545) were making regular exercise. Mean systolic and diastolic arterial blood pressures were 124.1±13.0 and 75.7±9.3 mm Hg, respectively. Conclusion: The “mean” levels of traditional coronary risk factors were in almost “normal” limits in healthy young-middle age male military professionals that were examined. It must be emphasized that the HDL-c level, which was defined as “genetically low in Turks” in some previous epidemiologic studies, was not really low. This finding may be due to relatively favorable life style of the study population. On the other hand, some recent population studies in Turkey had found HDL-c levels higher than it was thought. This issue needs further clarification in specific age groups without sedentary lifestyle.

10.The effect of Gilbert’s syndrome on the dispersions of QT and P-wave dispersion: an observational study
Erkan Cüre, Süleyman Yüce, Yüksel Çiçek, Medine Cumhur Cüre
PMID: 23886900  doi: 10.5152/akd.2013.180  Pages 559 - 565
Objective: Gilbert’s syndrome (GS) decreases the incidence of atherosclerotic heart disease. The aim of the study was to evaluate whether the arrhythmia risk markers such as P-wave dispersion (Pd), QT dispersion (QTd) are reduced in patients with GS compared with healthy subjects. Methods: Sixty-one patients diagnosed with GS (31 females, 30 males) who had applied to the internal medicine outpatient clinic in the hospital were included in this cross-sectional, observational study. A control group of 61 healthy persons (31 females, 30 males), who were non-smokers and drinkers, were included. Both groups were between 16-45 years old. Results of anthropometric measurements, laboratory assays and electrocardiographic findings were recorded for each participant. Independent sample t-test and nested ANOVA were used for data analysis. Results: In the GS group were Pd value 36±16.7 msec, QTd 48.7±10.7 msec and heart rate (HR) 74±8 beat/min. In the control group were Pd 51±28 msec, QTd 53±12 msec and HR 78±10 beat/min. The Pd of patients group (p<0.001), QTd (p=0.038) and HR (p=0.021) were significantly lower than the control group. Conclusion: According to our study’s results, in these patients, increased bilirubin levels are associated with decrease in HR, Pd and QTd, which consequently might decrease the incidence of cardiac arrhythmias and coronary artery disease. Further studies are needed to clarify the protective role of bilirubin in risk of arrhythmias in this category of patients.

11.Human left atrial appendage anatomy and overview to its clinical significance
Hülya Üçerler, Aslı Aktan İkiz, Tomris Özgür
PMID: 23886901  doi: 10.5152/akd.2013.181  Pages 566 - 572
Objective: The left atrial appendage (LAA) is an important anatomic region since it is a source of thromboembolism in patients with atrial fibrillation. Although this anatomic and clinical relation it has received little attention until recent years. Methods: This descriptive laboratory study was performed in 56 hearts of adult formalin fixed cadavers. The morphological characteristics of LAA were recorded. The distances between the orifices of left superior pulmonary veins (LSPV), circumflex artery, left anterior descending (LAD) artery, mitral valve and LAA were also measured in this study. Results: The morphological appearance of the LAA was classified into two different ways. There were two types according to the first classification: slender like a crooked finger (in 73.2%) and stump-like (in 26.8%). The lobe number of LAA was two in 64.3% specimens and three in 35.7%. The types of LAA were Cactus (24%), Chicken Wing (12%), Windsock (38%) and Cauliflower (26%) according to the second classification. The LAA orifice was oval-shaped in 37.5% and round-shaped in 62.5%. The bridge on the orifice was determined in one specimen. The longest diameter of LAA orifice was 16.5±4 mm. The presence of accessory left atrial appendage was observed in one specimen. The distance between LAA orifice and oval fossa was 27.5±5.5 mm. Conclusion: We highlighted the anatomic features of LAA and LAA orifice. LAA diameters, shape and the relation between neighboring structures in relation to atrial fibrillation and surgical approaches were discussed.

12.Validity of the Turkish version of the European Heart Failure Self-Care Behavior Scale
Canan Baydemir, Kazım Özdamar, Ahmet Ünalır
PMID: 23665988  doi: 10.5152/akd.2013.141  Pages 573 - 579
Objective: The specific purpose of this study was to investigate the validity of the Turkish version of the European Heart Failure Self-care Behavior Scale by applying to 494 Turkish Heart Failure Patients. Methods: The study was conducted as a cross-sectional sample survey, between October 2012 and January 2013. The 494 patients who applied with a diagnosis of heart failure were included in the study after determining the clinical diagnosis and type of treatment. Cronbach’s alpha coefficient was used to evaluate the validity and reliability of the scale. Exploratory and confirmatory factor analyses were applied for the determination of the sub-factors of the scale in Turkish adaptation; content, item and factor adaption. Structural Equation Modeling was used for the purpose of creation and supervision of the structural models of the scale. Results: Cronbach's alpha coefficient of internal consistency of Turkish version of the Scale was found to be 0.69. According to the results of the factor analysis, it was determined that the data is in a form suitable for factor analysis and the data have the assumption of multivariate normal distribution. The goodness of fit measures used for the validity of Structural Equation Modeling were obtained to be RMSEA=0.047 (CI=0.00-0.079), AGFI=0.83, GFI=0.91 respectively. Conclusion: The scale is divided into 4 sub-factors according to the Structural Equation Modeling. The European Heart Failure Self-care Behavior Scale is a scale that easily applied to measure the behavior of self-care in heart failure patients. In addition, the scale reaches the conclusion as soon as possible and does not require additional training for researchers. Further, patients can apply themselves the scale easily.

REVIEW
13.Updates on extracorporeal life support in the world and challenges in Turkey
Sertaç Haydin, Akif Ündar
PMID: 23886902  doi: 10.5152/akd.2013.182  Pages 580 - 588
Extracorporeal life support (ECLS) is instituted for the management of life threatening pulmonary or cardiac failure (or both), when no other form of treatment has been or is likely to be successful. It has being used in developed countries for many years. ECLS has come into practice for a while in Turkey, in order to ECLS recommendations. However, most of them are postcardiotomy cases. However, this therapeutic option has more indications including its reason that brought it into practice. All equipment of the system has being changed with the developing technology. The aim of this paper is to point out this modality, to introduce equipment, and to give information about organization and management to bring this therapeutic option in Turkey in order.

SCIENTIFIC LETTER
14.The effects and mechanisms of action of diethylcarbamazine citrate in isolated rat hearts
Ziya Kaygısız, Bilgin Kaygısız, Mete Özkurt, Erkan Kılınç
PMID: 23886903  doi: 10.5152/akd.2013.183  Pages 589 - 591
Abstract | Full Text PDF

15.Concerning recent decline in cardiovascular medical publications in Turkey
Altan Onat
PMID: 23886904  doi: 10.5152/akd.2013.184  Pages 592 - 593
Abstract | Full Text PDF

CASE REPORT
16.Pacemaker interrogation showing virtually no ventricular pacing in a ventricular pacing dependent patient: what is the explanation?
Gholamreza Davoodi, Negar Faramarzi, Akbar Shafiee, Ali Kazemisaeed
PMID: 24064080  doi: 10.5152/akd.2013.198  Pages 594 - 595
Abstract | Full Text PDF

17.Catheter ablation of electrical storm triggered by monomorphic ventricular ectopic beats after myocardial infarction
Emin Evren Özcan, Gabor Szeplaki, Istvan Osztheimer, Tamas Tahin, Laszlo Geller
PMID: 24064081  doi: 10.5152/akd.2013.199  Pages 595 - 597
Abstract | Full Text PDF

18.Successful ablation of cavo-tricuspid isthmus dependent atrial flutter in a patient with Senning operation
Kıvanç Yalın, Ebru Gölcük, Aygün Dindar, Ahmet Kaya Bilge
PMID: 24064082  doi: 10.5152/akd.2013.200  Pages 597 - 599
Abstract | Full Text PDF

19.Recurrent myocardial infarction in a young patient with PAI-1 4G/4G mutation
Nermin Bayar, Cem Yunus Baş, Zehra Erkal, Şakir Arslan
PMID: 24064083  doi: 10.5152/akd.2013.201  Pages 599 - 600
Abstract | Full Text PDF

20.An acute coronary syndrome patient: is this atherosclerosis?
Cihan Altın, Elif Sade, Banu Bilezikçi, Haldun Müderrisoğlu
PMID: 24064084  doi: 10.5152/akd.2013.202  Pages 600 - 602
Abstract | Full Text PDF

21.Late stent malapposition combined by thrombus resolution after primary stenting in acute myocardial infarction: Optical coherence tomography findings
Ae-Young Her, Jung-sun Kim, Yong Hoon Kim, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
PMID: 24064108  doi: 10.5152/akd.2013.149  Pages 603 - 604
Abstract | Full Text PDF

DIAGNOSTIC PUZZLE
22.Interatrial septal mass
Ahmet Güler, Süleyman Karakoyun, Alparslan Şahin, Mustafa Yıldız
PMID: 24064105  doi: 10.5152/akd.2013.223  Page 605
Abstract | Full Text PDF

LETTER TO THE EDITOR
23.Cardiovascular risk factors in Turkey
Murat Atalay, Murat Yalçın, Ömer Uz, Ejder Kardeşoğlu
PMID: 24064085  doi: 10.5152/akd.2013.203  Pages 606 - 607
Abstract | Full Text PDF

24.Appropriate methodology is essential for accurate conclusions
Tuğrul Norgaz, Şevket Görgülü
PMID: 24064086  doi: 10.5152/akd.2013.204  Pages 607 - 608
Abstract | Full Text PDF

25.Increased mean platelet volume in patients with familial Mediterranean fever may not be a marker of atherosclerosis risk
Cengiz Beyan
PMID: 24064087  doi: 10.5152/akd.2013.205  Pages 608 - 609
Abstract | Full Text PDF

26.Mean platelet volume in patients with idiopathic and ischemic cardiomyopathy
Ercan Varol, Mehmet Özaydın
PMID: 24064088  doi: 10.5152/akd.2013.206  Pages 609 - 610
Abstract | Full Text PDF

27.Epicardial adipose tissue measurement: inexpensive, easy accessible and rapid practical method
Şevket Balta, Sait Demirkol, Ömer Kurt, Hakan Şarlak, Muharrem Akhan
PMID: 24064089  doi: 10.5152/akd.2013.207  Pages 611 - 612
Abstract | Full Text PDF

28.LDL cholesterol measurement in terms of CHOLINDEX
Rıfat Eralp Ulusoy
PMID: 24064090  doi: 10.5152/akd.2013.208  Pages 612 - 613
Abstract | Full Text PDF

29.Does left ventricular function deteriorate in patients with nasal polyposis?
Sait Demirkol, Şevket Balta, Mustafa Çakar, Uğur Küçük
PMID: 24064091  doi: 10.5152/akd.2013.209  Pages 613 - 614
Abstract | Full Text PDF

30.The heart project: a cost-effective method to save a life
Mutlu Vural
PMID: 24064092  doi: 10.5152/akd.2013.210  Pages 614 - 615
Abstract | Full Text PDF

31.Atypical presentation of adult celiac disease: myocarditis and liver abnormality
Hamzaoui Amira, Hajji Raouf, Belakhal Syrine, Nfoussi Haifa, Smiti Khanfir Monia, Haouet Slim, Houman Mohamed Habib
PMID: 24064093  doi: 10.5152/akd.2013.211  Pages 615 - 616
Abstract | Full Text PDF

32.Diffuse coronary ectasia and acute coronary syndrome in a young man. Who is guilty? Cannabis, smoking or dyslipidemia?
Muhammet Raşit Sayın, İbrahim Akpınar, Mehmet Ali Çetiner, Turgut Karabağ
PMID: 24064094  doi: 10.5152/akd.2013.212  Pages 616 - 618
Abstract | Full Text PDF

33.High dose cytosin arabinoside induced sinus bradycardia in a Hodgkin`s lymphoma patient
Hava Üsküdar Teke, Mustafa Karagülle, Olga Meltem Akay
PMID: 24064095  doi: 10.5152/akd.2013.213  Pages 618 - 619
Abstract | Full Text PDF

34.Medium-long term follow-up results of valvular pulmonary stenosis in Turkish children
Fevzi Ataseven, Funda Öztunç, Bülent Koca, Selman Gökalp, Ayşe Güler Eroğlu, Levent Saltık
PMID: 24064096  doi: 10.5152/akd.2013.214  Pages 619 - 620
Abstract | Full Text PDF

DIAGNOSTIC PUZZLE - ANSWER
35.İnteratriyal septal kitle
Ahmet Güler, Süleyman Karakoyun, Alparslan Şahin, Mustafa Yıldız
Page 621
Abstract | Full Text PDF

ALMANAC SERIAL
36.Almanac 2013: novel non-coronary cardiac interventions
Pascal Meier, Olaf Franzen, Alexandra J Lansky
PMID: 24064106  doi: 10.5152/akd.2013.224  Pages 622 - 631
Recent innovations in interventional cardiology have dramatically expanded the therapeutic options for patients with cardiac conditions. Interventional cardiology is no longer limited to the treatment of coronary artery disease but allows also treatment of valvular disease, stroke prevention, hypertension, etc. One of the most important new treatment options is the percutaneous treatment for aortic valve stenosis (transcatheter aortic valve implantation), since aortic valve disease is a rather common problem  in elderly patients, with many of them at high risk for surgery. Similarly, mitral regurgitation  is often associated with comorbidities which make surgery high risk. The MitraClip is a promising percutaneous alternative to surgical valve repair or replacement. Other procedures discussed in this review are the percutaneous left atrial appendage closure as a non-pharmacologic therapy to prevent strokes, and renal denervation for resistant hypertension. This review explains the basic principles of these procedures, the most important clinical evidence, and also provides additional recent clinical data on each of these them.

E-PAGE ORIGINAL IMAGES
37.An adult patient with coexistence of coarctation of aorta and patent ductus arteriosus: multimodality imaging
Zafer Işılak, Mehmet İncedayı, Mehmet Uzun, Bekir Sıtkı Cebeci
PMID: 24064097  doi: 10.5152/akd.2013.215  Page E30
Abstract | Full Text PDF

38.Multimodality imaging of persistent left superior vena cava and an absent right superior vena cava in a patient with dextrocardia
Sait Demirkol, Şevket Balta, Sabahattin Sarı, Uğur Bozlar
PMID: 24064098  doi: 10.5152/akd.2013.216  Page E31
Abstract | Full Text PDF

39.Mitral valve perforation from aortic insufficiency
Vikas Singh, Claudia A. Martinez, William W. Oneill
PMID: 24064099  doi: 10.5152/akd.2013.217  Page E32
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40.Giant aneurysm with thrombosis refractory to medical therapy due to Kawasaki disease
Önder Doksöz, Rahmi Özdemir, Timur Meşe, Yılmaz Yozgat
PMID: 24064100  doi: 10.5152/akd.2013.218  Pages E32 - E33
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41.Right ventricular penetration and acute cardiac tamponade caused by sewing needle in a woman under antipsychotherapeutic treatment
Mahmut Mustafa Ulaş, Sinan Sabit Kocabeyoğlu, Adem Diken, Gökhan Lafçı, Adnan Yalçınkaya
PMID: 24064101  doi: 10.5152/akd.2013.219  Pages E33 - E34
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42.Acute myocardial infarction caused by severe muscular bridges of the left anterior descending artery and diagonal branch: a very unusual cause of myocardial infarction
Celal Kilit, Mehmet Melek
PMID: 24064102  doi: 10.5152/akd.2013.220  Pages E34 - E35
Abstract | Full Text PDF

43.Tako-tsubo-like cardiomyopathy induced by pheochromocytoma crisis
Muhammed Bora Demirçelik, Halil İbrahim Aydın
PMID: 24064103  doi: 10.5152/akd.2013.221  Pages E35 - E36
Abstract | Full Text PDF

44.Pulmonary artery sling and tracheal bronchus in an infant with severe respiratory distress
Abdullah Kocabaş, Fırat Kardelen, Gayaz Akçurin, Halil Ertuğ
PMID: 24064104  doi: 10.5152/akd.2013.222  Page E37
Abstract | Full Text PDF