ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 9 (3)
Volume: 9  Issue: 3 - June 2009
1.(Education in foreign language, meetings of study group)
Bilgin Timuralp
PMID: 19520646  Page 157
Abstract |Full Text PDF

2.E-learning and problem based learning integration in cardiology education
Erol Gürpınar, Neşe Zayim, İbrahim Başarıcı, Filiz Gündüz, Mevlüt Asar, Nurettin Oğuz
PMID: 19520647  Pages 158 - 164
Objective: The aim of this study was to determine students’ satisfaction with an e-learning environment which is developed to support classical problem-based learning (PBL) in medical education and its effect on academic achievement. Methods: In this cross-sectional study, students were provided with a web-based learning environment including learning materials related to objectives of the subject of PBL module, which could be used during independent study period. The study group comprised of all of the second year students (164 students) of Akdeniz University, Medical Faculty, during 2007-2008 education period. In order to gather data about students’ satisfaction with learning environment, a questionnaire was administered to the students. Comparison of students’ academic achievement was based on their performance score in PBL exam. Statistical analyses were performed using unpaired t test and Mann Whitney U test. Results: Findings indicated that 72.6% of the students used e-learning practice. There is no statistically significant difference between mean PBL performance scores of users and non-users of e-learning practice (103.58 vs. 100.88) (t=-0.998, p=0.320). It is found that frequent users of e-learning application had statistically significant higher scores than non-frequent users (106.28 vs. 100.59) (t=-2.373, p=0.01). In addition, 72.6% of the students declared they were satisfied with the application. Conclusion: Our study demonstrated that the most of the students use e-learning application and are satisfied with it. In addition, it is observed that e-learning application positively affects the academic achievement of the students. This study gains special importance by providing contribution to limited literature in the area of instructional technology in PBL and Cardiology teaching

3.E-learning in cardiology education
Özer Badak
PMID: 19520648  Pages 165 - 166
Abstract |Full Text PDF

4.Heart murmurs auscultation as professional learning problems
Leonid B. Naumov
PMID: 19520649  Pages 167 - 175
Objective: To compare the effectiveness of traditional and innovative methods of training for heart auscultation in medical students, physicians, and medical teachers, to find out the major reasons of the deficient auscultative skills, and to determine a place and significance of alternative methods of auscultation training. Methods: By principle of other equal conditions, the comparison of traditional and algorithmic diagnostics by the same auscultative signs in textual tasks, magnetic sound records and heart auscultation of patients. The independent diagnostics has been reflected the results of usual medical education. The same data have been used by the same examinees for diagnostics by original innovative diagnostic algorithm of heart auscultation, and programmed training. Results: Murmurs diagnostics on magnetic recording was erroneous frequently. For reliable diagnostics of acoustic phenomena is needed the constant feedback, and much more time, than is scheduled in standard curriculum. Conclusion: Conventional training for heart auscultation is ineffective. Auscultation skills acquired by medical students do not grow up during their program of study. Even graduated cardiologists and instructors clinicians themselves make frequent errors in diagnostics of heart murmurs. The proposed diagnostic algorithm decreases the number of errors many times. The programmed teaching with constant feedback is the optimal method for flawless recognition of acoustic signs.

5.Effects of proadrenomedullin N-terminal 20 peptide and calcitonin on isolated perfused rat hearts
Ziya Kaygısız, Hilmi Özden, Nilüfer Erkasap, Tülay Köken, Murat İkizler, Tuğrul Kural
PMID: 19520650  Pages 176 - 182
Objective: There are evidences that proadrenomedullin N-terminal 20 peptide (PAMP) and calcitonin may be involved in cardiovascular function. Therefore, we studied effects of rat PAMP and human PAMP as well as rat calcitonin and salmon calcitonin on coronary perfusion pressure, heart rate and contractile force. Methods: Isolated rat hearts were perfused under constant flow condition and rat PAMP (1.10 and 100 nM), human PAMP (1,10 and 100 nM), rat calcitonin (10.100 and 1000 nM) or salmon calcitonin (10.100 and 1000 nM) were infused to the hearts. Coronary perfusion pressure, heart rate, left ventricular developed pressure and +dP/dtmax were measured. Statistical analysis was performed using repeated measures ANOVA and Bonferroni posthoc tests. Results: Rat PAMP (1.10 and 100 nM) did not alter perfusion pressure. However, it increased heart rate from 257.83 ± 23.89 to 282±24.98 beats/min (p<0.001), from 259.83±25.05 to 289.8±19.5 beats/min (p<0.001) and from 249.66±19.19 to 280.50±25.26 beats/min (p<0.001) for 1.10 and 100 nM, respectively. Rat PAMP decreased left ventricular developed pressure from 90.5±18.5 to 79±15.3 mmHg (p<0.05), from 88.00±10.12 to 73.00±12.38 mmHg (p<0.05) and from 79.83±8.98 to 64.83±10.12 mmHg (p<0.05) for 1.10 and 100 nM, respectively. The peptide also decreased+dP/dtmax from 3710.5±370.6 to 3223.8±261.1 mmHg s-1 (p<0.001), from 3683.16±327.27 to 3040.6±423.8 mmHg s-1 (p<0.01) and from 3746.16±315.76 to 3009.83±204.64 mmHg s-1 ( p<0.001) for 1.10 and 100 nM, respectively. Rat calcitonin (10.100 and 1000 nM) did not change perfusion pressure but it decreased heart rate from 269.16±22.6 to 253.6±22.84 beats/min (p<0.05), from 263.8±27.3 to 247.00±36.63 beats/min (p<0.05) and from 285.0±32.4 to 264.00±39.83 beats/min (p<0.01) for 10.100 and 1000 nM, respectively. Rat calcitonin did not significantly affect left ventricular developed pressure. Human PAMP or salmon calcitonin did not change perfusion pressure, heart rate and left ventricular developed pressure. Conclusion: We conclude that rat PAMP may induce positive chronotropic and negative inotropic effect while rat calcitonin may produce a negative chronotropic effect. Human PAMP or salmon calcitonin could not alter perfusion pressure, heart rate and contractility in isolated, perfused rat hearts.

6.The effect of the content of the knowledge on adherence to medication in hypertensive patients
Hayrettin Karaeren, Mehmet Yokuşoğlu, Şenay Uzun, Oben Baysan, Cem Köz, Belgüzar Kara, Ata Kırılmaz, İlkin Naharcı, Murat Pınar, Mehmet Birhan Yılmaz, Mehmet Uzun
PMID: 19520651  Pages 183 - 188
Objective: It was suggested that knowledge might influence the adherence to treatment in hypertension. Accordingly, in this study, we investigated the effects of content of knowledge on medication adherence and knowledge-based predictors of adherence to treatment in hypertensive patients Methods: This cross-sectional study included 227 hypertensive patients (70% female; mean age: 57±12 years), who were followed by cardiology and internal medicine clinics. The patients were asked to fulfill a questionnaire including 40 items. Besides the demographic and disease-related questions, the patients were also asked (1) the name of the drug, (2) the duration of the drug use; (3) the reason of using the drug; (4) the cause of hypertension; (5) the target level of hypertension; (6) the result of hypertension; (7) the side effects of antihypertensive medicines. Statistical analyses were performed using Chi-square, Fischer exact, Mann Whitney U tests and logistic regression analysis. Results: It was found that 163 (72%) were adherent and 64 (28%) were nonadherent to the treatment. Angiotensin-II receptor antagonist use (OR= 4.405; 95%CI: 1.561-12.365, p=0.022) and hypertension duration ≥5 years (OR= 0.446; 95%CI: 0.246-0.811, p=0.006) was found to be independently related to adherence. Among the knowledge-based variables, knowing the duration of use of the medicine (OR= 6.822; 95% CI: 1.478-31.241, p=0.075), the reason of use of medicine (OR= 2.828; 95% CI: 1.445-5.543, p=0.018), the cause of the hypertension (OR= 3.447; 95% CI: 1.889-6.290, p=0.037) and the target level of blood pressure (OR= 12.859; 95% CI: 5.045-32.640, p<0.001) significantly increased the adherence rates. On the other hand, knowing the name of the medicine (p=0.112) or the results of hypertension (p=0.719) had no effect on adherence, while knowing the side effects of the medicine (OR= 0.607; 95% CI: 0.340-1.084, p=0.005) had negative effect. The total number of correct answers was also higher in patients with adherence to treatment (p=0.002). Conclusion: Patient knowledge about hypertension and medications is associated with higher adherence rates. However, it should be taken into consideration that the possible effects of knowledge may differ according to its content.

7.Usefulness of automatic QT dispersion measurement for detecting exercise-induced myocardial ischemia
Bonpei Takase, Nobuyuki Masaki, Hidemi Hattori, Masayuki Ishihara, Akira Kurita
PMID: 19520652  Pages 189 - 195
Objective: The electrocardiographic index of QT dispersion (QTd) is related to the occurrence of arrhythmia. In patients with suspected or known coronary artery disease, QTd may be affected by exercise. We investigated whether QTd that is automatically calculated by a newly developed computer system could be used as a marker of exercise-induced myocardial ischemia. Methods: The design of this study was prospective and observational. Eighty-three consecutive patients were enrolled in this study. Their QTd was measured at rest and after 3 min of exercise during exercise-stress Thallium-201 scintigraphy and compared with conventional ST-segment changes. The patients were classified into 4 groups (normal group, redistribution group, fixed defect group, redistribution with fixed defect group) based on the result of single photon emission computed tomography. As statistical analysis, one-way ANOVA with post-hoc Scheffe’s method, receiver-operating characteristics (ROC) and multiple logistic regression analysis were performed. Results: At rest, QTd was significantly greater (p<0.05) in the fixed defect group (52±21 ms) and the redistribution with fixed defect group (53±20 ms) than in the normal group (32±14 ms) and the redistribution group (31±16 ms). However, QTd tended to increase after exercise in the redistribution group, while QTd tended to decrease in the normal group, the fixed defect group, and the redistribution with fixed defect group (QTd after exercise, normal group, 28±17 ms, redistribution group, 35±19 ms, fixed defect group, 43±25 ms, redistribution with fixed defect group, 49±27 ms). Exercise significantly increased QTcd (RR interval-corrected QT dispersion) in the redistribution group. The best cut-off values of QTd and QTcd obtained from ROC curves for exercise-induced myocardial ischemia were 41.6 ms and 40.4 ms, respectively (Qtd - AUC 0.68, 95%CI 0.53- 0.83 and QTcd – AUC 0.67, 95%CI 0.55-0.80). Using these values as cut-off ones, QTd, QTcd, and conventional ST-segment change had comparable sensitivities and specificities for detecting exercise-induced myocardial ischemia (sensitivity - 60%, 58% and 49%, respectively; specificity - 78%, 80% and 83%, respectively). In addition, multiple logistic regression analysis showed that QTd (OR=2.01, 95%CI 1.15-4.10, p<0.05), QTcd (OR=2.12, 95% CI 1.02-4.30, p<0.05) and ST-segment change (OR=1.89, 95%CI 1.03-3.40, p<0.05), were the significantly associated with exercise-induced myocardial ischemia. Conclusion: QT dispersion and/or QTcd after exercise could be a useful marker for exercise-induced myocardial ischemia in routine clinical practice.

8.Papillary muscle dyssynchrony as a cause of functional mitral regurgitation in non-ischemic dilated cardiomyopathy patients with narrow QRS complexes
Kürşat Tigen, Tansu Karaahmet, Emre Gürel, Cihan Çevik, Mohammad Otahbachi, Selçuk Pala, Ali Cevat Tanalp, Bülent Mutlu, Yelda Başaran
PMID: 19520653  Pages 196 - 203
Objective: Mitral regurgitation (MR) increases mortality in dilated cardiomyopathy (DCM). We investigated the prevalence of functional MR in non-ischemic DCM patients with narrow QRS intervals and its association with papillary muscle dyssynchrony. Methods: Ninety-three patients were enrolled consecutively in this cross-sectional study. Patients were evaluated for the presence of intraventricular (DYS Sep-Lat Sys) and papillary muscle (DYS Inter PAP Sys) systolic dyssynchrony using tissue Doppler echocardiographic imaging (TDI). Two-dimensional and Doppler echocardiography were used for quantification of MR. Statistical analyses were performed using unpaired t test, Mann-Whitney U test, correlation and logistic regression analyses. Results: Thirty-seven patients (39%) had significant DYS Sep-Lat Sys and 25 patients (26%) had DYS Inter PAP Sys. Patients with DYS Inter PAP Sys had lower basal septum systolic (p=0.007) and late diastolic velocities (p=0.049), greater MR volume (p=0.01), effective regurgitant orifice (ERO) (p=0.01), and E/A ratios (p=0.03) than the patients without DYS Inter PAP Sys. Fifty-five patients with narrow QRS intervals were also evaluated for DYS Inter PAP Sys. Patients with DYS Inter PAP Sys and narrow QRS had lower basal septum TDI peak systolic velocities (p=0.038), higher MR volume (p=0.03) and ERO (p=0.03). Logistic regression analysis revealed that NYHA Class III-IV (OR=6.4, 95% CI: 1.1-37.1, p=0.038) and DYS Inter PAP Sys (OR=9.5, 95% CI: 1.17-75.78, p=0.034) were the independent predictors of functional MR >20 ml. Conclusion: Papillary muscle systolic dyssynchrony is common and correlated with functional MR in non-ischemic DCM patients with sinus rhythm and narrow QRS. Papillary muscle systolic dyssynchrony may help predict patients who will benefit from cardiac resynchronization therapy.

9.Rethink RethinQ? Papillary muscle dyssynchrony and functional mitral regurgitation
Raymond Q. Migrino
PMID: 19520654  Pages 204 - 205
Abstract |Full Text PDF

10.Acute effects of adaptive servo-ventilation therapy on neurohormones and Cheyne-Stokes respiration in the patients with heart failure
Şükrü Gür, Dursun oğlu, Neşe Dursunoğlu, Mustafa Kılıç
PMID: 19520655  Pages 206 - 214
Objective: Cheyne Stokes respiration (CSR) is frequently seen in the patients with heart failure (HF) and it increases mortality. In the present study, we aimed to evaluate acute effects of adaptive servo ventilation (ASV) on CSR and neurohormones in the patients with HF. Methods: Nineteen males and 1 female patients with HF in the functional capacity of NYHA II-III were included into the study prospectively. One night polysomnography (PSG) was performed to all patients. In addition to medical treatment, 10 patients having CSR were applied ASV in another night together with PSG.. Arterial blood gases, plasma epinephrine and norepinephrine, serum N-terminal -pro-B type brain natriuretic peptide (NT-pro-BNP) were studied in the first night and after ASV treatment. A Wilcoxon test was used for comparison of parameters before and after treatment; and Mann-Whitney-U test was used for comparison of parameters between the patients with CSR and without CSR. Results: Mean age of 10 patients with CSR was 62.2±11.1 years. Their etiologies were ischemic in 9 patients and idiopathic dilated cardiomyopathy in 1 patient. While there were no significant differences in the levels of PaCO2, HCO3, PH, before and after treatment; PaO2 (75.3 mmHg) and SatO2 (94.7%) significantly increased after the therapy (84.7 mmHg, 96.5% and p=0.007 and p=0.008 respectively). While NT-proBNP (3029.6±1450.5 pg/ml), norepinephrine (625.4±304.7 pg/ml) and epinephrine (65.4±24.1 pg/ml) were higher than normal before ASV treatment, all of them showed significant reductions after treatment (1694.0±925.9 pg/ml, 333.9±165.4 pg/ml and 45.0±20.5 pg/ml; p=0.005, p=0.005 and p=0.02, respectively). Conclusions: One night ASV treatment improves CSR, partial pressure of oxygen in arterial blood, and oxygen saturation and provides significant reductions in plasma catecholamines and NT-proBNP levels in the patients with HF and CSR. Prospective studies are needed to evaluate long-term effects of ASV treatment on morbidity and mortality in the patients with HF.

11.Pulmonary artery banding operation and results of terminal biventricular and univentricular repair
Ersin Erek, Yusuf Kenan Yalçınbaş, Yasemin Türkekul, Kazım Öztarhan, Ayşe Çolakoğlu, Arda Saygılı, Ayşe Sarıoğlu, Tayyar Sarıoğlu
PMID: 19520656  Pages 215 - 222
Objective: In this study, we report the current indications, early-midterm results and the outcome of pulmonary artery banding (PAB) operation after definitive repair. Methods: Between 2000 and 2007, 28 infants underwent PAB operation. Ages were between 21 days and 6 months (mean 3.0±1.7 months). All patients had pulmonary hypertension at systemic level. Fourteen patients were candidates for terminal biventricular repair [atrioventricular septal defect (AVSD) (n=6), double outlet right ventricle (DORV)+ ventricular septal defect (VSD) (n=4), Swiss cheese VSD (n=2), transposition of the great arteries(TGA)+Swiss cheese VSD (n=1), ASD+VSD+aortic coarctation (n=1)], and the remaining 14 were candidates for terminal univentricular repair [double inlet left ventricle (n=5), double inlet right ventricle (n=2), AVSD+left ventricular (LV) hypoplasia (n=2), DORV+LV hypoplasia (n=2); tricuspid atresia (n=1), left AV valve atresia (n=1), TGA+Swiss cheese VSD+LV hypoplasia (n=1). Results: Three patients (1 in biventricular group; 2 in univentricular group) died in the early postoperative period (10.7%). Three patients needed long duration of mechanical ventilatory support. Twenty- three of the surviving patients (92%) were followed –up between 1 month to 7 years. Currently 7 patients underwent successful biventricular repair and five patients underwent univentricular repair (extracardiac Fontan 3; Glenn 2). Two patients died early and 1 patient died 1 year after extracardiac Fontan operation. Survival for biventricular group was 92.8% at 1 and 4 years and 85.7% and 58.4% respectively for univentricular group (p<0.05) Conclusion: Pulmonary artery banding operation has still a significant role in the palliation of certain congenital cardiac anomalies. Outcome of patients who are candidates for biventricular repair is better than the univentricular repairs.

12.Timing of levosimendan in cardiac surgery
Murat Aksun, Nagihan Karahan, Tayfun Adanır, Gülçin Aran, Ufuk Yetkin, Tülin Öztürk, Atilla Şencan, Uğur Özgürbüz, Ali Gürbüz
PMID: 19520657  Pages 223 - 230
Objective: Levosimendan (LS) is a new inodilator agent that improves cardiac contractility by increasing the sensitivity of troponin C to calcium, which usage in cardiac surgery has been growing in the recent years. We aimed to determine the best timing of the administration of LS in high-risk patients who underwent cardiovascular surgery. Methods: Fifteen patients were evaluated retrospectively who have left ventricular dysfunction, underwent open-heart surgery and were applied LS in different phases of operation. Patients were divided into 3 groups according to timing of LS. Levosimendan infusion (0. 1 µg-1kg-1min) was applied after the induction of anaesthesia (n=5) (Group 1), during the pump removal period (n=5) (Group 2) and in postoperative period (n=5) (Group 3). Demographic data, operative characteristics, mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), pulmonary wedge capillary pressure (PWCP), cardiac index (CI), inotropic agent consumption, postoperative urine output, lactate levels of groups were compared between before and after LS treatment. Data were evaluated by Fisher exact, Kruskal-Wallis, Mann-Whitney U and Wilcoxon rank tests. Results: In all patients, urine output was satisfactory 24 hours after LS application. There was a significant increase in CI of all 3 groups (p=0.04). Also, there was a significant decrease in PCWP of all 3 groups before and after LS (p=0.04). There was a significant decrease in MPAP in Group 2 and 3 (p=0.04). Twenty- four hours after LS application, whereas all inotropic agents could be stopped in Group 1 and 2, in Group 3 inotropic infusion (dopamine [10 µg-1kg-1min (5-17.5)], dobutamine [15 µg-1kg-1min (5-20)] and adrenaline [0.4 µg-1kg-1min (0.15–0.65)]) couldn’t be stopped (p= 0.007). During postoperative period, in Groups 1 and 2 one case from each required intraaortic balloon pump, while in Group 3 four patients were applied intraaortic balloon pump (p=0.08). Conclusion: According to our experience, LS is effective in high-risk cases during cardiac surgery, especially during the intra-operative and pump removal periods; however, no successful outcomes were observed during the post-operative period. As a result, case selection and timing should be performed well when using LS.

13.Clopidogrel resistance
Yeşim Güray, Ümit Güray, Şule Korkmaz
PMID: 19520658  Pages 231 - 237
Platelets play a critical role in pathogenesis of atherothrombotic diseases such as acute coronary syndromes and ischemic stroke. Clopidogrel, a thienopyridine derivative is an effective antiplatelet drug mostly used in combination with aspirin or as a single drug in aspirin intolerant patients. However, despite its proven efficacy in various clinical trials, some patients exhibit impaired response to clopidogrel and have activated platelets while on usual clopidogrel treatment. Although definition and mechanism(s) of this therapeutic failure are poorly understood, it is associated with higher morbidity and mortality as in aspirin resistance. Various causes have been implicated in clopidogrel resistance and alternative therapies are recommended. The aim of this review is to evaluate possible mechanisms, its clinical relevance and alternative treatments of this significant issue.

14.Management of diabetes in cardiac diseases
Serhat Işık, Tuncay Delibaşı, Dilek Berker, Yusuf Aydın, Serdar Güler
PMID: 19520659  Pages 238 - 247
Type 2 diabetes mellitus (DM) is a common disease affecting people in the world and its incidence is increasing rapidly. Cardiovascular disease (CVD) is the most important cause of mortality and morbidity among patients with type 2 DM. Patients with diabetes have a poorer prognosis than patients without diabetes. It is well known that other cardiovascular risk factors such as hyperlipidemia, hypertension and obesity that usually accompany to diabetes mellitus or impaired glucose tolerance as a metabolic syndrome component or not, can contribute to accelerated atherosclerosis and increased risk of cardiovascular event in diabetes mellitus. The management of patient with type 2 DM is not only glucocentric but focuses on multiple risk factor intervention.

15.Transient femoral nerve palsy after diagnostic coronary angiography
Cem Barçın, Hürkan Kurşaklıoğlu, Sedat Köse, Ersoy Işık
PMID: 19520660  Pages 248 - 249
Abstract |Full Text PDF

16.Giant vegetation on permanent endocavitary pacemaker lead and successful open intracardiac removal
Ali Gürbüz, Murat Yeşil, Ufuk Yetkin, Nursen Postacı, İsmail Yürekli, Erdinç Arıkan
PMID: 19520661  Pages 249 - 251
Abstract |Full Text PDF

17.Operation of coarctation with saccular aneurysm of descending aorta under support of low flow cardiopulmonary bypass
Bilgehan Savaş Öz, Mehmet Yokuşoğlu, Erkan Kuralay, Harun Tatar
PMID: 19520662  Pages 251 - 252
Abstract |Full Text PDF

18.Alternate-day dosing of statins for secondary prevention of coronary artery disease
Murat Çelik, Turgay Çelik
PMID: 19520663  Pages 253 - 254
Abstract |Full Text PDF

19.Dilemma in the strategy of treatment: revascularization or medical treatment?
Cevdet Uğur Koçoğulları, Mehmet Melek
PMID: 19520664  Pages 254 - 255
Abstract |Full Text PDF

20.A normofunctioning caged-ball aortic valve prosthesis for 31 years
Murat Başkurt, Fatma Nihan Turhan, Barış Ökçün, Serdar Küçükoğlu
PMID: 19520665  Pages 255 - 256
Abstract |Full Text PDF

21.Hypokalemic periodic paralysis associated with coronary angiography
Ömer Uz, Ömer Yiğiner, Ejder Kardeşoğlu, Namık Özmen, Mustafa Aparcı
PMID: 19520667  Page 256
Abstract |Full Text PDF

22.Long-term follow-up of adult patients with isolated congenital AV block
Murat Yeşil, Erdinç Arıkan, Serdar Bayata, Nursen Postacı, Eyüp Avcı
PMID: 19520666  Pages 256 - 257
Abstract |Full Text PDF

23.Left atrial myxoma in association with atrial septal defect in a patient with acute myocardial infarction; an uncommon association with an unusual presentation
Ali Can Hatemi, Mete Gürsoy, Aybala Tongut, İlhan Özgöl, Gürkan Çetin, Işıl Uzunhasan, Serdar Küçükoğlu, Erhan Kansız
PMID: 19520668  Pages 257 - 258
Abstract |Full Text PDF

24.Double-chambered left ventricle with nonsustained ventricular tachycardia
Cem Köz, Mehmet Uzun, Mehmet Yokuşoğlu, Oben Baysan, Nail Bulakbaşı
PMID: 19520641  Page E5
Abstract |Full Text PDF

25.Perfect delineation of the localization and size of the paravalvular leak due to extensive suture loosening
Mehmet Özkan, Hasan Kaya, Tayyar Gökdeniz, Murat Biteker, Nilüfer Ekşi Duran, Mustafa Yıldız
PMID: 19520643  Pages E6 - E7

26.An unusual appearance: a heart in the heart in a patient with congenitally corrected transposition of great arteries
Gülten Taçoy, Serdar Kula, Mustafa Cemri
PMID: 19520642  Pages E6 - E7

27.Pulmonary artery coil migration after management of patent ductus arteriosus in a 65-year-old female patient
Tunay Şentürk, Zeynel Abidin Yetgin, Tolga Doğan, Ali Aydınlar
PMID: 19520644  Pages E7 - E8

28.Endovascular stent graft implantation in thoracic aortic aneurysm
Adem Güler, Mehmet Ali Şahin, Murat Kadan, Mehmet Yokuşoğlu, Hakan Bingöl, Ufuk Demirkılıç
PMID: 19520645  Pages E8 - E9

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