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    Transcatheter Interatrial Septal Defect Closure in a Large Cohort: Midterm Follow-up Results
    (Tech Science Press, 2013) Aytemir, Kudret; Oto, Ali; Ozkutlu, Suheyla; Canpolat, Ugur; Kaya, Ergun Baris; Yorgun, Hikmet; Sahiner, Levent
    ObjectivesWe evaluated immediate and midterm results of transcatheter closure of atrial septal defects (ASDs) and patent foramen ovale (PFO) using various closure devices. Materials and MethodsThe study included four hundred fourteen patients (one hundred eighty-two men, two hundred thirty-two women; mean age 39 12.3 years; range 17-67 years) who underwent transcatheter closure of secundum ASD (n = 193) or PFO (n = 221). All the patients were evaluated by transthoracic echocardiography and transesophageal echocardiography before the procedure. Transcatheter closure was performed by using Amplatzer (n = 184), Occlutech Figulla (n = 209), or BioSTAR (n = 21) devices. Closure of ASDs was performed under general anesthesia with transesophageal echocardiography guidance, and closure of PFOs was performed under local anesthesia with transthoracic echocardiography guidance. Follow-up controls were at 1, 6, and 12 months and annually thereafter. The median follow-up periods of ASD and PFO patients were 43 and 30 months. ResultsThe mean device size was 19.3 +/- 6.2mm for ASD patients and 24.6 +/- 2.6mm for PFO patients. The mean procedural and fluoroscopy times were 22.3 +/- 4.7 and 4.1 +/- 1.9 minutes for ASD closure and 12.4 +/- 3.2 and 3.1 +/- 1.2 minutes for PFO closure, respectively. Procedural device embolization occurred in only two patients (0.48%). During follow-up, recurrent embolic events occurred in four patients (1.8%) after PFO closure, and no residual shunts were seen after ASD closure. Device thrombosis developed in two ASD patients during the procedure and in one PFO patient at 12th month of the follow-up (0.72%). ConclusionTranscatheter closure of PFOs and secundum-type ASDs using the Amplatzer, Occlutech Figulla, and BioSTAR devices is an efficacious and safe therapeutic option.
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    Öğe
    Transthoracic Echocardiography Guidance during Percutaneous Closure of Patent Foramen Ovale
    (Wiley, 2011) Oto, Ali; Aytemir, Kudret; Ozkutlu, Suheyla; Kaya, Ergun Baris; Yorgun, Hikmet; Canpolat, Ugur; Ates, Ahmet Hakan
    Background: Percutaneous closure of patent foramen ovale (PFO) has been increasingly performed for several indications; mostly due to cryptogenic stroke. In this study we aimed to evaluate the safety and efficacy of transthoracic echocardiographic (TTE) guidance during percutaneous closure of PFO in using the Amplatzer and Occlutech Figulla PFO occluder devices. Methods: Between October 2005 and March 2011, 139 patients (74 male, mean age: 40.4 +/- 10.3) underwent transcatheter PFO closure. In all patients transesophageal echocardiography performed subsequently to diagnose, assess the size and evaluate for suitability of the defect for percutaneous closure. During the procedure fluoroscopy and TTE were used for guidance. Results: Among 139 patients, Amplatzer PFO occluder was used in 74 patients and in 65 of them Occlutech Figulla device was selected for occlusion. The indications for PFO closure were ischemic stroke in 98 (70.5%), recurrent transient ischemic attacks (TIA) in 40 (28.7%), peripheral embolism in 1 (0.8%) of the patients. In all patients, percutaneous intervention was performed successfully under TTE guidance. There have been no neurologic (recurrent strokes or TIAs) and cardiovascular complications during the immediate and long-term follow-up period (267 months, median 29). There was significant difference between the mean fluoroscopic time from the beginning which is 8.6 +/- 3.4 min in the former versus 3.4 +/- 1.9 min in the latter (P < 0.05). Conclusion: Our study confirms the efficacy and safety of TTE guidance during percutaneous closure of PFO, which shortens the procedural time and obviates the need for general anesthesia or endotracheal intubation. (Echocardiography 2011;28:1074-1080)