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    Clinical features and factors affecting in-hospital mortality of patients who underwent pericardiocentesis due to moderate to severe pericardial effusion
    (2021) Şenöz, Oktay; Yapan Emren, Zeynep; Erseçgin, Ahmet; Emren, Volkan; Yurdam, Ferhat Siyamend; Nazlı, Cem
    Introduction: The aim of this study was to determine the primary etiology of pericardial effusion in patients undergoing percutaneous pericardiocentesis. Possible in-hospital mortality related predictors were also investigated. Patients and Methods: A retrospective analysis was made of the clinical and laboratory features of 268 patients who underwent pericardiocentesis due to moderate to severe pericardial effusion between January 2009 and March 2020. Results: The patients comprised 57.5% males and 42.5% females with a mean age of 62.3 ± 15.4 years. Cardiac compression was detected in 220 (82.1%) patients, of which 208 (77.6%) were clinically tamponade and 12 (4.5%) were asymptomatic cardiac compression. The most common symptom was dyspnea (58.6%) and 10.8% of patients were asymptomatic. Pericardial fluid was exudate in 235 (87.7%) patients. The most common causes were malignancy (37.3%) followed by idiopathic (22.1%) and iatrogenic (12.7%) causes. The patients with asymptomatic cardiac compression were more likely to have malignant effusion than those with other etiologies (p= 0.001). In-hospital mortality developed in 37 (13.8%) patients. The independent predictors of in-hospital mortality were determined as follows; etiology other than infectious or idiopathic (OR= 3.447; 95% CI= 1.266, 9.386; p= 0.015), and receiving antithrombotic therapy (OR= 2.306; 95% CI= 1.078, 4.932; p= 0.031). Conclusion: Malignancy is the most common cause of moderate to severe pericardial effusions. The detection of cardiac compression in asymptomatic patients may be an important indicator of malignancy. Receiving antithrombotic therapy and having a non-idiopathic and non-infectious etiology may be predictors of in-hospital mortality.
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    Mitral valve obstruction caused by heart-shaped large left atrial myxoma
    (2021) Şenöz, Oktay; Yurdam, Ferhat; Emren, Zeynep Yapan; Emren, Volkan; Tomakin, Fatma Nur
    Myxoma is one of the most common benign primary cardiac tumors, usually detected at ages between 30 and 60 years. It accounts for 50% of the primary cardiac tumors. The most common location of a myxoma is the left atrium. Myxomas are more prevalent in females. The clinical outcomes can differ depending on the tumor’s size, location, and architecture. The clinical picture can mimic mitral stenosis, which causes mitral valve obstruction. Syncope is a rare but life-threatening symptom and requires early surgical treatment. This paper describes a patient with a large left atrial myxoma, causing mitral valve obstruction
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    Predictors of Percutaneous Lead Extraction Major Complications: A Tertiary Center Experience
    (Galenos Publishing House, 2024) Tiryaki, Muhammet Mücahit; Emren, Zeynep Yapan; Emren, Volkan; Özdemir, Emre; Kocabaş, Uğur; Kırış, Tuncay; Karaca, Mustafa
    Background and Aim: Over the years, transvenous lead extraction (TLE) procedures (TLEP) have been increasing because of factors such as infection, loss of device function, and lead-related complications. This study aimed to evaluate the factors affecting major complications during TLEP. Materials and Methods: Between January 2011 and May 2023, patients who underwent TLE of cardiac implantable electronic devices were included in the study. The demographic and procedural features of all patients were evaluated according to major complications. Results: A total of 121 consecutive patients (192 leads) underwent TLEP. The mean age was 63 ± 17.3 years, and 76% were male. Most leads were active fixation leads (67%) and 74 procedures (61%) required an extraction device. The mean lead dwell time was 5.6 ± 5.2 years. Major complications were observed in 16 procedures (13.2%) and 5 of them (4.1%) resulted in exitus. When we compared the groups according to the major complication, the rates of chronic obstructive pulmonary disease (4 vs. 3; P = 0.020), existence of passive fixation leads (PFL) (24 vs. 9; P = 0.013), and device indication (P = 0.012) were higher in the complication group. Multivariate analysis revealed that only the presence of PFL was associated with major complications. (odds ratio 4.486, 95% confidence interval 1.365-14.748; P = 0.013) Conclusion: The present study showed that the presence of a PFL is a predictive factor for major complications. © 2024 by the Cardiovascular Academy Society.