Person: KAHRAMAN AY, NURAY
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Publication Metadata only Swiss Cheese-Like Atrial Septal Defect Detected by Three-Dimensional Echocardiography(2015-07-01T00:00:00Z) Vatankulu, Mehmet A.; Jafarov, Parviz; KAHRAMAN AY, Nuray; KAHRAMAN AY, NURAYMini-Abstract A 33-year-old female presented to the outpatient clinic with progressive exertional dyspnea. Transthoracic echocardiography revealed enlarged right heart chambers with left-to-right shunting. Two-dimensional transesophageal echocardiography confirmed these findings and showed three defects on interatrial septum. Real time three-dimensional transesophageal echocardiography was performed to better visualize the anatomy of the interatrial septum. Reconstruction of the three-dimensional images revealed multiple defects of interatrial septum like a Swiss cheese. The patient underwent surgical closure of the atrial septal defect.Publication Metadata only Impact of age on long term survival following transcatheter aortic valve implantation(2019-01-01T00:00:00Z) KAHRAMAN AY, Nuray; KAHRAMAN AY, NURAYObjective To compare the long-term survival following transcatheter aortic valve implantation (TAVI) in an octogenarian population with that in a younger population. Methods This retrospective study included 274 patients that underwent TAVI for severe symptomatic aortic stenosis. The study group was divided into two age groups, as those with an age >= 80 years (octogenarians, n = 132), and age < 80 (younger patients, n = 142). The two groups were compared in terms of clinical outcomes and survival. In addition, significant predictors of survival were estimated. Results Non-cardiac mortality (during follow-up) (21.9% vs. 10.5%, P = 0.01) and in-hospital stroke (8.3% vs. 2.8%, P = 0.01) were more common among octogenarians. The two groups did not differ in terms of mean survival (41.0 +/- 2.1 vs. 38.2 +/- 2.2 months, respectively, P = 0.18). Multivariate analysis identified left ventricular ejection fraction < 35% (OR: 2.17, 95% CI: 1.17-4.03; P = 0.01), preoperative of moderate to severe mitral insufficiency (OR: 1.88, 95% CI: 1.15-3.06; P = 0.01), postoperative major and life-threating bleeding (OR: 2.49, 95% CI: 1.05-5.89; P = 0.03), and in-hospital stroke (OR: 2.29, 95% CI: 1.04-5.04; P = 0.03) as potential predictors of poor survival. Conclusions In this study, similarly favorable survival outcomes were achieved in the elderly population as in younger patients, despite the presence of comorbid conditions. A consideration should be given to non-surgical management of severe aortic stenosis with the TAVI procedure in elderly patients, in the absence of co-existent conditions associated with shortened life expectancy.Publication Metadata only A rare complication of pre-Eisenmenger patent ductus arteriosus: Pulmonary artery dissection(2013-01-01T00:00:00Z) AY, YASİN; KAHRAMAN AY, Nuray; AYDIN, CEMALETTİN; KARA, İBRAHİM; ZEYBEK, RAHMİ; AY, YASİN; KAHRAMAN AY, NURAY; AYDIN, CEMALETTİN; ZEYBEK, RAHMİINTRODUCTION: Pulmonary artery dissection associated with patent ductus arteriosus is usually seen in patients with pulmonary hypertension and Eisenmenger-s syndrome. This paper presents a case with pre-Eisenmenger patent ductus arteriosus complicated by pulmonary artery dissection, and explains how she was surgically treated.Publication Metadata only Improvements in quality of life in septuagenarians versus octogenarians undergoing trans-catheter aortic valve replacement(2016-01-01T00:00:00Z) KAHRAMAN AY, Nuray; AY, YASİN; Sonmez, Osman; Vatankulu, Mehmet Akif; Goktekin, Omer; KAHRAMAN AY, NURAY; AY, YASİNBackground Very elderly patients represent a distinct patient group in clinical setting in terms of a decision for trans-catheter aortic valve replacement (TAVR) when one considers the potential improvement in the quality of life (QoL) on one hand and the benefit to risk ratio on the other. This study aimed to compare functional and QoL outcomes of TAVR between octogenarians and septuagenarians. Methods This prospective cohort study included 136 elderly patients (70 to 89 years of age), who underwent transfemoral TAVR due to degenerative aortic stenosis. Patients were allocated into one of the following age groups: septuagenarians (n = 67) and octogenarians (n = 69). Preoperative and early postoperative clinical parameters were recorded. In addition, QoL of the patients was evaluated using SF-36 questionnaire preoperatively and six month postoperatively. Results Groups were similar in terms of early postoperative mortality and morbidity parameters. The mean New York Heart Association (NYHA) class improved after TAVR in both groups. In addition, all SF-36 norm-based scale and SF-36 summary scale scores improved significantly in both groups during the postoperative period. Postoperatively, physical functioning, general health and physical component summary scores were significantly better in the septuagenarian group (P = 0.02, 0.01, 0.03, respectively). Conclusion Although the improvement in the QoL in terms of physical health was more marked in septuagenarians than in octogenarians, substantial benefits on the QoL and particularly on mental health seem to justify re-consideration of TAVR indications in the very elderly.Publication Open Access A Case of Spontaneous Multivessel Coronary Artery Spasm That Underwent Stent Implantation Accompanying ST Segment Elevation on Inferior Electrocardiographic Leads(2016-01-01T00:00:00Z) KAHRAMAN AY, Nuray; Nasifov, Muharrem; Goktekin, Omer; KAHRAMAN AY, NURAYCoronary artery spasm is usually defined as a focal constriction of a coronary artery segment, which is reversible, and causes myocardial ischaemia by restricting coronary blood flow. A coronary spasm may rarely compromise all three epicardial arteries simultaneously. We present a case of severe coronary spasm afflicting all coronary arteries accompanying an ST segment elevation in leads D2-D3 and aVF.Publication Metadata only Diagnostic value of transthoracic echocardiography and computerized tomography for surgically confirmed late tamponade after cardiac surgery(2019-12-01T00:00:00Z) AY, YASİN; KAHRAMAN AY, Nuray; AY, YASİN; KAHRAMAN AY, NURAYBackground Late tamponade after cardiac surgery is a clinically obscure condition presenting significant diagnostic challenges, since it may be difficult to detect using routine imaging studies. This study is aimed to investigate the diagnostic value of transthoracic echocardiography (TTE) and contrast-enhanced computerized tomography (cCT) in the diagnosis of late tamponade following open-heart surgery. Methods A total of 88 patients who underwent reoperation after cardiac surgery with suspected late cardiac tamponade were included in this retrospective study. All the patients had TTE and cCT examinations before reoperation. The diagnostic values of these imaging modalities were investigated using surgically confirmed late tamponade as the standard. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of an optimal cutoff value of greater than 3.1 cm pericardial fluid thickness on cCT images for predicting surgically confirmed late tamponade were 91.4%, 66.6%, 97.4%, 36.3%, and 89.7%, respectively. Accordingly, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of TTE for the diagnosis of late tamponade were 34.1%, 50.0%, 90.3%, 5.2%, and 35.2%, respectively. The cCT provided false-negative results in seven patients (8%), while this figure was 54 (61.4%) for that of TTE. Conclusion Computerized tomography imaging seems to represent a superior imaging technique in terms of visualizing the intrapericardial fluid collections after cardiac surgery and has the potential to readily diagnose late tamponade and effectively prevent unnecessary morbidity and mortality.Publication Metadata only Comparative efficacy and life quality effects of surgical stripping, radiofrequency ablation, and cyanoacrylate embolization in patients undergoing treatment for great saphenous vein insufficiency(2020-08-01T00:00:00Z) AY, YASİN; Gunes, Esra; TÜRKKOLU, ŞEVKET TUNA; SELÇUK, Emre; ÇALIM, Muhittin; AKAL, Ramazan; AYDIN, CEMALETTİN; İNAN, BEKİR; KÖKSAL, CENGİZ; KAHRAMAN AY, Nuray; AY, YASİN; TÜRKKOLU, ŞEVKET TUNA; SELÇUK, EMRE; ÇALIM, MUHITTIN; AKAL, RAMAZAN; AYDIN, CEMALETTİN; İNAN, BEKİR; KÖKSAL, CENGİZ; KAHRAMAN AY, NURAYObjectives To compare traditional surgery with two minimally invasive endo-venous procedures in terms of their long-term effect on the quality of life in great saphenous vein insufficiency (GSV). Method This prospective observational study included 217 patients that underwent surgical stripping (n = 62), radiofrequency ablation (n = 70), or cyanoacrylate embolization (n = 85) for the treatment of GSV insufficiency. Venous Clinical Severity Score (VCSS) assessments were made, 36-item Short-Form Health Survey (SF-36) questionnaire and Chronic Venous Insufficiency quality of life Questionnaire (CIVIQ-14) were administered, before and 1 year after the treatments. Results Surgical stripping group had significantly higher closure rates than the other groups (p < 0.05). At 12 months, decrease in VCSS scores was less pronounced in the cyanoacrylate embolization group when compared to the other two groups (p < 0.05). Improvement in CIVIQ-14 scores was better in the radiofrequency ablation group when compared to the cyanoacrylate embolization group (p < 0.05). Surgical stripping or radiofrequency ablation groups performed better on several domains of SF-36, when compared to the cyanoacrylate embolization group. Conclusions Surgical stripping and radiofrequency ablation seem to provide a better quality of life results at one year in patients undergoing treatment for GSV insufficiency.Publication Metadata only Iloprost treatment on top of infrapopliteal angioplasty accelerates wound healing in critical leg ischemia(2019-07-29T04:00:00Z) KAHRAMAN AY, Nuray; İNAN, BEKİR; KAHRAMAN AY, NURAY; İNAN, BEKİRObjectives: This study aimed to examine the efficacy of the concomitant use of infrapopliteal drug-eluting balloon angioplasty and a medical treatment (iloprost) in the treatment of critical leg ischemia.Publication Open Access Comparison of the Health Related Quality of Life of Patients Following Mitral Valve Surgical Procedures in the 6-Months Follow-up: A Prospective Study(2013-04-01T00:00:00Z) AY, YASİN; KARA, İBRAHİM; AYDIN, CEMALETTİN; KAHRAMAN AY, Nuray; İNAN, BEKİR; Basel, Halil; ZEYBEK, RAHMİ; AY, YASİN; AYDIN, CEMALETTİN; KAHRAMAN AY, NURAY; İNAN, BEKİR; ZEYBEK, RAHMİPurpose: The aim of the present study is to evaluate the health-related quality of life of the patients who underwent mitral valve repair (MvRp) and mitral valve replacement (MVR).