Browsing by Author "Ertas, Faruk"
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Article Citation - WoS: 1Citation - Scopus: 1Comparison of Evolut-R 34 Mm Valve and Smaller Evolut-R Valves in Patients Undergoing Transcatheter Aortic Valve Implantation and Determination of Mild Paravalvular Leak Predictors(Kare Publ, 2024) Aktan, Adem; Kilic, Raif; Kılıç, Raif; Guzel, Tuncay; Aktan, Adem; Günlü, Serhat; Demir, Muhammed; Gunlu, Serhat; Arslan, Bayram; Ertas, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri BölümüObjective: The main purpose of this study was to evaluate and compare the in -hospital, 1 -month and 1 -year post -procedure outcomes of patients treated with Evolut-R 34 mm and Evolut-R 23/26/29 mm devices. Additionally, the study aimed to identify factors that could predict the occurrence of >= mild paravalvular leaks (PVL). Methods: Between April 2015 and May 2022, 269 consecutive patients who underwent transcatheter aortic valve implantation (TAVI) with Evolut-R 34 mm (n = 66, 24.5%) and Evolut-R 23/26/29 mm (n = 203, 75.5%) devices in a single center were retrospectively analyzed. Results: Patients in the Evolut-R 34 mm group had a lower female sex ratio (16.7% vs. 66.5%, P < .001, respectively), ejection fraction (50.7 +/- 10.1% vs. 54.5 +/- 9.3%, P = .016, respectively), and mean aortic gradient (7.4 +/- 3.3 vs. 9.2 +/- 5.0, P = .026, respectively) compared to the Evolut-R 23/26/29 mm group. The groups did not exhibit any statistically significant distinctions with regard to technical success, the need for a permanent pacemaker, occurrences of stroke, major vascular complications, PVL, major adverse cardiovascular and cerebrovascular events, or mortality. Peak velocity was confirmed as a significant pre- dictor of >= mild PVL in both patient groups in the receiver operating characteristic curve analysis. In logistic regression analysis; In patients with Evolut-R 34 mm valve, pre-TAVI aortic valve peak velocity (odds ratio (OR) = 23.202; P = .019) and calcium volume 800 Hounsfield Units (mm(3)) (OR = 1.017; P < .001) were independent predictors of >= mild PVL. Conclusion: The Evolut-R 34 mm valve has shown comparable in -hospital results with smaller valve sizes. Pre-TAVI aortic valve peak velocity and calcium volume predicted >= mild PVL in Evolut-R 34 mm patients.Article Citation - WoS: 1Citation - Scopus: 1The Effect of Aortic Angulation on Clinical Outcomes of Patients Undergoing Transcatheter Aortic Valve Replacement(Soc Brasil Cirurgia Cardiovasc, 2024) Aktan, Adem; Demir, Muhammed; Guzel, Tuncay; Karahan, Mehmet Zulkuf; Aslan, Burhan; Kilic, Raif; Ertas, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri BölümüIntroduction: The aim of this study was to assess the impact of aortic angulation (AA) on periprocedural and in -hospital complications as well as mortality of patients undergoing Evolut (TM) R valve implantation. Methods: A retrospective study was conducted on 264 patients who underwent transfemoral-approach transcatheter aortic valve replacement with self-expandable valve at our hospital between August 2015 and August 2022. These patients underwent multislice computer tomography scans to evaluate AA. Transcatheter aortic valve replacement endpoints, device success, and clinical events were assessed according to the definitions provided by the Valve Academic Research Consortium -3. Cumulative events included paravalvular leak, permanent pacemaker implantation, new-onset stroke, and in -hospital mortality. Patients were divided into two groups, AA <= 48(degrees) and AA > 48(degrees), based on the mean AA measurement (48.3 +/- 8.8) on multislice computer tomography. Results: Multivariable logistic regression analysis was performed to identify predictors of cumulative events, utilizing variables with a P-value < 0.2 obtained from univariable logistic regression analysis, including AA, age, hypertension, chronic renal failure, and heart failure. AA (odds ratio [OR]: 1.73, 95% confidence interval [CI]: 0.89-3.38, P=0.104), age (OR: 1.04, 95% CI: 0.99-1.10, P=0.099), hypertension (OR: 1.66, 95% CI: 0.82-3.33, P=0.155), chronic renal failure (OR: 1.82, 95% CI: 0.92-3.61, P=0.084), and heart failure (OR: 0.57, 95% CI: 0.27-1.21, P=0.145) were not found to be significantly associated with cumulative events in the multivariable logistic regression analysis. Conclusion: This study demonstrated that increased AA does not have a significant impact on intraprocedural and periprocedural complications of patients with new generation self-expandable valves implanted.Article Citation - WoS: 2Citation - Scopus: 2The Performance of the Naples Prognostic Score in Predicting One-Year Mortality and Major Adverse Cardiovascular Events After Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis(Polish Cardiac Soc, 2025) Aktan, Adem; Guzel, Tuncay; Kis, Mehmet; Coskun, Ferhat; Isik, Mehmet Ali; Aktan, Adem; Ertas, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri BölümüBackground: Existing risk scores for transcatheter aortic valve implantation (TAVI) may not fully capture patient complexity. Combining nutritional and inflammatory markers, the NPS (the NAPLES prognostic score) might improve outcome prediction. Aims: This study investigated the associations of the NPS with one-year mortality and major adverse cardiovascular events (MACEs) in TAVI patients. Material and methods:This retrospective analysis included 222 patients with severe aortic stenosis who underwent TAVI. The NPS was calculated based on the serum alb & uuml;min concentration, cholesterol concentration, lymphocyte/monocyte ratio, and neutrophil/lymphocyte ratio. The patients were subsequently categorized into two groups: the low-NPS group (NPS 0-2) and the high-NPS group (NPS 3-4). Results: A high NPS was significantly associated with increased one-year mortality (4.8% vs. 23.7%; P <0.001) and MACE rates (7.2% vs. 35.9%; P <0.001). Cox regression analysis demonstrated that a high NPS was an independent predictor of both mortality (HR, 5.94; 95% CI, 2.03-17.37; P = 0.001) and MACEs (HR, 5.09; 95% CI, 2.15-12.02; P <0.001). Conclusions: The NPS emerged as a potential predictor of long-term mortality and MACEs in TAVI patients. Further validation through larger, multicenter, studies is warranted.This research contributes valuable data on the role of the NPS in TAVI risk stratification.Article Citation - WoS: 0Citation - Scopus: 0Predictive Value of Nutritional Scores in Non-Valvular Atrial Fibrillation Patients: Insights From the After-2 Study(Elsevier Sci Ltd, 2025) Aktan, Adem; Guzel, Tuncay; Aktan, Adem; Kilic, Raif; Arslan, Bayram; Demir, Muhammed; Ertas, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri BölümüBackground and aim: Many scoring systems are used to evaluate malnutrition, but there is no consensus on which scoring system would be more appropriate. We aimed to investigate the effect of malnutrition in patients with non-valvular atrial fibrillation (NVAF) and to compare three scoring systems. Methods and results: A total of 2592 patients with non-valvular AF from 35 different centers in Turkey were included in this prospective study. All participants were divided into two groups: 761 patients who died and 1831 patients who were alive. The malnutrition status of all participants was evaluated with three scoring systems. The primary outcome was all-cause mortality. The mean age of the population was 68.7 +/- 11.1 years, and 55.5 % were female. According to Cox regression analysis, the geriatric nutritional risk index (GNRI) (HR = 0.989, 95 % CI: 0.982-0.997, p = 0.007), controlling nutritional status (CONUT) score (HR = 1.121, 95 % CI: 1.060-1.185, p < 0.001), and prognostic nutritional index (PNI) (HR = 0.980, 95 % CI: 0.962-0.999, p = 0.036) were found to be significant mortality predictors. ROC curve analysis indicated GNRI (AUC = 0.568), CONUT (AUC = 0.572), and PNI (AUC = 0.547) had moderate predictive values. Kaplan-Meier analysis showed that increasing the risk class based on GNRI (p < 0.001) and CONUT (p < 0.001) was associated with decreased survival, while PNI staging had no statistically significant effect (p = 0.266). Conclusions: Malnutrition, determined by three scoring systems, was found to be an independent predictor of all-cause mortality in NVAF patients. Nutritional examination may provide useful information for prognosis and risk stratification in patients with NVAF.