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    Effect of Coronary Tortuosity on Exercise Stress Test
    (Istanbul Training & Research Hospital, 2020) Alsancak, Yakup; Gurbuz, Ahmet Seyfeddin; Ozcelik, Abdullah; Icli, Abdullah
    Introduction: Coronary tortuosity (CT) is a common anatomical finding during coronary angiography (CA); however, its aetiology and clinical importance have not been clearly defined. We aimed to evaluate the effect of the presence or severity of CT and effect of the sigma-shaped right coronary artery (RCA) on the exercise stress test (EST). Methods: The study included 175 patients who underwent CA due to cardiac symptoms and positive EST and had no obstructive coronary artery disease in a single centre between 2017 and 2018 June. The patients were divided into two groups: Group 1, patients with CT (n=88), and group 2, patients without CT (n=87). The patients were also categorised as low and moderate-to-high risk based on Duke treadmill score (DTS). Results: The running distance and DTS were lower, and the rate of sigma-shaped RCA was higher in the CT group (p<0.006). The DTS was lower (p=0.024) in the presence of tortuosity in the left anterior descending coronary artery and negatively influenced as the number of coronary arteries affected by tortuosity increased (p<0.001). Based on the DTS score, patients with moderate-to-high risk have a higher number of vessels affected by tortuosity, involvement of left anterior descending coronary artery, and proportion of sigma-shaped RCA (p<0.001). Conclusion: In the presence of CT, the rate of positivity is significantly higher, and the DTS is lower in the stress test.
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    A rare echocardiographic image of aortic prosthetic valve endocarditis complicated with paravalvular abscess, pseudoaneurysm and aorto-right atrial fistula
    (Wiley, 2018) Gurbuz, Ahmet Seyfeddin; Alsancak, Yakup; Ozcelik, Abdullah; Ozer, Sumeyye Fatma; Duzenli, Mehmet Akif
    Early infectious endocarditis (IE) occurs in 3% of prosthesis in the first 12months. Early IE is more aggressive than late prosthetic valve endocarditis. Mortality remains high, despite combined medical and surgical treatment. We present a case of early IE in aortic prosthetic valve complicated with paravalvular abscess, pseudoaneurysm and aorto- right atrial fistula.