Hasan Feray - Academia.edu (original) (raw)

Papers by Hasan Feray

Research paper thumbnail of Coronary-to-bronchial artery fistula with conventional and multi-detector computed tomography angiographic images

Hellenic journal of cardiology: HJC = Hellēnikē kardiologikē epitheōrēsē

A 64-year-old male patient with the risk factors of smoking and hypertension was admitted to our ... more A 64-year-old male patient with the risk factors of smoking and hypertension was admitted to our department with anginal symptoms. Coronary angiography showed significant stenotic lesions in the left main and left anterior descending coronary arteries. There was no ...

Research paper thumbnail of Severe tricuspid regurgitation in a patient receiving low-dose cabergoline for the treatment of acromegaly

The Journal of heart valve disease

Cabergoline, an ergot-derived dopamine receptor agonist, is used widely in the treatment of Parki... more Cabergoline, an ergot-derived dopamine receptor agonist, is used widely in the treatment of Parkinson's disease (PD) and hyperprolactinemia, but may cause heart valve fibrosis, retraction, and clinically significant regurgitation in PD patients. While cabergoline has been used at much lower doses in patients with hyperprolactinemia, controversy persists as to whether it may cause heart valve disease in this situation. Cabergoline is also used in acromegaly at doses similar to those used in hyperprolactinemia. The case is reported of a female patient with acromegaly who had been taking low-dose (0.5 mg/day) cabergoline for one year, and presented with signs and symptoms of right-sided heart failure. Echocardiography revealed a thickened and retracted tricuspid valve associated with severe tricuspid regurgitation and enlargement of the right-heart chambers. The morphology of the tricuspid valve was typical for cabergoline-related valvulopathy. Cabergoline may not be totally safe e...

Research paper thumbnail of Coronary-to-bronchial artery fistula with conventional and multi-detector computed tomography angiographic images

Hellenic journal of cardiology : HJC = Hellēnikē kardiologikē epitheōrēsē

A 64-year-old male patient with the risk factors of smoking and hypertension was admitted to our ... more A 64-year-old male patient with the risk factors of smoking and hypertension was admitted to our department with anginal symptoms. Coronary angiography showed significant stenotic lesions in the left main and left anterior descending coronary arteries. There was no ...

Research paper thumbnail of Anomalous Origin and Interarterial Course of Right Coronary Artery Associated with Angina and Proven Ischemia

International Journal of Angiology, 2014

origin of the RCA from the left sinus of Valsalva is an extremely rare anomaly found in approxima... more origin of the RCA from the left sinus of Valsalva is an extremely rare anomaly found in approximately 0.019% to 0.49% of patients undergoing coronary angiography. 1 An abnormal RCA origin may be either a benign and asymptomatic finding or a high-risk anatomical feature. Patients with the abnormal RCA origin may have a slit-like orifice and intramural or interarterial course (between the aorta and pulmonary artery). 2 The artery may be compressed, and acute ischemia may occur. 1,3 Moreover, an acute take--off angle and compression of the intramural segment narrowing the orifice may cause flow limitation. For this reason, such anatomic variants are considered potentially malignant. However, not all cases of the abnormal RCA origin have clinical implications because sudden cardiac death is rare in asymptomatic patients with this anomaly.

Research paper thumbnail of How should I treat an ostial thrombotic occlusion of the right coronary artery in the setting of an acute myocardial infarction?

EuroIntervention, 2012

ABSTRACT

Research paper thumbnail of Is Radial Access and Transradial Cardiac Catheterization Feasible without the Use of Any Vasodilator?

International Journal of Angiology, 2014

This is a "proof of concept" study to assess fe... more This is a "proof of concept" study to assess feasibility of transradial access without use of vasodilators. Radial artery spasm (RAS) is an important cause of patient discomfort and procedural failure with use of radial access. Vasodilators are routinely used to prevent RAS. However, the use of vasodilators may not be appropriate in substantial groups of patients. These include patients with myocardial infarction and low blood pressure who will benefit from radial access the most. No specific recommendations about use of vasodilators in these settings are stated on consensus documents on radial access. During a short period of shortage of verapamil in our country, 15 consecutive patients underwent cardiac catheterization by transradial route without the use of vasodilators. Procedural success, and pain perceived by the patients along with radial occlusion after the procedure were assessed. In 14 of the 15 patients, the procedure was completed successfully without the use of vasodilators. In one patient, RAS developed and the procedure could be completed after injection of verapamil. Mean pain score was 5.3 on a scale of 0 to 10. No radial occlusion was detected early after the procedure. In three of the patients, a reason that would otherwise preclude use of a vasodilator was identified. Radial access can safely and effectively be performed without the use of vasodilators. Consideration of this approach when use of vasodilators is not appropriate should be formally discussed by the interventional cardiology community.

Research paper thumbnail of Effectiveness of enoxaparin for prevention of radial artery occlusion after transradial cardiac catheterization

Journal of Thrombosis and Thrombolysis, 2010

The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (R... more The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (RA) occlusion after transradial access for diagnostic and interventional cardiac procedures. RA occlusion is a potential complication of transradial cardiac catheterization. Conventionally, unfractionated heparin is used for prevention of RA occlusion. Effectiveness of low molecular weight heparins for prevention of this complication has not been tested before. Fifty transradial catheterizations were performed for diagnostic and/or interventional cardiac procedures in 39 patients. All the patients received 60 mg enoxaparin through the radial sheath at the beginning of the procedure for prevention of RA occlusion. RA patency was evaluated by Doppler examination. Patients were assessed for postprocedural RA occlusion at discharge and 5.5 +/- 2.8 days follow-up. RA occlusion was detected after 2 of the 50 transradial accesses, yielding a RA occlusion rate of % 4. In this study we found a low rate of RA occlusion with use of enoxaparin during transradial access. Enoxaparin is safe and effective in transradial procedures with a RA occlusion rate comparable to use of unfractionated heparin.

Research paper thumbnail of Isolated cleft of the posterior mitral valve leaflet in a patient with Marfan syndrome

International Journal of Cardiology, 2010

Isolated cleft of the mitral valve is an uncommon congenital cause of mitral regurgitation. Most ... more Isolated cleft of the mitral valve is an uncommon congenital cause of mitral regurgitation. Most of the clefts involve the anterior leaflet and isolated clefts of the posterior leaflet have been anecdotally identified. We report a case of Marfan syndrome in whom an echocardiographic examination revealed a cleft in the posterior mitral leaflet. Marfan syndrome frequently involves the mitral valve causing mitral valve prolapse. Occurrence of a cleft may be an extension of its mitral valve involvement.

Research paper thumbnail of Demonstration of coronary-to-pulmonary fistula with MDCT and conventional angiography

International Journal of Cardiology, 2009

The coronary pulmonary fistulas are usually discovered incidentally during routine cardiac cathet... more The coronary pulmonary fistulas are usually discovered incidentally during routine cardiac catheterization after the development of atherosclerotic coronary artery disease. Here we present a 59-year-old man with anginal symptoms who was found to have two fistulas originating from the left coronary system and right coronary sinus and draining into the pulmonary trunk. We delineated the courses of the fistulas in detail using both of the imaging techniques of MDCT and conventional angiograhy.

Research paper thumbnail of Systolic Anterior Motion of the Mitral Valve in the Absence Left Ventricular Hypertrophy: Role of Mitral Leaflet Elongation and Papillary Muscle Displacement

Echocardiography, 2010

We report a 15-year-old patient who presented with exercise dyspnea and limitation of physical ac... more We report a 15-year-old patient who presented with exercise dyspnea and limitation of physical activity. Echocardiography revealed significant left ventricular outflow tract obstruction caused by systolic anterior motion (SAM) of the mitral valve. The wall thickness of the left ventricle was within normal limits. Elongation of the mitral leaflets and anterior displacement of the posteromedial papillary muscle were apparent in the echocardiographic examination. These two factors have been previously demonstrated to play a central role in the occurrence of SAM in patients with hypertrophic cardiomyopathy. The present case validates that such intrinsic abnormalities of the mitral valve can cause significant SAM even in the absence of left ventricular hypertrophy. (Echocardiography 2010;27:E36-E38)

Research paper thumbnail of Right coronary artery arising as a sidebranch from the left anterior descending artery: a single coronary ostium anomaly

Kardiologia Polska, May 1, 2010

We present a patient with abnormal origin of the right coronary artery from the left anterior des... more We present a patient with abnormal origin of the right coronary artery from the left anterior descending artery. The patient had chest pain probably related to myocardial ischemia. This anomaly is very rare and has only been reported in a few cases. The abnormal vessel had a rightward course following its take-off from the left anterior descending artery and remained anterior to the main pulmonary artery. There was no significant obstruction. The mechanism of myocardial ischemia remains unexplained.

Research paper thumbnail of Coronary-to-bronchial artery fistula with conventional and multi-detector computed tomography angiographic images

Hellenic journal of cardiology: HJC = Hellēnikē kardiologikē epitheōrēsē

A 64-year-old male patient with the risk factors of smoking and hypertension was admitted to our ... more A 64-year-old male patient with the risk factors of smoking and hypertension was admitted to our department with anginal symptoms. Coronary angiography showed significant stenotic lesions in the left main and left anterior descending coronary arteries. There was no ...

Research paper thumbnail of Severe tricuspid regurgitation in a patient receiving low-dose cabergoline for the treatment of acromegaly

The Journal of heart valve disease

Cabergoline, an ergot-derived dopamine receptor agonist, is used widely in the treatment of Parki... more Cabergoline, an ergot-derived dopamine receptor agonist, is used widely in the treatment of Parkinson's disease (PD) and hyperprolactinemia, but may cause heart valve fibrosis, retraction, and clinically significant regurgitation in PD patients. While cabergoline has been used at much lower doses in patients with hyperprolactinemia, controversy persists as to whether it may cause heart valve disease in this situation. Cabergoline is also used in acromegaly at doses similar to those used in hyperprolactinemia. The case is reported of a female patient with acromegaly who had been taking low-dose (0.5 mg/day) cabergoline for one year, and presented with signs and symptoms of right-sided heart failure. Echocardiography revealed a thickened and retracted tricuspid valve associated with severe tricuspid regurgitation and enlargement of the right-heart chambers. The morphology of the tricuspid valve was typical for cabergoline-related valvulopathy. Cabergoline may not be totally safe e...

Research paper thumbnail of Coronary-to-bronchial artery fistula with conventional and multi-detector computed tomography angiographic images

Hellenic journal of cardiology : HJC = Hellēnikē kardiologikē epitheōrēsē

A 64-year-old male patient with the risk factors of smoking and hypertension was admitted to our ... more A 64-year-old male patient with the risk factors of smoking and hypertension was admitted to our department with anginal symptoms. Coronary angiography showed significant stenotic lesions in the left main and left anterior descending coronary arteries. There was no ...

Research paper thumbnail of Anomalous Origin and Interarterial Course of Right Coronary Artery Associated with Angina and Proven Ischemia

International Journal of Angiology, 2014

origin of the RCA from the left sinus of Valsalva is an extremely rare anomaly found in approxima... more origin of the RCA from the left sinus of Valsalva is an extremely rare anomaly found in approximately 0.019% to 0.49% of patients undergoing coronary angiography. 1 An abnormal RCA origin may be either a benign and asymptomatic finding or a high-risk anatomical feature. Patients with the abnormal RCA origin may have a slit-like orifice and intramural or interarterial course (between the aorta and pulmonary artery). 2 The artery may be compressed, and acute ischemia may occur. 1,3 Moreover, an acute take--off angle and compression of the intramural segment narrowing the orifice may cause flow limitation. For this reason, such anatomic variants are considered potentially malignant. However, not all cases of the abnormal RCA origin have clinical implications because sudden cardiac death is rare in asymptomatic patients with this anomaly.

Research paper thumbnail of How should I treat an ostial thrombotic occlusion of the right coronary artery in the setting of an acute myocardial infarction?

EuroIntervention, 2012

ABSTRACT

Research paper thumbnail of Is Radial Access and Transradial Cardiac Catheterization Feasible without the Use of Any Vasodilator?

International Journal of Angiology, 2014

This is a "proof of concept" study to assess fe... more This is a "proof of concept" study to assess feasibility of transradial access without use of vasodilators. Radial artery spasm (RAS) is an important cause of patient discomfort and procedural failure with use of radial access. Vasodilators are routinely used to prevent RAS. However, the use of vasodilators may not be appropriate in substantial groups of patients. These include patients with myocardial infarction and low blood pressure who will benefit from radial access the most. No specific recommendations about use of vasodilators in these settings are stated on consensus documents on radial access. During a short period of shortage of verapamil in our country, 15 consecutive patients underwent cardiac catheterization by transradial route without the use of vasodilators. Procedural success, and pain perceived by the patients along with radial occlusion after the procedure were assessed. In 14 of the 15 patients, the procedure was completed successfully without the use of vasodilators. In one patient, RAS developed and the procedure could be completed after injection of verapamil. Mean pain score was 5.3 on a scale of 0 to 10. No radial occlusion was detected early after the procedure. In three of the patients, a reason that would otherwise preclude use of a vasodilator was identified. Radial access can safely and effectively be performed without the use of vasodilators. Consideration of this approach when use of vasodilators is not appropriate should be formally discussed by the interventional cardiology community.

Research paper thumbnail of Effectiveness of enoxaparin for prevention of radial artery occlusion after transradial cardiac catheterization

Journal of Thrombosis and Thrombolysis, 2010

The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (R... more The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (RA) occlusion after transradial access for diagnostic and interventional cardiac procedures. RA occlusion is a potential complication of transradial cardiac catheterization. Conventionally, unfractionated heparin is used for prevention of RA occlusion. Effectiveness of low molecular weight heparins for prevention of this complication has not been tested before. Fifty transradial catheterizations were performed for diagnostic and/or interventional cardiac procedures in 39 patients. All the patients received 60 mg enoxaparin through the radial sheath at the beginning of the procedure for prevention of RA occlusion. RA patency was evaluated by Doppler examination. Patients were assessed for postprocedural RA occlusion at discharge and 5.5 +/- 2.8 days follow-up. RA occlusion was detected after 2 of the 50 transradial accesses, yielding a RA occlusion rate of % 4. In this study we found a low rate of RA occlusion with use of enoxaparin during transradial access. Enoxaparin is safe and effective in transradial procedures with a RA occlusion rate comparable to use of unfractionated heparin.

Research paper thumbnail of Isolated cleft of the posterior mitral valve leaflet in a patient with Marfan syndrome

International Journal of Cardiology, 2010

Isolated cleft of the mitral valve is an uncommon congenital cause of mitral regurgitation. Most ... more Isolated cleft of the mitral valve is an uncommon congenital cause of mitral regurgitation. Most of the clefts involve the anterior leaflet and isolated clefts of the posterior leaflet have been anecdotally identified. We report a case of Marfan syndrome in whom an echocardiographic examination revealed a cleft in the posterior mitral leaflet. Marfan syndrome frequently involves the mitral valve causing mitral valve prolapse. Occurrence of a cleft may be an extension of its mitral valve involvement.

Research paper thumbnail of Demonstration of coronary-to-pulmonary fistula with MDCT and conventional angiography

International Journal of Cardiology, 2009

The coronary pulmonary fistulas are usually discovered incidentally during routine cardiac cathet... more The coronary pulmonary fistulas are usually discovered incidentally during routine cardiac catheterization after the development of atherosclerotic coronary artery disease. Here we present a 59-year-old man with anginal symptoms who was found to have two fistulas originating from the left coronary system and right coronary sinus and draining into the pulmonary trunk. We delineated the courses of the fistulas in detail using both of the imaging techniques of MDCT and conventional angiograhy.

Research paper thumbnail of Systolic Anterior Motion of the Mitral Valve in the Absence Left Ventricular Hypertrophy: Role of Mitral Leaflet Elongation and Papillary Muscle Displacement

Echocardiography, 2010

We report a 15-year-old patient who presented with exercise dyspnea and limitation of physical ac... more We report a 15-year-old patient who presented with exercise dyspnea and limitation of physical activity. Echocardiography revealed significant left ventricular outflow tract obstruction caused by systolic anterior motion (SAM) of the mitral valve. The wall thickness of the left ventricle was within normal limits. Elongation of the mitral leaflets and anterior displacement of the posteromedial papillary muscle were apparent in the echocardiographic examination. These two factors have been previously demonstrated to play a central role in the occurrence of SAM in patients with hypertrophic cardiomyopathy. The present case validates that such intrinsic abnormalities of the mitral valve can cause significant SAM even in the absence of left ventricular hypertrophy. (Echocardiography 2010;27:E36-E38)

Research paper thumbnail of Right coronary artery arising as a sidebranch from the left anterior descending artery: a single coronary ostium anomaly

Kardiologia Polska, May 1, 2010

We present a patient with abnormal origin of the right coronary artery from the left anterior des... more We present a patient with abnormal origin of the right coronary artery from the left anterior descending artery. The patient had chest pain probably related to myocardial ischemia. This anomaly is very rare and has only been reported in a few cases. The abnormal vessel had a rightward course following its take-off from the left anterior descending artery and remained anterior to the main pulmonary artery. There was no significant obstruction. The mechanism of myocardial ischemia remains unexplained.