Person: MUTLU, BÜLENT
Loading...
Email Address
Birth Date
Research Projects
Organizational Units
Job Title
Last Name
MUTLU
First Name
BÜLENT
Name
5 results
Search Results
Now showing 1 - 5 of 5
Publication Metadata only Prevalence of Coronary Artery to Pulmonary Artery Collaterals in Patients with Chronic Thromboembolic Pulmonary Hypertension: Retrospective Analysis from a Single Center(GEORG THIEME VERLAG KG, 2018) KEPEZ, ALPER; Kepez, Alper; Mutlu, Bulent; Paudel, Ashok; Ileri, Cigdem; Atas, Halil; Yildizeli, BedrettinBackground Our aim was to determine the prevalence of coronary artery-pulmonary artery collaterals in patients with chronic thromboembolic pulmonary hypertension (CTEPH) by retrospectively evaluating coronary angiograms of eligible consecutive patients who had undergone pulmonary endarterectomy (PEA). We also aimed to evaluate predictors and potential clinical associates of these collaterals. Methods Coronary angiograms of 83 consecutive CTEPH patients who had undergone coronary angiography before PEA operation between January 1, 2012 and June 1, 2015 were retrospectively evaluated for presence of coronary artery-pulmonary artery collaterals. Medical records of all patients were also retrospectively reviewed for demographic information, cardiovascular risk factors, preoperative right heart catheterization reports, operation reports, and follow-up data. Data of CTEPH patients with coronary artery-pulmonary artery collaterals were compared with data of CTEPH patients without such collaterals. Results There were 15 patients (18.1%) with definite and 4 patients (4.8%) with probable coronary artery-pulmonary artery collaterals among the study population. CTEPH patients with collaterals had higher preoperative pulmonary artery pressures, higher pulmonary vascular resistance (PVR) and lower cardiac index values compared with CTEPH patients without collaterals. However, CTEPH patients with collaterals displayed higher amount of reduction in PVR after PEA compared with patients without collaterals. There were no significant differences between groups regarding incidence of reperfusion injury or mortality. Conclusion Prevalence of coronary artery-pulmonary artery collaterals seems to be increased in our CTEPH patients compared with the general population. The presence of coronary artery-pulmonary artery collaterals is often combined with proximal disease with the possibility of increased reduction of PVR after PEA operation.Publication Metadata only Outcomes of Patients with Behcet's Syndrome after Pulmonary Endarterectomy(GEORG THIEME VERLAG KG, 2018) YILDIZELİ, BEDRETTİN; Yildizeli, Sehnaz Olgun; Yanartas, Mehmed; Tas, Serpil; Direskeneli, Haner; Mutlu, Bulent; Ceyhan, Berrin; Yildizeli, BedrettinBackground Behcet's syndrome (BS) is a multisystem disorder and is not known as a risk factor for chronic thromboembolic pulmonary hypertension (CTEPH), for which the treatment of choice is pulmonary endarterectomy (PEA). The aim of this study was to review our experience in the surgical treatment of CTEPH in patients with BS. Methods Data were collected prospectively for consecutive patients with BS who underwent PEA over a 6-year period. Results We identified nine patients (seven males, two females, mean age: 34.79.9 years) with BS. The mean disease duration before PEA was 88.0 +/- 70.2 months. All patients but one received immunosuppressive therapy before the surgery. Exercise-induced dyspnea presented symptoms in six patients. One patient had associated intracardiac thrombosis. PEA was bilateral in five patients, unilateral in three, and lobar in one. No perioperative mortality was observed; however, one patient died four weeks after PEA due to massive hemoptysis. Morbidity was observed in two patients. The systolic pulmonary artery pressure fell significantly from 59.0 +/- 22.7mm Hg to 30.0 +/- 6.5mm Hg after surgery ( p =0.031). Pulmonary vascular resistance also improved significantly from 611.8 +/- 300.2 to 234.7 +/- 94.9 dyn/s / cm (5) ( p =0.031). After a median follow-up of 29.4 months, all patients improved to the New York Heart Association (NYHA) functional class I and II. Conclusion Patients with BS may suffer recurrent pulmonary embolism and develop CTEPH. In patients who do not respond to anticoagulation or immunosuppressive therapy, PEA may be a therapeutic option when thrombotic lesions are surgically accessible. Due to the high risk of perioperative mortality, the procedure should be undertaken in centers with experience.Publication Open Access Effect of pulmonary endarterectomy on six-minute walking test and echocardiography in the early stage(TURKISH SOC CARDIOLOGY, 2016) YILDIZELİ, BEDRETTİN; Kivrak, Tarik; Durmus, Erdal; Sunbul, Murat; Yildizeli, Bedrettin; Mutlu, BulentObjective: Pre- and postoperative changes in echocardiographic parameters and results of 6-minute walking test (6-MWT) were investigated in the present study. Methods: Seventy-six patients (32 males, 44 females; mean age 45.9 +/- 15.1 years) were included. Before and after surgery, 6-MWT and echocardiography were performed. Changes in postoperative parameters were compared to basal walking test and other basal parameters. Results: Distance covered in 6-MWT significantly increased after surgery (p<0.001). Significant decrease in right ventricular diameter and pressure, and significant increase in left ventricular diameter were also observed. While changes in ejection fraction (EF) were not significant, significant reduction in systolic pulmonary artery pressure (sPAP) and tricuspid regurgitation were observed. No statistically significant correlation was observed between baseline 6-MWT results and echocardiographic parameters. Conclusion: The present study was the first to investigate the correlation between baseline 6-MWT results and right ventricular echocardiographic parameters. Myocardial performance index (MPI) and TAPSE were important parameters in follow-up after pulmonary endarterectomy. Improvement in quality of life parameters was also important.Publication Metadata only Evaluation of Improvement in Exercise Capacity after Pulmonary Endarterectomy in Patients with Chronic Thromboembolic Pulmonary Hypertension: Correlation with Echocardiographic Parameters(GEORG THIEME VERLAG KG, 2014) KEPEZ, ALPER; Kepez, Alper; Sunbul, Murat; Kivrak, Tarik; Eroglu, Elif; Ozben, Beste; Yildizeli, Bedrettin; Mutlu, BulentBackgroundThe study evaluates the alterations in exercise capacity of chronic thromboembolic pulmonary hypertension (CTEPH) patients after pulmonary endarterectomy (PEA) and investigates the echocardiographic parameters associated with the degree of functional recovery. MethodsThirty consecutive patients with the diagnosis of CTEPH (17 males; mean age, 45.915.1 years) who had been referred for PEA operation were included in the study. Each patient underwent transthoracic echocardiography and 6-minute walk test (6-MWT) before and 6 months after PEA. ResultsAfter PEA, 6-MWT distances significantly increased (242.8 +/- 112.8 m vs. 423.6 +/- 89.1 m, p<0.001), whereas systolic pulmonary artery pressures and right ventricular dimensions significantly decreased (86 +/- 25.1mm Hg vs. 41.9 +/- 15.6mm Hg, p<0.001 and 42.1 +/- 10.1mm vs. 35.3 +/- 5.6mm, p<0.001, respectively). Magnitude of change in 6-MWT distance (-6-MWT) was found to be correlated with concomitant change in tricuspid annular plane systolic excursion and left ventricular myocardial performance index (r: 0.518, p: 0.004 and r: -0.385, p: 0.043, respectively). Linear regression analysis revealed preoperative 6-MWT distance as an independent negative predictor of delta-6-MWT (beta: -0.89, t: -3.97, p: 0.001). ConclusionCTEPH patients with more severely depressed exercise capacity at baseline displayed relatively greater degree of functional recovery after PEA in our study. Improvement in functional capacity was found to be correlated with improvement in parameters reflecting right ventricular functions rather than improvement in pulmonary artery pressure after PEA operation.Publication Metadata only Extracellular matrix collagen biomarker levels in patients who underwent pulmonary endarterectomy(2023-04-01) OLGUN YILDIZELİ, ŞEHNAZ; MUTLU, BÜLENT; YILDIZELİ, BEDRETTİN; Zengin A., Kalkan R., Aydin K. Y., OLGUN YILDIZELİ Ş., MUTLU B., Karakoc A. Z., Tas S., Sunar H., Kilic U., Yanartas M., et al.OBJECTIVES: The role of extracellular matrix collagen biomarkers in chronic thromboembolic pulmonary hypertension (CTEPH) is not well known. Our goal was to investigate the matrix metalloproteinase (MMP)-2 and -9 protein levels in patients with CTETH.