Description

Cardiology

Our Cardiology Department is a department where up-to-date diagnosis and treatment methods are applied in all areas of cardiology. Adult Cardiology has a coronary intensive care unit, a ward where patients undergoing coronary angiography are followed, a cardiology outpatient clinic, a cardiology laboratory where non-invasive examinations (ECG, effort test, echocardiography, rhythm holter and blood pressure holter) are performed.

Angiography

There are 2 angio units in our hospital and all arterial imaging procedures such as coronary angio (imaging of heart vessels), peripheral angio (imaging of leg and foot vessels), carotid angiography (imaging of carotid artery / carotid artery), renal angio (imaging of renal artery) are performed. .

Arm Angio (Radial Angiography)

It is an angiography procedure performed by placing the angio sheath from the radial artery in the wrist. It can be applied to patients with an angiography of 2 mm and above. What is the advantage of an angiography from the inguinal region? When angiography is performed from the groin area, it is required to lie on the back for 6 hours after the procedure and sandbag / weight / close pet application to the groin area. However, after arm angiography, the patient can easily stand up and be discharged home the same day. In addition, symptoms such as bleeding, swelling, and bruising in the groin area may rarely (4-5%) develop in angiography from the groin area. This risk is eliminated with angiography in the arm. Some patients cannot be intervened in the groin due to the occlusion of the veins in the groin area, and arm angioplasty is the only method in these patients. Strictures over 70 often cause symptoms and require intervention. First of all, the area of ​​the stenosis is reached with plastic tubes called catheters and very thin wires are passed through the stenosis and the balloon is inflated at the narrowest part by sliding the balloon over this wire. Afterwards, the balloon is taken back and the stent is advanced to the area of ​​stenosis and the stent is opened and inflated in the appropriate place.

What is a medicated stent? Why is it necessary?

Drugs that delay or seriously prevent the stent from narrowing over the years are placed on the stents with a number of different technologies. As the length of the stenosis in the heart vessel increases and the vessel becomes thinner, the probability of narrowing of the stent placed increases in the following years, for some patients, this rate reaches 30% for non-drug stents. This rate may decrease to 10% or less in medicated stents. All over the world, stent research that will reduce the possibility of re-narrowing to zero continues rapidly. Stents covered with different drugs and different metal braided stents are being tried. Unfortunately, he has not yet developed a perfect stent. However, it is a fact that much progress has been made compared to drug-free bare metal stents. Thin diameters of drug-coated stents are paid by the government, while those with a diameter of 3.5 mm or more are excluded from the government payment.

What is a fusible stent?

These stents are biologically highly absorbed and disappeared by the body within 2-3 years. Its advantage is that it does not create a permanent metal load in the vein. Even if it contracts again afterwards, since there is no metal part, it provides the opportunity to treat from scratch like a stenosis that has never been intervened before. The disadvantage is that they are expensive and not subject to government payments.

Pacemaker and shock device (pacemaker and ICD)

Pacemakers are devices that are used for different purposes as single-wire, double-wire and 3-wire. In some models, one of these cables also has a shock feature (ICD). The batteries are placed completely under the skin and are about the size of a matchbox. The size of those with a shock feature is about 2 matchboxes. All of the devices are activated when the heart needs it, and at other times they wait like insurance. Some of the batteries are activated when the heart rate, in other words, the pulse falls below 60 per minute. Those who have the feature of shocking usually step in when the heart rate rises above 170-180 / min and bring the heart rhythm and speed to normal. Three-wire batteries are used in some patients with heart failure, and they provide more harmonious and effective contraction of the heart. The batteries are placed under the skin after the skin is numbed with a painkiller needle and the patient is conscious during the procedure. When the process is over, the skin is closed by stitching 4-5 stitches. Which device will be attached to which patient is decided as a result of a careful examination of your cardiologist. All types of pacemakers and shock devices are installed in our hospital.

Mitral Balloon Valvuloplasty

It is a treatment option for patients with rheumatic mitral valve stenosis with shortness of breath due to the disease and limitation of daily activities, to give the patient time before surgery. It is preferred in patients whose valve structure is not excessively calcified and does not have a clot in the heart. The younger the patient’s age and the less calcareous the valve structure, the higher the chance of success. Valve rupture and severe mitral valve leakage during the procedure are one of the most important risks. In this case, the patient is directed to valve surgery. A hole is formed between the right and left auricles of the heart by advancing through the vein from the groin area, and through this hole, the narrowed rheumatic valve is reached and the valve is expanded. During the procedure, the patient is fully awake.

Congenital heart hole closure (ASD / VSD / PDA)

After the painkiller needle made from the groin area to the skin, the vein is entered into the heart and the hole is closed by opening the umbrellas or occluders in the area where the hole is located. Operation success is over 90% in selected cases.

Heart Catheterization

It is an important test to investigate the cause in cases of pulmonary hypertension (pulmonary hypertension). It is a procedure where resistance is not calculated after the actual and most accurate measurement of the pulmonary artery and the response of pulmonary artery pressure to drugs is evaluated in the angio laboratory (vasoreactivity test). After the pain relief applied to the skin from the groin area, the vein is entered into the right heart and the pulmonary artery, and both pressure measurement and blood gas analysis are performed from many areas where the catheter passes.

Cardiology outpatient services

In our outpatient clinic, the Blood Pressure Holter Device, which is used to diagnose hypertension in the most accurate way and to evaluate the treatment response, 24-hour rhythm holter for the detection of rhythm disorders, effort test in the diagnosis and evaluation of the effectiveness of the treatment in patients with suspected cardiovascular occlusion and heart failure, valvular disease, heart holes, heart membrane and heart muscle diseases, aortic enlargement and so on. All examinations such as echocardiography (heart ultrasound), which are indispensable in the diagnosis of many diseases, are performed.