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    A Rare Coronary Anomaly: Single Coronary Artery; Two Cases
    (2025) Ayhan, Selçuk; Köseoğlu, Cemal; Öncel, Can Ramazan
    We present two cases of a rare coronary anomaly—single coronary artery—identified incidentally during routine coronary angiography. Both patients presented with symptoms of chest pain and exertional angina. In both cases, the anomaly is located in the right sinus of Valsalva (R-1-A) and crosses the heart anterior to the right ventricle. (Figure 3) The first patient experienced significant stenosis in the proximal left anterior descending artery, which was successfully treated with percutaneous stent implantation. The second patient's chest pain was managed effectively with medical therapy alone. These cases highlight that a single coronary artery, often asymptomatic, can exist as a congenital anomaly in patients experiencing myocardial ischemia due to atherosclerotic coronary artery disease. Furthermore, they demonstrate that percutaneous coronary intervention, including stent placement, offers a promising treatment approach. In the literature, coronary artery bypass surgery should particularly be considered as a treatment option for these coronary anomalies. However, it has also been shown that in selected cases, percutaneous intervention or medical therapy can be viable alternatives.
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    Case Report: Tetris Ball In The Left Atrium
    (2025) Ayhan, Selçuk; Altun, Uğur
    A free-floating ball thrombus in the left atrium is a rare and serious medical problem that can cause fatal systemic emboli or block the flow of blood into the left ventricle, which usually ends in sudden death.This report discusses a case of a significant left atrial thrombus that was found to be free-floating in an enlarged left atrium. A 73-year-old male, who had experienced a cerebrovascular infarction and hemorrhage five days earlier, along with a history of chronic atrial fibrillation, was referred to the cardiology department to investigate the embolic cause. A transthoracic echocardiogram identified a free-floating ball thrombus. Thrombolytic therapy was not recommended because there were areas of bleeding within the cerebrovascular infarction and the patient had a high risk profile The individual, with several comorbid conditions, a Glasgow Coma Scale score of 8, and right-sided hemiplegia, was classified as high-risk by the cardiovascular surgery team. In spite of the potential for bleeding complications, treatment with warfarin and unfractionated heparin was started. Subsequent evaluations indicated that the thrombus did not diminish in size. We lost our patient due to progressive heart failure and cardiogenic shock while anticoagulant treatment was continuing. As a result, in such cases, it is important to determine the treatment according to the patient's general condition, glaskow coma score, embolization and the risk of fatal bleeding.
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    Predicting Postoperative Atrial Fibrillation Using HARMS2-AF Score
    (2024) Öncel, Can Ramazan; Köseoğlu, Cemal; Dagasan, Goksel; Çoner, Ali; Ayhan, Selçuk; Akkaya, Özgür; Karahan, Oğuz
    Background: Postoperative atrial fibrillation (POAF) remains a common complication after cardiac surgery. The ability to accurately identify patients at risk through previous risk scores is limited. This study aimed to evaluate the new HARMS2-AF risk score to pre- dict POAF after coronary artery bypass grafting (CABG) surgery. Methods: In this retrospective cohort study, we included 265 patients undergoing CABG surgery from 2022-2023. Data were obtained from the medical files of the patients and hospital records. Each patient was assigned a HARMS2-AF risk score. A univariate and multivariate regression analyses were done to analyze independent predictors of POAF. Results: Of 265 patients, 49 had postoperative atrial fibrillation. HARMS2-AF score was significantly higher in patients with POAF. Age, sleep apnea, left atrial diameter (LAd), and HARMS2-AF score were independently associated with POAF. A HARMS2-AF score ? 4.5 predicted POAF with 91% sensitivity and 64% specificity (AUC = 0.787, 95% CI = 0.731- 0.842, P < .001). Conclusion: The HARMS2-AF score is a strong predictor of atrial fibrillation (AF) develop- ment after isolated CABG surgery. It can be used as a novel stratification tool to estimate AF after cardiac surgery.