Ibrahim Akin

By Ibrahim Akin, Uzair Ansari and Christoph A. Nienaber

An aging western and oriental population coupled with breakthrough advances in modern diagnostic imaging modalities has evoked renewed interest in the hitherto underdiagnosed acute and chronic diseases of the aorta, which also include aortic aneurysm and aortic dissection. Although classical surgical strategies still dominate the clinical management of acute and chronic pathologies of the ascending aorta and the proximal arch region, the emergence of novel endovascular concepts has offered an interesting therapy alternative for the treatment of descending aortic pathology in suitable patients and is highly likely to evolve as the primary treatment strategy in majority of the cases. Moreover, the use of hybrid approaches combining surgical head-vessel debranching and interventional stent-graft implantation in an attempt to improve clinical outcome in aortic arch pathologies has helped avoid the high risk of open arch repair or complete replacement. Notwithstanding these recent advancements, the complex nature of the underlying vascular disease still dictates that the proposed management of every diagnosed patient is discussed in a team constituting cardiologists, cardiac surgeons, anesthesiologists, and radiologists, with the conceptualization of individualized therapeutic strategies and conducted in a center with significant surgical and endovascular experience.

Part of the book: Aortic Aneurysm

By Mustafa Yildiz, Dogac Oksen and Ibrahim Akin

Stent thrombosis is an uncommon but serious complication that causes sudden death or myocardial infarction (MI). A large MI, especially with ST elevation, can cause cardiogenic shock and pose a significant incidence of morbidity and mortality. Largeness of ischemic territory is the main reason that causes cardiogenic shock. The fundamental treatment strategies are immediate coronary revascularization and perfusion support to avoid end organ damage with medically or mechanical in intensive care units. The prevention, incidences, mechanisms, management, and clinical impacts of cardiogenic shock discussed under this topic.

Part of the book: Interventional Cardiology

By Michael Behnes, Philipp Kuche, Ibrahim Akin and Kambis Mashayekhi

Acute myocardial infarction and coronary artery disease (CAD) are the most common causes for the development of malignant arrhythmia often leading to cardiogenic shock and cardiac arrest. Structural heart disease represents the main pathology in older patients, whereas young adults mostly suffer from cardiomyopathies and channelopathies. This book chapter delineates modern interventional therapies for patients with cardiogenic shock or aborted cardiac arrest. Epidemiological data on the incidence of malignant arrhythmia depending causing cardiac arrest depending on the presence or absence of CAD and myocardial infarction are presented. Realistic difficulties within clinical decision-making are counterbalanced for and against an early, aggressive and invasive therapeutic approach including early coronary angiography with percutaneous coronary intervention (PCI), targeted temperature management and mechanical cardiac assist devices, depending on the individual clinical presentation and underlying cardiac arrhythmia.

Part of the book: Myocardial Infarction