Bioprosthetic valves have risk of gradual valve degeneration and dysfunction in follow-up period. In this case report, we describe a 72-year-old man who suffered from severe transvalvular mitral valve regurgitation due to isolated rupture of the bioprosthetic mitral valve without significant degeneration, calcification and thickness. We would like to emphasize this rare prosthetic valve-related complication in a 10-year-old bioprosthetic valve.

Herein we present a case of concomitant congenital anomalies with an iatrogenic defect. The female patient underwent a percutaneous mitral balloon valvuloplasty due to rheumatic mitral stenosis. Unfortunately, an iatrogenic atrial septal defect (ASD) occurred and also, partial anomalous pulmonary venous return was observed at post-procedure evaluation. The patient had severe symptoms and the right heart chambers were dilated on imaging. But perhaps, the most crucial point was that the patient was planning a pregnancy. After a difficult and patient-involved decision process, the patient underwent to successful robotic surgery for iatrogenic ASD and partial anomalous pulmonary venous return. After operation, the patient was asymptomatic and right heart chambers normalized.

Objective: Indications and appropriateness of aspirin use have not been well investigated in Turkey. Therefore, the aim of this study is to investigate the prescription patterns and appropriateness of aspirin in a real-world clinical setting. Methods: The ASSOS study is a cross-sectional, multicenter registry involving consecutive cardiology patients who were using aspirin. Patients were divided into two groups according to the use of aspirin; primary prevention and secondary prevention group. The indication of aspirin use was evaluated according to 2016 the European Society of Cardiology (ESC) and 2016 the United States Preventative Services Task Force (USPTF) guidelines in the primary prevention group. Results: A total of 5007 patients (mean age 62.15± 11.05, 39% female) were enrolled. The primary prevention group included 1132 (22.6%) patients and the secondary prevention group included 3875 (77.4%) patients. Of the 1132 patients, inappropriate use of aspirin was determined in 100% of the patients according to the ESC guidelines, and 71 % of the patients according to the USPTF guidelines. Conclusion: Although there are considerable differences between the USPTF and the ESC guidelines with respect to recommendations for aspirin use in primary prevention, inappropriate use of aspirin in Turkey is frequent in real-world practice for both guidelines.

Cogan syndrome is an autoimmune disorder characterized with ocular and vestibular symptoms and only minority (less than 15%) of patients suffer from systemic disease which is explained by autoimmuune vasculitis.Cardiovascular involvement of Cogan syndrome is rare and  effects mostly subclavian and carotid arteries, aortic valve or aorta.Mitral valve involvement is rare. Below, we report a case with mitral valve involvement and Cogan syndrome. 39 year old male patient had admitted to our hospital with shortness of breath. He had history of previous aortic valve implantation in 2012. His transthorasic echocardiography demonstrated massively thickened mitral leaflets as well as moderate to severe mitral regurgitation.Transoesaphageal echocardiography revealed moderate to severe mitral regurgitation, severe thickening in both mitral leaflets and and mild restriction in leaflet motions.. Surgery was decided in case progressive dyspnea develops. Cogan syndrome is a vasculitis which effects medium sized arteries and aortic valve. Mitral valve involvement is rare. Differential diagnoses , as well as using certain medical treatments and rheumatic valve disease, were ruled out. This case is one of the rare examples of Cogan syndrome with mitral valve thickening.