Browsing by Author "Ayabakan, Canan"

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Le-Compte Maneuver in Surgical Correction of Absent Pulmonary Valve. Does it Improve Severe Bronchial Compression?
(2017) Saritas, Bulent; Ozker, Emre; Sansoy, Ozlem; Sahin, Murat; Gumus, Burcak; Ayabakan, Canan; 28094129; P-4569-2015
Long-term outcomes in patients who underwent surgical correction for atrioventricular septal defect
(2018) Ayabakan, Canan; Sarisoy, Ozlem; Tokel, Kursad; Ozkan, Murat; Turkoz, Riza; Aslamaci, Sait; 30297581
Objective: The follow-up results of patients operated for atrioventricular septal defect (AVSD) during 1996-2016 at Baskent University are presented. Methods: Data obtained from hospital records consists of preoperative echocardiographic and angiographic details, age and weight at surgery, operative details, Down syndrome presence, postoperative care details, early postoperative and latest echocardiographic findings and hospitalization for reintervention. Results: A total of 496 patient-files were reviewed including 314 patients (63.4%) with complete and 181 (36.6%) with partial AVSD (48.4% of all patients had Down syndrome). Atrioventricular (AV) valve morphology was Rastelli type A in 92.2%, B in 6.5%, and C in 1.3% of patients. The operative technique used was single-patch in 21.6% (108), double-patch in 25.8% (128), and modified single-patch (Wilcox) in 52.5% (260) of patients. The follow-up time was 37.79 +/- 46.70 (range, 0-198) months. A total of 64 patients (12.9%) had a rrhythmias while in the intensive care unit; pacemaker was implanted in 12 patients. A total of 78 patients (15.7%) were treated for pulmonary hypertensive crisis. The early morbidity and mortality in the postoperative first month were calculated as 38% and 10%, and the late morbidity and mortality (>1 month) were calculated as 13.1% and 1.9%, respectively. The rate of reoperation in our cohort was 8.9%. Conclusion: Although the early morbidity and mortality are low in AVSD operations, the rate of reoperations for left AV valve insufficiency are still high. Although Down syndrome is not a risk factor for early mortality, the co-morbid factors, such as longer postoperative mechanical ventilator or inotropic support, lead to higher risk for morbidity. The frequency of pulmonary hypertension and consequent complications are also high.
Radiofrequency catheter ablation of left-sided accessory pathways via retrograde aortic approach in children
(2016) Ayabakan, Canan; Sahin, Murat; Celiker, Alpay; 27354861
Background: We aimed to analyze the results of retrograde aortic radiofrequency catheter ablation of left-sided accessory pathways in children. Methods: Between January 2010 and September 2014, 25 children who underwent left-sided accessory pathway ablation with a retrograde aortic approach were evaluated retrospectively. Results: The mean age of the patients was 11.09 +/- 3.71 years. Seventeen patients were male (68%). The mean procedure and fluoroscopy times were 71.54 +/- 21.05 min and 31.42 +/- 19.57 min, respectively. Radiofrequency energy was delivered with 41.38 +/- 15.32 W at 52.38 +/- 5.45 degrees C. Sixteen patients (64%) presented with manifest preexcitation and, 9 had concealed accessory pathways. The location of accessory pathway was left lateral in 16 patients, posteroseptal in 5, left anterolateral in 2, and left posterolateral and left posterior in the remaining 2. The acute success rate was 96%. The patients were followed for a mean of 16.68 +/- 18.01 months. There were 2 recurrences. No major complications were observed in the periprocedural period. One patient had groin hematoma, another one had transient severe headache and vomiting. Trivial mitral regurgitation was noted in a patient, which remained the same throughout follow-up. None of the patients developed new aortic regurgitation, pericardial effusion, or thrombi at the site of ablation. Conclusions: The retrograde aortic approach can be safely employed with a high success rate for ablation of left-sided accessory pathways in children. (C) 2016 Japanese Heart Rhythm Society. Published by Elsevier B.V.
Surgical Options in Complex Transposition of Great Arteries
(2016) Ayabakan, Canan; Saritas, Bulent; Ozker, Emre; Turkoz, Riza; Tokel, Kursad; 0000-0002-6759-1795; P-4569-2015; AAF-3253-2021
Background: In this study, we present our experience in selecting surgical approach for transposition of the great arteries and left ventricular outflow tract obstruction or aortic arch obstruction with ventricular septal defect and to report early and mid-term results. Methods: Between February 2007 and June 2012, a total of 18 patients (9 males, 9 females; median age 4.25 months; range, 12 days to 96 months) who were operated for transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction or aortic arch obstruction were retrospectively analyzed. Results: Cardiac pathologies were transposition of the great arteries, ventricular septal defect and coarctation of aorta in four patients; transposition of the great arteries, ventricular septal defect and valvular pulmonary stenosis in two patients, and transposition of the great arteries, ventricular septal defect, valvular or subsubvalvular pulmonary stenosis in 12 patients. Arterial switch operation with ventricular septal defect closure and left ventricular outflow tract obstruction procedures were performed in nine patients, two of which were modified Konno operations. The other operations were arterial switch operation with ventricular septal defect closure and arcus reconstruction in four patients, Rastelli operation in three patients, and Nikaidoh operation in two patients. Median cardiopulmonary bypass and cross-clamp times were 228.5 min and 107 min, respectively. The median length of stay in the intensive care unit was 102.5 hours (range, 28 to 765 hours), while the median duration of intubation was 40.5 hours (range 17 to 275 hours). All patients were discharged within median seven days (range 5 to 55 days). The median follow-up was 37.7 months (range, 15 days to 74 months). Two patients who underwent Rastelli operation died due to low cardiac output in the intensive care unit. At the final echocardiographic examination, the median left ventricular outflow tract gradient was 12.4 mmHg (range, 2 to 38 mmHg) in the patients operated for left ventricular outflow tract obstruction, whereas the median descending aorta gradient was 13.5 mmHg (range, 7.8 to 28 mmHg) in the patients with arcus reconstruction. Only one patient with bicuspid neoaortic valve and posterior septal malalignment was reoperated due to a left ventricular outflow tract gradient of 38 mmHg. Conclusion: Our study results suggest that arterial switch operation is a preferable alternative, if the left ventricular outflow tract obstruction is resectable. Intraventricular re-routing procedures may be the choice in selected patients. We believe that choosing the optimal surgical technique demands appreciation of the particular anatomic features in each individual patient.