Browsing by Author "Celik, Mehmet"

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Alternate Approach to Hypoplastic Left Heart Syndrome Stage 1 Surgery
(2021) Celik, Mehmet; Ozkan, Murat; 0000-0002-5018-0068; 32841624; AAT-2031-2021
Hypoplastic left heart syndrome is almost always fatal in neonates unless it is palliated surgically. The conventional Norwood procedure with a Blalock-Taussig shunt or a Sano modification and a hybrid approach with branch pulmonary artery banding and ductal stenting are common surgical options. An alternate technique with a different strategy to restore pulmonary blood flow is described in this report. (C) 2021 by The Society of Thoracic Surgeons
Comparison of Surgical Techniques Used in Ventricular Septal Defect Closure
(2023) Celik, Mehmet; Aygun, Fatih; Gunaydin, Asim Cagri; Gokdemir, Mahmut; Cindik, Nimet; 0000-0002-5018-0068; 36592069; AAT-2031-2021
Introduction: We compared transatrial closure, tricuspid valve septal detachment, and tricuspid valve chordal detachment techniques for ventricular septal defect (VSD) closure. Methods: Patients who had VSD closure with three different techniques in our clinic between September 2016 and December 2020 were retrospectively reviewed. A total of 117 patients were included in the study. The patients were divided into three groups: group 1, classical transatrial closure; group 2, closure with tricuspid valve septal detachment; and group 3, closure with tricuspid valve chordal detachment. The groups were evaluated by serial transthoracic echocardiography (preoperative, postoperative 1st day, postoperative 1st month). Cardiac rhythm checks and recordings were performed. Results: No residual VSD was observed in early or late periods in any of the groups whose VSD closure was performed with the three different techniques. No severe tricuspid regurgitation (TR) was detected during the early and late postoperative periods of all operating procedures. When the groups were compared in terms of early/late TR after the operation (without TR+trace amount of TR and mild TR+moderate TR were compared), no statistically significant difference was found (P>0,05; P=0,969 and P>0,05; P=0,502). Conclusion: In this study, we found no statistically significant difference between three VSD closure techniques in terms of early TR, late TR, residual VSD, and permanent atrioventricular complete block during postoperative period. We hope that our results will be supported by the results of researches that are being made about this subject in large series.
Hybrid approach: an alternative prior to corrective surgery in a patient with arch hypoplasia and complete atrioventricular septal defect
(2018) Celik, Mehmet; Gokdemir, Mahmut; Cindik, Nimet; Ozkan, Murat; 32082782
The hybrid approach is mostly preferred in patients with hypoplastic left heart syndrome or univentricular physiology. Here, the hybrid approach is applied as a palliative procedure prior to corrective surgery in a patient with complete atrioventricular septal defect associated with arcus hypoplasia and results are discussed according to the literature.
New Approach in Stage 1 Surgery for Hypoplastic Left Heart Syndrome: Preliminary Outcomes
(2023) Celik, Mehmet; Gokdemir, Mahmut; Cindik, Nimet; Gunaydin, Asim C.; Aygun, Fatih; Ozkan, Murat; 0000-0002-5018-0068; 0000-0002-5676-2747; 36004405; AAT-2031-2021; N-4174-2014
Objectives: We present the short-term results of an alternative method in stage 1 surgery for hypoplastic left heart syndrome. Methods: Data of 16 consecutive patients who were treated with the novel method in our clinic between February 2019 and March 2021 were analysed retrospectively. Preoperative data and postoperative follow-up were recorded. Results: Of the 16 operated patients, 12 were diagnosed with hypoplastic left heart syndrome, while four were diagnosed with hypoplastic left heart syndrome variants. Seven patients died during early postoperative period. One patient died at home waiting stage 2 surgery. Three patient underwent stage 2 surgery. Pulmonary artery reconstruction was performed in one patient due to left pulmonary artery distortion. Conclusions: We believe that our method can be an effective alternative in the surgery of hypoplastic left heart syndrome and its variants. It is hoped that with increasing number of studies and more experience better outcome will be achieved.
Pleuropericardial Window Prevents Pericardial Effusion Following Surgical Atrial Septal Defect Closure
(2022) Ozkan, Murat; Beyazpinar, Deniz Sarp; Celik, Mehmet; Gunaydin, Cagri; 35943313
Background: Pericardial effusion occurs frequently after surgical atrial septal defect closure. This complication carries the risk of development of cardiac tamponade and death. It is also the responsibility of the hospital for readmissions. Any measure in preventing the development of pericardial effusion is of paramount importance. In this report, our objective was to demonstrate the protective effect of creating a pleuropericardial window against the development of postsurgical pericardial effusion. Methods: Hospital records of all patients who underwent surgical atrial septal defect closure between January 2015 and December 2020 were reviewed. Patients were divided into 2 groups according to the creation of right/left pleuropericardial window during surgical ASD closure. There were 45 patients in group I in which a right pleuropericardial window was done, and 85 patients constituted group II in which pericardium was left intact. Results: None of the 45 patients in group I developed pericardial effusion, while 15 of 85 patients in group II developed pericardial effusion (P =.001). Ten patients developed more than mild pericardial effusion which required medical treatment, while 5 patients had to be re-hospitalized because of massive pericardial effusion and effusions were managed by percutaneous drainage. Conclusions: The creation of a right pleuropericardial window resulted in a safe postoperative recovery after surgical atrial septal defect closure in all patients with the development of no pericardial effusion. No adverse effect of the creation of a pleural communication was noted.
Risk Factors for and Incidence of Hospital-Acquired Infections After Cardiac Surgery in Children with Congenital Heart Disease: A Single Center Experience
(2023) Cindik, Nimet; Gokdemir, Mahmut; Celik, Mehmet; Gunaydin, Asim Cagri; 0000-0001-8544-0125; 37853968; AAD-9425-2021
Background. The epidemiology of hospital-acquired infections (HAIs) has been less well studied in critically ill children in pediatric cardiothoracic intensive care units. This study aimed to investigate independent risk factors for and incidence of HAIs after cardiac surgery in children with congenital heart disease (CHD).Methods. Our study included 574 patients who underwent congenital heart surgery and were followed up in the cardiothoracic intensive care unit between September 2016 and December 2020. All patients were divided into four groups according to age: 0-1 months, 1-6 months, 6-12 months, and 1-18 years, and into two subgroups according to HAI development.Results. The patients' median age and weight at surgery were 3.28 (interquartile range [IQR]): 0.43-8.1) months and 4.34 (IQR: 4.34-6.69) kg, respectively. HAIs and infection-related deaths were observed in 223 and 21 patients, respectively. Age at surgery, weight at surgery, concomitant syndromes and immunodeficiency status, presence of cyanotic heart disease, intubation, and use of antibiotics during hospitalization were statistically significant between the two groups with and without infection (p<0.05). In logistic regression analysis, surgical weight <5 kg (odds ratio [OR]: 2.55; 95% confidence interval [CI]: 1.56-4.17; p <0.001), preoperative mechanical ventilation (OR: 2.0; 95% CI: 1.26-3.12; p=0.003), complexity of cardiac surgery according to the risk-adjusted congenital heart surgery classification score 3 (OR: 3.13; 95% CI: 1.24-7.92; p=0.016), presence of an concomitant syndrome (OR: 1.56; 95% CI: 1.02-2.88; p=0.040), age (OR: 1.01; 95% CI: 1.01-1.04; p=0.044) were independent risk factors for HAIs after cardiac surgery in children with CHD.Conclusions. In this study, younger age, presence of an associated syndrome, preoperative mechanical ventilation, and weight less than 5 kg were found to be independent risk factors for HAI after cardiac surgery in children with CHD.
Sternotomy with electrocautery and sternal wound infection in congenital heart surgery in patients under 1 year of age
(2021) Celik, Mehmet; Aygun, Fatih; Ozkan, Murat; 33896040
Objective The present study aimed to compare the rate of wound site infection in patients <1 year of age who underwent sternotomy using electrocautery, a routinely performed procedure in our clinic, with those reported in the literature. Methods This double-center study included patients In our study, seven patients developed SSI, which was superficial in six (1.3%) patients and in the form of mediastinitis in one (0.2%) patient. Conclusion Sternotomy with electrocautery, which we consider an easy and safe method, was also not found to be statistically different from the other methods in terms of SWI.
Vasoactive Inotropic Score for Predicting Pediatric Tracheostomy
(2022) Silahli, Musa; Tekin, Mehmet; Celik, Mehmet
Background: Although tracheostomy is not performed as frequently as in adults, it is also used in children. There is no clear consensus on timing and risk factors, especially in early infancy and in cases who underwent cardiac surgeries. In the early infancy period, pediatric cardiac surgery patients have to receive an inotropic agent after the cardiac surgery due to poor general condition or hemodynamic instability. As a result of prolonged intubation, tracheostomy is required to be performed in some of these patients. Objectives: The present study aimed to investigate the relationship between vasoactive inotropic scores (VIS) and tracheostomy in pediatric cardiac surgery patients. Methods: A total of 47 patients, 21 with tracheostomy and 26 without tracheostomy, who underwent cardiac surgery were included in this retrospective study. The VIS and inotrope score (IS) values were calculated and recorded hourly for 48 h postoperatively. Scores were calculated by multiplying the inotropes infusion rate of the patients with certain coefficients. It was attempted to determine objective formalized models and cut-off values that may benefit the relationship between VIS values and tracheostomy. Results: The median weight was 3,630 g (range, 2,040-13,400), and the median age was 69 days (range, 1-1,081) on the surgery day. The majority (93.6%) of the patients were aged < 1 year. Preoperative C-reactive protein measurements were significantly higher by 50% in patients who underwent tracheostomy (P=0.005). The albumin levels in the tracheostomy group (TG) were low, although not significantly (P=0.057). The VIS values of TG had 50% higher values than the non-tracheostomy group (NTG) (P<0.001). In addition, formula 1 predicted with 57% accuracy that a tracheostomy could be performed (VIS =18.170-0.170* HOUR; P < 0.001), and formula 2 predicted with 72% accuracy that a tracheostomy could not be performed (VIS =17.170-0.170* HOUR; P < 0.001). Hospital stay (P<0.001), mechanical ventilation duration (P<0.001), and the number of ongoing intubation on the 7th day post-surgery were significantly higher in TG. Conclusion: After pediatric cardiac surgery, VIS values can predict tracheostomy status and help intensive care professionals make decisions.