Browsing by Author "Oktay, Ayla"

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A case of neonatal arterial thrombosis mimicking interrupted aortic arch
(2015) Gursu, Hazim Alper; Varan, Birgul; Oktay, Ayla; Ozkan, Murat; 26265897
Neonatal arterial thrombosis is a very rare entity with clinical findings resembling coarctation of aorta or interrupted aortic arch. A two day-old male newborn was admitted to another hospital with difficulty in sucking and sleepiness. On echocardiographic examination, a diagnosis of interrupted aortic arch was made and he was treated with prostoglandin E2. On physical examination, on admission to our center, the feet were bilaterally cold. The pulses were not palpable and there were ecchymotic regions in the lower extremities. Echocardiography ruled out interrupted aortic arch. Computerized tomographic angiography revealed a large thrombosis and total occlusion of the abdominal aorta. Since there was no response to treatment with tissue plasminogen activator, we performed thrombectomy. Homozygous Factor V Leiden and Methylenetetrahydrofolate reductase mutations were found in this patient. Neonatal aortic thrombosis which is observed very rarely but which is fatal should be considered in the differential diagnosis of coarctation of aorta and interrupted aortic arch.
Çocuklarda açık kKalp ameliyatı sonrası erken dönemde gelişen ritim bozukluklarının değerlendirilmesi
(Başkent Üniversitesi Tıp Fakültesi, 2013) Oktay, Ayla; Varan, Birgül
Ritim bozuklukları açık kalp cerrahi sonrası erken dönemde sık görülmekte ve önemli komplikasyonlara yol açmaktadır. Bu çalışmada çocuk yaş grubunda kalp cerrahisi geçiren hastalarda erken postoperatif dönemde gelişen aritmilerin insidans, risk faktörleri ve sonuçlarının belirlenmesi amaçlanmıştır. Pediatrik hastalarda yapılmış benzer çalışmalardan farklı olarak; aritmi tanı ve tiplendirmesi için yüzeyel EKG’ye ek olarak intrakardiyak EKG kullanılmıştır. Çalışmaya Ocak 2011-Aralık 2011 tarihleri arasında konjenital kalp hastalığı nedeniyle açık kalp cerrahisi geçiren ve Çocuk Kardiyoloji ve Kalp Damar Cerrahisi Yoğun Bakım Ünitesinde izlenen pediatrik hastalar (n=326) alındı. Aritmi grubunda 46 hasta vardı. Kontrol grubu olarak aynı dönemde opere edilen ve ritim problemi olmayan hastalar (n=280) seçildi. Tüm hastalar yaş, cinsiyet, boy ve vücut ağırlığı, kardiyopulmoner bypass süresi, aort klemp zamanı, cerrahi süresi, hipotermi derecesi; aritmisi olan hastalar aritmi tipi, aritmi sırasındaki vücut sıcaklığı, kan glukoz ve elektrolit seviyeleri, asid-baz durumu, tedaviler ve sonuçları açısından değerlendirildi. Aritmi insidansı %14.2 bulundu. En sık karşılaşılan aritmi tipi %4.2 oranı ile atriyal taşikardi idi. Tam AV blok %3.3, JET %2.1, sinüs düğüm disfonksiyonu %2.1, SVT %1.8 oranında görülen diğer ritim bozuklukları idi. Operasyon yaşının küçük olması (p=0.001), düşük vücut ağırlığı (p=0.000) ve boy (p=0.001), total bypass (p=0.000), aort klemp (p=0.000) ve total operasyon (p=0.03) sürelerinin uzun olması, hipotermi derecesi (p=0.000) postoperatif aritmi oluşma riskini artıran faktörler idi. Tüm aritmiler arasından 33’üne (%72) pil veya antiaritmik ilaç tedavisi uygulandı ve hastalarda eksitusa neden olacak bir aritmi gözlenmedi. Çalışmamızda en sık gözlenen aritmi tipi atriyal taşikardi olup; bu sonuç literatürden farklıdır. Bu da intrakardiyak EKG ile atriyal aktivite ve aritmi tiplendirmesi hakkında daha doğru bilgi elde edilebilmesine bağlı olabilir.
Cor Triatriaturn: A Single Institution's Experience
(2015) Gursu, Hazim Alper; Varan, Birgul; Ozkan, Murat; Erdogan, Ilkay; Oktay, Ayla; Aslamaci, Salt; 0000-0002-6719-8563; 0000-0002-0707-2678; 0000-0001-6887-3033; ABB-1767-2021; AHI-4502-2022; ABB-2220-2021; AAJ-2305-2021
Background: This study aims to analyze the data regarding cases diagnosed with cor triatriatum sinistrum at a single pediatric center, highlighting symptoms on presentation of the anomaly, mode of diagnosis, age at the time of diagnosis, any other accompanying cardiac defects, and outcomes. Methods: Records of 21 patients (13 females, 8 males; mean age 32.4 month; range 7 days to 57 years) diagnosed with cor triatriatum sinistrum between January 1997 and January 2012 at the pediatric cardiology clinic were analyzed retrospectively. Medical records including demographic data, clinical progress, diagnostic approach, and surgical interventions were reviewed. Results: The majority of patients (81%) had accompanying cardiac defects, atrial septal defect being the most frequent (33%). Restrictive pattern was detected in five patients. Seven patients (33%) died after diagnosis. We resect the fibromuscular diaphragm in 11 of 21 patients. One patient died after operation. Most common presenting symptoms were lower respiratory tract infections, dyspnea, and early fatigue. Sixteen patients were diagnosed with echocardiography. Conclusion: Despite the diversity in clinical findings at presentation and accompanying cardiac lesions, cor triatriatum sinistrum is a treatable defect with satisfying treatment outcomes.
Transposition of The Great Arteries and Cor Triatriatum: A Rare Combination
(2014) Gursu, Hazim A.; Varan, Birgul; Erdogan, Ilkay; Oktay, Ayla; https://orcid.org/0000-0002-0707-2678; https://orcid.org/0000-0002-6719-8563; https://orcid.org/0000-0001-6887-3033; 24018011; AHI-4502-2022; ABB-1767-2021; AAJ-2305-2021
In this case report, we present a 5-month-old girl diagnosed with a unique combination of transposition of the great arteries and cor triatriatum sinistra. A 1-day-old female patient presented to our hospital with cyanosis since the early neonatal period. We confirmed transposition of the great arteries by echocardiography. The patient underwent arterial switch operation on day 8 and was discharged on day 35. After 5 months of the operation, the patient had a lower respiratory tract infection and was unable to gain weight. Echocardiography revealed mild neopulmonary regurgitation, minimal neoaortic regurgitation, and pulmonary arterial hypertension. In addition, a fibrous membrane was also seen dividing the left atrium. The patient was diagnosed with cor triatriatum and underwent successful resection of the membrane.