Browsing by Author "Tokel, Kursad"

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Acute Respiratory Distress Syndrome and Myocarditis Caused by Human Metapneumovirus in a Child
(2020) Yakut, Kahraman; Varan, Birgul; Erdogan, Ilkay; Tokel, Kursad; 0000-0002-6759-1795; 0000-0002-9221-5636; AAJ-2305-2021; AAF-3253-2021
Human metapneumovirus (hMPV), a recently described paramyxovirus, has commonly been associated with upper and lower respiratory tract infections in young children. Severe infections including cardiovascular disease associated with hMPV have been particularly reported in older and immunocompromised patients; however, there has been no previous report of hMPV causing myocarditis in a child. In this article, we present a rare case with acute respiratory distress syndrome and myocarditis associated with hMPV in a child.
Case report and the surgical treatment of two cases with pulmonary atresia in which pulmonary arteries is circulated by coronary arteries
(2018) Tokel, Kursad; Yakut, Kahraman; Varan, Birgul; Erdogan, Ilkay; Ozkan, Murat; 0000-0002-6719-8563; 0000-0001-6887-3033; 0000-0002-6759-1795; 29664428; ABB-1767-2021; AAJ-2305-2021; ABB-2220-2021; AAF-3253-2021
Pulmonary atresia (PA) and ventricular septal defect (VSD) can occur in a variety of ways, from simple valve atresia to a condition in which circulation to the pulmonary bed occurs through collateral arteries separated from the aorta and there are no real pulmonary arteries, or they are present but hypoplastic. The size of the pulmonary arteries and concomitant complex cardiac lesions are important in making decisions about treatment and correctional alternatives. While complete correction surgeries in the style of a correction of tetralogy of Fallot are performed in simpler cases, many very invasive procedures are also performed and the resulting quality of life is very variable. The size of the pulmonary artery and its branches and the presence of accompanying collateral vessels are determining factors in the management of the disease. In this report, 2 cases of VSD and PA, in which the circulation of the pulmonary arteries was through the coronary arteries, diagnosed as a result of echocardiography performed following murmurs heard during examination, are described. The first patient was 40 days old and the second was 2 days old. In the second case, diagnosis was confirmed by catheter angiography, and in the first case, the final diagnosis was made during surgery. The aim of this report is to emphasize the importance of pulmonary artery size, the presence of pulmonary confluence, the origin of circulation, and concomitant collateral arteries when considering treatment methods.
"Learning curve'' in congenital cardiac surgery Reply
(2019) Sarisoy, Ozlem; Aybakan, Canan; Tokel, Kursad; Ozkan, Murat; Turkoz, Riza; Aslamaci, Sait; 0000-0002-6759-1795; 30694805; P-4569-2015; AAF-3253-2021
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.
Posterior Reversible Encephalopathy Syndrome After Pediatric Heart Transplantation
(2018) Orgun, Ali; Erdogan, Ilkay; Varan, Birgul; Tokel, Kursad; Ozkan, Murat; Sezgin, Atilla; Ersoy, Ozgur; Aslamaci, Sait; 0000-0002-6719-8563; 0000-0002-6759-1795; 0000-0001-6887-3033; AAJ-2305-2021; ABB-1767-2021; AAF-3253-2021; ABB-2220-2021
A rare complication of balloon pulmonary angioplasty: Aortopulmonary window and its treatment
(2019) Varan, Birgül; Yakut, Kahraman; Tokel, Kursad; Ozkan, Suleyman; Aslamaci, Sait; 0000-0002-6759-1795; 30587706; AAF-3253-2021
Results of Endomiocardial Biopsy in Children with Heart Transplantation
(2018) Erdogan, Ilkay; Orgun, Ali; Varan, Birgul; Tokel, Kursad; Ozkan, Murat; Sezgin, Atilla; Ersoy, Ozgur; Aslamaci, Sait; 0000-0001-6887-3033; 0000-0002-6719-8563; 0000-0002-6759-1795; ABB-2220-2021; ABB-1767-2021; AAF-3253-2021
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.
Surgical Outcomes and Long-Term Follow-Up of Patients with Large Ventricular Septal Defects with Severe Pulmonary Arterial Hypertension: Single-Center Experience
(2023) Orgun, Ali; Tokel, Kursad; Erdogan, Ilkay; Varan, Birgul; Ozkan, Murat; Aslamaci, Sait
Purpose: In this retrospective study, pediatric patients who underwent surgery for large ventricular septal defect (VSD) with severe pulmonary arterial hypertension (PAH) were evaluated in detail in terms of clinical characteristics, and long-term results, and reinterpreted with the current surgical criteria.Materials and Methods: Twenty-four patients who underwent surgery for large VSD due to PAH between 1994 and 2005 were included in the study. The patients were divided into two groups according to their pulmonary vascular resistance index (PVRI) and compared (group 1 with PVRI <6 WU.m(2) and group 2 with PVRI >= 6 WU.m(2)). The patients with PVRI 6-8 WU.m(2) were accepted as being in the gray zone and were evaluated in detail.Results: Age at diagnosis ranged from 5 months to 17 years (median: 5 years). PVRI ranged between 3 and 18.4 WU.m(2) (median PVRI was 5 WU.m(2).) According to the PVRI, 13 patients were accepted as group 1, and 11 patients were accepted as group 2. mPAP, PVR/SVR, and last PAP values were found statistically significantly lower in group 1 than in group 2. The median postoperative follow-up time was 6 years (range, 1 month-18 years). PAH was seen in 15/24 (62.5%) patients. Severe PAH was observed in seven of these 15 patients and all were in group 2 (four had PVRI >= 8WU.m(2) and three had PVRI 6- 8 WU.m(2)).Conclusion: Patients with large VSD with severe PAH should be carefully evaluated before surgery to more accurately identify suitable candidates.
Type 3 Gaucher disease presented with cardiac manifestations
(2019) Gumus, Ersin; Tokel, Kursad; Karhan, Asuman Nur; Demir, Hulya; Ozen, Hasan; Temizel, Inci Nur Saltik; Olcay, Lale; Yuce, Aysel; 0000-0002-6759-1795; AAF-3253-2021