Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Ozkan, Muratsearch.filters.applied.f.publicationcategory: search.filters.publicationcategory.Makale - Uluslararası Hakemli Dergi

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    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.
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    A Rare Cardiovascular Finding in Two Cases with Williams Syndrome: Recurrent Coarctation of Aorta
    (2015) Ari, Mehmet Emre; Erdogan, Ilkay; Varan, Birgul; Ozkan, Murat; 0000-0002-6719-8563; 0000-0001-6887-3033; 0000-0001-7932-1074; ABB-1767-2021; ABB-2220-2021; W-1590-2017
    Williams syndrome is a genetic disorder caused by multiple gene deletions on chromosome 7. The majority of the cases is sporadic and has typical facial appearance, cardiac anomalies and mental retardation. Cardiovascular anomalies are present in about 80% of the cases, most frequently supravalvular aortic stenosis and pulmonary arterial stenosis. In this article, we report two pediatric cases with a rapidly progressive form of aortic coarctation, each of whom required two surgeries and two percutaneous balloon dilatations within the first five months of life.
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    Left Ventricular Assist Device Results: Single Center Experience
    (2015) Gultekin, Bahadir; Ersoy, Ozgur; Ozkan, Murat; Akkaya, Ilknur; Umaroglu, Sevi; Sezgin, Atilla; 26640938; ABA-7388-2021
    Objectives: The number of patients with end-stage cardiac failure who are waiting for transplant has been increasing, although number of heart donations stays limited. This has resulted in an increased use of left ventricular assist devices. Here, we present results of patients who received left ventricular assist device implants at Baskent University Ankara Hospital. Materials and Methods: We retrospectively evaluated 24 patients who received a HeartWare left ventricular assist device (HeartWare Inc, Framingham, MA, USA) between April 2012 and February 2015; 2 patients (8.33%) were female. Results: Patients had end-stage heart failure as a result of the following causes: 11 patients (45%) had ischemic cardiomyopathy, 12 patients (50%) had dilated cardiomyopathy, and 1 patient (4.1%) had acute myocarditis. Regarding use of the left ventricular assist device, 10 patients (41.6%) had the device as destination therapy, and the remaining 14 patients (48.6%) had it as bridge to transplant. The Interagency Registry for Mechanically Assisted Circulatory Support Profile was 1 for 3 patients (12.5%), 2 for 9 patients (37.5%), and 3 for 12 patients (50%). Mean follow-up was 239.8 days, and the mortality rate was 33.3% (8 patients died). During follow-up, we found that 3 patients (12.5%) had received a heart transplant and 1 patient (4.1%) eventually recovered, with the device extracted. Six patients had driveline infections, and 3 patients had cerebrovascular events. Conclusions: With the insufficient number of cardiac donors, use of a left ventricular assist device for patients with end-stage cardiac failure who are awaiting transplant may be the best option.
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    Effect of Left Ventricular Assist Devices on Red Blood Cell Distribution Width
    (2015) Ersoy, Ozgur; Gultekin, Bahadir; Ozkan, Murat; Akkaya, Ilknur; Umaroglu, Sevi; Sezgin, Atilla; 26640934; ABA-7388-2021
    Objectives: Red blood cell distribution width is a measure of the variability in the size of circulating erythrocytes, which is calculated by automated blood cell counters as part of a routine blood cell count analysis. Our aim was to examine whether continuous flow left ventricular assist devices affected red blood cell distribution width. Materials and Methods: Our study included 16 of 24 patients who received a HeartWare HVAD Pump (HeartWare Inc, Framingham, MA, USA) implant (continuous flow left ventricular assist device) between April 2012 and February 2015 at our institution. The mean age of the patients was 46.6 years. We compared patient erythrocyte, leucocyte, and platelet counts, hemoglobin and hematocrit levels, mean corpuscular volume, and red blood cell distribution width values before and 6 months after implant. Results: Hemoglobin level (P=.008), hematocrit level (P=.027), and mean corpuscular volume (P=.003) were significantly decreased; however, we observed no significant change in red blood cell distribution width. Conclusions: Although we did not find significant results in our group of patients with left ventricular assist device implant, a larger group of patients may show more significant results, and an increase in red blood cell distribution width can be used as an indicator of a negative prognosis in these patients.
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    Incidence and Outcomes of Acute Kidney Injury After Orthotopic Cardiac Transplant: A Population-Based Cohort
    (2015) Gultekin, Bahadir; Beyazpinar, Deniz Sarp; Ersoy, Ozgur; Ozkan, Murat; Akay, Hakki Tankut; Sezgin, Atilla; 26640905; ABA-7388-2021; ABA-9675-2021
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    A Rare Cause of Cyanosis in Newborns: Arteriovenous Fistula Between the Right Pulmonary Artery and the Left Atrium and Its Treatment
    (2018) Yakut, Kahraman; Varan, Birgul; Ozkan, Murat; 0000-0002-6719-8563; 29362005; ABB-1767-2021
    The formation of a fistula between the right pulmonary artery and the left atrium via a sac is a very rare cyanotic congenital cardiopulmonary defect. A fistula between the pulmonary artery and left atrium may cause cardiac failure in utero. It can safely be treated surgically and in selected cases closure can be performed with transcatheter insertion of a device. In this article, we present a case with a fistula between the right pulmonary artery and the left atrium that was considered unsuitable for transcatheter closure and was safely treated surgically.
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    Removal of Left Ventricular Assist Device: First Case from Turkey
    (2016) Gultekin, Bahadir; Ozkan, Murat; Ersoy, Ozgur; Varan, Birgul; Sezgin, Atila; 0000-0002-6719-8563; ABA-7388-2021; ABB-1767-2021
    In recent years, due to the donor shortage for heart transplantation, the utilization of the left ventricular assist devices has been increasing in Turkey, as well as the worldwide. Herein, we report the first case from Turkey, a 12-year-old male case of left ventricular assist devices due to cardiomyopathy developing after monomorphic atrial tachycardia which was explanted after 109 days follow-up.
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    A Randomized Controlled Comparison of the Internal Jugular Vein and the Subclavian Vein as Access Sites for Central Venous Catheterization in Pediatric Cardiac Surgery
    (2016) Firat, Aynur Camkiran; Zeyneloglu, Pinar; Ozkan, Murat; Pirat, Arash; 0000-0003-1470-7501; 0000-0003-2312-9942; 27472252; C-3736-2018
    Objectives: To compare internal jugular vein and subclavian vein access for central venous catheterization in terms of success rate and complications. Design: A 1:1 randomized controlled trial. Setting: Baskent University Medical Center. Patients: Pediatric patients scheduled for cardiac surgery. Interventions: Two hundred and eighty children undergoing central venous catheterization were randomly allocated to the internal jugular vein or subclavian vein group during a period of 18 months. Measurements and Main Results: The primary outcome was the first-attempt success rate of central venous catheterization through either approach. The secondary outcomes were the rates of infectious and mechanical complications. The central venous catheterization success rate at the first attempt was not significantly different between the subclavian vein (69%) and internal jugular vein (64%) groups (p = 0.448). However, the overall success rate was significantly higher through the subclavian vein (91%) than the internal jugular vein (82%) (p = 0.037). The overall frequency of mechanical complications was not significantly different between the internal jugular vein (25%) and subclavian vein (31%) (p = 0.456). However, the rate of arterial puncture was significantly higher with internal jugular vein (8% vs 2%; p = 0.03) and that of catheter malposition was significantly higher with subclavian vein (17% vs 1%; p < 0.001). The rates per 1,000 catheter days for both positive catheter-tip cultures (26.1% vs 3.6%; p < 0.001) and central-line bloodstream infection (6.9 vs 0; p < 0.001) were significantly higher with internal jugular vein. There were no significant differences between the groups in the length of ICU and hospital stays or in-hospital mortality rates (p > 0.05 for all). Conclusions: Central venous catheterization through the internal jugular vein and subclavian vein was not significantly different in terms of success at the first attempt. Although the types of mechanical complications were different, the overall rate was similar between internal jugular vein and subclavian vein access. The risk of infectious complications was significantly higher with internal jugular vein access.
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    Hypomagnesemia in Pediatric Heart Transplant Patients Treated with Tacrolimus
    (2018) Erdogan, Ilkay; Gursu, Hazim A.; Varan, Birgul; Ozkan, Murat; Sezgin, Atilla; 0000-0001-6887-3033; 0000-0002-0707-2678; 0000-0002-6719-8563; 27364480; ABB-2220-2021; AHI-4502-2022; ABB-1767-2021
    Objectives: We aimed to investigate the frequency of hypomagnesemia and urinary magnesium excretion in pediatric heart transplant recipients. Materials and Methods: In this study, 22 pediatric patients who underwent heart transplanted at a single center between March 2014 and April 2015 and who were treated with oral tacrolimus were analyzed prospectively. Serum magnesium, creatinine, and tacrolimus levels and total amount of urinary magnesium excretion were measured. Serum tacrolimus levels were measured 12 hours after the last dose of tacrolimus. Results: Our patient group included 11 boys (50%) and 11 girls (50%) with a mean age of 16.72 +/- 4.78 years. Serum tacrolimus levels were in the therapeutic range, with a mean of 1.48 +/- 0.13 ng/mL (range, 1.2-1.69 ng/mL), mean fractional magnesium excretion was 8.59 +/- 5.9% (range, 3%-22%), and 24-hour urinary magnesium excretion was 90.2 +/- 62.95 mg/d. Hypermagnesuria was assessed in 80% of patients. We found 24-hour urinary magnesium excretion to be higher than normal in 27% of patients. There was no association between serum tacrolimus levels and serum magnesium levels or urinary magnesium excretion. Conclusions: Serum magnesium levels should be periodically measured in pediatric heart transplant patients treated with tacrolimus.
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    Treatment of Left Ventricular Assist Device Thrombosis: Single-Center Experience
    (2018) Beyazpinar, D. Sarp; Ersoy, Ozgur; Gultekin, Bahadir; Aliyev, Anar; Avsever, Mert; Akay, H. Tankut; Ozkan, Murat; Sezgin, Atilla; Aslamaci, Sait; 29528019; ABA-9675-2021; ABA-7388-2021
    Heart failure is the one of the biggest health problem in the world. Because of limited donors for heart transplant procedures, the ventricular assist device has become a solution for heart failure therapy. With the increase in number of ventricular assist devices, the incidence of complications has also increased. One of the most important life-threatening complications is ventricular assist device thrombosis. Medical therapy and changes in the ventricular assist device are the main therapy methods for ventricular assist device thrombosis. In this study, we showed our clinical experience with treatment of ventricular assist device thrombosis.