Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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, SaitPurpose: 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.Item 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-2305-2021Background: 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.Item A Rare Variation in Drainage of Total Anomalous Pulmonary Venous Return(2016) Gursu, Alper Hazim; Varan, Birgul; Ozkan, Murat; 0000-0002-6719-8563; 0000-0002-0707-2678; 26536995; ABB-1767-2021; AHI-4502-2022Item Mid-Term Results of Patients with Transposition of Great Arteries Who Underwent Senning Procedure(2014) Gursu, Hazim Alper; Varan, Birgul; Ozkan, Murat; Tokel, Kursat; Erdogan, Ilkay; https://orcid.org/0000-0002-0707-2678; https://orcid.org/0000-0002-6719-8563; https://orcid.org/0000-0002-6759-1795; https://orcid.org/0000-0001-6887-3033; AHI-4502-2022; ABB-1767-2021; AAF-3253-2021; ABB-2220-2021Background: This study aims to evaluate mid-term follow-up results for patients with transposition of great arteries to whom Senning procedure was performed. Methods: Files of 95 child patients (63 boys, 22 girls; mean age 15.2 +/- 23.9 months; range 1 month to 12.5 years), who were diagnosed with transposition of great arteries and underwent atrial switch operation in our institute, were retrospectively evaluated. In the follow-ups; physical examination, electrocardiography, and echocardiography were performed. In addition, ambulatory electrocardiography monitorization was conducted on 25 patients. Results: Out of 95 patients who were performed atrial switch operation, 10 died in the postoperative period. The mean follow-up period was 33.4 +/- 43.7 months (1-16 years; mean 18 months). During the follow-ups, arrhythmia was detected in 25.8% of the patients, stenosis of pulmonary venous baffle was detected in 21.2%, systolic dysfunction of the right ventricle was detected in 19%, severe tricuspid valve insufficiency was detected in 18.9%, and baffle leak was detected in 15.3%. Of the patients, 11.7% were operated a second time, and 8.2% were reoperated due to stenosis of pulmonary venous baffle. Conclusion: Short and mid-term results of Senning procedure are not satisfactory. Patients should be monitored for possible right ventricle dysfunction, arrhythmia, systemic valve insufficiency, and stenosis of the tunnel.Item 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-1590-2017Williams 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.Item Left Ventricular Assist Device Results: Single Center Experience(2015) Gultekin, Bahadir; Ersoy, Ozgur; Ozkan, Murat; Akkaya, Ilknur; Umaroglu, Sevi; Sezgin, Atilla; 26640938; ABA-7388-2021Objectives: 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.Item 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-7388-2021Objectives: 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.Item 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-9675-2021Item Left Ventricular Assist Device As The Bridge to Heart Transplantation: Five-Case Series(2016) Firat, Aynur Camkiran; Akovali, Nukhet; Gedik, Ender; Zeyneloglu, Pinar; Ozkan, Murat; Sezgin, Atilla; Pirat, Arash; https://orcid.org/0000-0002-7175-207X; ABI-2971-2020Item 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-1767-2021The 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.