Fakülteler / Faculties
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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 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-3253-2021Background: 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.Item 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-2220-2021Item 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-3253-2021Item 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-3253-2021Item "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