Atakan Atalay - Academia.edu (original) (raw)

Papers by Atakan Atalay

Cukurova Medical Journal, 2016

Intramural coronary artery is known to be a risk factor for early death after an arterial switch ... more Intramural coronary artery is known to be a risk factor for early death after an arterial switch operation (ASO). We evaluated the early and mid-term results of ASO for patients with intramural coronary artery. From September 2008 to March 2012, seven patients with an intramural coronary artery underwent ASO at our hospital. The mean age at operation was 2.4 months (2 days-1 year), and the mean body weight was 4.3 ± 2.2 kg. The mean follow-up was 35.3 ± 16.5 months (22-63 months). The individual coronary button technique was used in seven patients. The intramural segment was unroofed in one patient; in one patient with myocardial ischemia, the intramural segment was unroofed and enlarged using a patch of autologous pericardium. There was one operative death because of low cardiac output syndrome (14.2 % mortality). In the same time period at our hospital, three deaths were reported in 68 ASO patients (4.4 % mortality) without an intramural coronary artery. There was no statistical difference between the two groups (P [ 0.05). There were no late deaths, and no patients required a coronary intervention. Intramural coronary artery is a wellknown risk factor for early death after ASO. To optimize results, the coronary transfer technique should be tailored to each patient's particular anatomy. Intraoperative or postoperative myocardial ischemia should be addressed aggressively by immediately reimplanting the coronary artery. Unroofing the intramural segment, even the distal portion, should restore normal coronary blood flow.

Turkish Journal of Thoracic and Cardiovascular Surgery, Jul 18, 2018

ÖZ Okronozis, aort kapak darlığına neden olabilen bir otozomal resesif metabolik bozukluktur. Bu ... more ÖZ Okronozis, aort kapak darlığına neden olabilen bir otozomal resesif metabolik bozukluktur. Bu yazıda, ciddi aort kapak darlığı nedeniyle kliniğimize başvuran alkaptonürisi olan 58 yaşında bir erkek hasta sunuldu. Hastaya mekanik protez ile başarılı aort kapak replasmanı yapıldı. Kapak dokusunda yabancı maddelerin birikimi ciddi sorunlara yol açan nadir durumdur ve yönetimi kalp kapak protezi ile kapak replasmanı gerektirebilir.

DergiPark (Istanbul University), Mar 1, 2016

Background: Cardiopulmonary bypass is known to cause inflammatory events. Inflammation occurs due... more Background: Cardiopulmonary bypass is known to cause inflammatory events. Inflammation occurs due to many known important biological processes. Numerous mechanisms are known to be responsible for the development of inflammatory processes. Currently, there are many defined mediators as a tumor necrosis factor-α (TNF-α) playing an active role in this process. Aims: This research was to investigate the effects of preoperative steroid use on inflammatory mediator TNF-α and on time to extubation postoperatively in ventricular septal defect patients undergoing cardiopulmonary bypass surgery. Study Design: Controlled clinical study. Methods: This study included 30 patients. These patients were assigned into two groups, each containing 15 patients. 5 micrograms/kg methylprednisolone was injected intravenously 2 hours before the surgery to Group I, whereas there was no application to the patients in Group II. TNF-α (pg/mL) level was measured in arterial blood samples obtained at four periods including: the preoperative period (Pre TNF); at the 5 th minute of cross-clamping (Per TNF); 2 hours after termination of cardiopulmonary bypass (Post TNF); and at the postoperative 24th hours in cardiovascular surgery intensive care unit (Post 24 h TNF). Results: The mean cross-clamp time was 66±40 and 55±27 minutes in Group I and Group II respectively. No significant difference was found between the groups in terms of cross-clamp time (p>0.05). The mean time to extubation was 6.1±2.3 hours in Group I and 10.6±3.4 hours in Group II. Group I extubation time was significantly shorter than Group II. Group I TNF-α levels at Post TNF and Post24h TNF was lower than Group II. These differences are also statistically significant (p<0.05). Conclusion: There is a strong indication that preoperative steroid treatment reduced the TNF-α level together with shortens duration of postoperative intubation and positively contributes to extubation in ventricular septal defect patients operated in cardiac surgery with cardiopulmonary bypass.

Heart Surgery Forum, Feb 28, 2017

Background: The arterial switch operation (ASO) has become the surgical approach of choice for tr... more Background: The arterial switch operation (ASO) has become the surgical approach of choice for transposition of the great arteries. The aim of this paper was to describe the outcomes in patients who underwent arterial switch operation and to analyze the predictors of in-hospital mortality and further need for reoperation at a single-center institution. We reviewed our 9-year experience with arterial switch operation (ASO) for transposition of the great arteries (TGA) or Taussig-Bing anomaly (TBA) to assess the early and midterm outcomes. Methods: Between January 2007 and May 2016, 34 consecutive patients who underwent ASO for TGA with IVS; and TGA with ventricular septal defect (VSD); and double outlet right ventricle (DORV) with subpulmonary VSD at our institution were included in this retrospective study. The same surgeons operated on all patients. Patients' charts, surgical reports, and echocardiograms were retrospectively reviewed. Median follow-up time ranged from 1 to 9 years, 54.2 (0.4-108) months. Results: There were 2 (5%) in-hospital deaths. Late death occurred in 1 (2.9%) of 32 survivors. One patient (2.9%) required reintervention. The freedom from reintervention rate was 95.9 ± 1.8% at 9 years. Two patients (3.9%) developed moderate neoaortic regurgitation during the follow-up and one patient underwent reoperation mainly for neopulmonary artery stenosis. The analysis showed that weight, crossclamp (CC) time, cardiopulmonary bypass (CPB) time, and age of operation are strong predictors for mortality. Conclusion: ASO remains the procedure of choice for the treatment of various forms of TGA with acceptable early and midterm outcome, and can also be performed with a low risk of early mortality and satisfactory midterm outcomes even in a small-volume center. Early and midterm survival is excellent after arterial switch operation.

The Turkish Journal of Thoracic and Cardiovascular Surgery, 2020

Blunt abdominal aortic injuries are very rare in childhood. In these injuries, abdominal aorta an... more Blunt abdominal aortic injuries are very rare in childhood. In these injuries, abdominal aorta and intra-abdominal organs can be damaged to various degrees. In this article, we report a unique pediatric case of isolated middle sacral artery injury following trauma.

Genel tıp dergisi, Jun 19, 2023

Objective: Different patch techniques were virtually always used in the surgery of pediatric pati... more Objective: Different patch techniques were virtually always used in the surgery of pediatric patients with complete atrioventricular septal defects. In this study, we describe our single center, single surgeon experiences and results about the classic single patch and double patch techniques to repair complete atrioventricular septal defects. Materials and Methods: This retrospective descriptive study included 30 patients who underwent intracardiac repair of complete atrioventricular septal defect in …………………………, Department of Paediatric Cardiovascular Surgery, The study was conducted between February 2019 to December 2021. Patients in group S underwent surgery using the traditional single-patch method, while group D included patients who underwent repair using the double patch approach (n = 10). Patients’ demographic and clinical information was taken from institutional databases and medical records.. Postoperative complications were recorded. Results: When the preoperative/postoperative insufficiency levels of the valves were compared with the Wilcoxon Signed rank test, the findings were not statistically significant for the left atrioventricular valves, but were statistically significant for the right atrioventricular valves. (p=0.02) When we compared postoperative valve regurgitation of both techniques with the Kruskall-Wallis test, no significant difference was found between postoperative valve regurgitation and function, independent of preoperative findings. Conclusion: Both operation techniques did not make a difference between operative or late mortality and morbidity. Depending on the surgeon's experience, ventricular septal defect size does not play a restrictive role in the selection of the technique to be used. The single-patch and double patch method as described here is methodical, comprehensible, repeatable, and reasonably long-lasting.

Turkish Journal of Pediatrics, 2022

Background. Anomalies in systemic venous return most commonly involve a persistent left superior ... more Background. Anomalies in systemic venous return most commonly involve a persistent left superior vena cava draining into the left atrium. Anomalous drainage of the inferior vena cava (IVC) into the left atrium is a rare congenital vascular disorder. The diagnosis was confirmed as anomalous drainage of the right superior pulmonary vein and large atrial septal defect following echo-cardiography. Anomalous drainage of the inferior vena cave was confirmed with computed tomog-raphy (CT). We report a rare combination of drainage of the inferior vena cava associated with atrial septal defect (ASD) and partial anomalous pulmonary venous return. Case. A 14-year-old girl was referred to our hospital for the evaluation of palpitations, hypoxia, exertional dyspnea, and cyanosis. Transthoracic echocardiography (TTE) revealed a large sinus venosus ASD and anomalous right superior pulmonary venous return. A cardiac CT demonstrated IVC drainage to the left atrium and an anomalous right superior pulmonary vein draining into the right atrium. Conclusions. In older patients with cyanosis, further imaging methods together with TTE will be useful in detecting additional cardiac anomalies. Patients with inferior vena cava opening to the left atrium are different from caval type ASD's and should be surgically repaired using a patch. Corrective surgery involves repositioning of the interatrial septum via a patch.

Heart Lung and Circulation, Oct 1, 2022

Cardiology in the Young

Native valve aortic endocarditis is rarely seen in the paediatric population. Although, the first... more Native valve aortic endocarditis is rarely seen in the paediatric population. Although, the first-line of treatment is medical, surgical intervention may be indicated in patients with unrepairable valvular and subvalvular disease. Recently, the aortic valve neocuspidization (AVNeo) procedure has gained popularity both in adult and children in whom other repair techniques are not feasible. In this case report, we present an urgent aortic valve replacement using the AVNeo technique in a critically ill infant with a small annulus, severe left ventricular outflow tract stenosis, and severe aortic regurgitation.

The Turkish Journal of Thoracic and Cardiovascular Surgery, 2018

Journal of cardiovascular disease research, Sep 1, 2013

A 58-year-old male patient had diagnosed with Buerger's disease for 30 years. Patient referred us... more A 58-year-old male patient had diagnosed with Buerger's disease for 30 years. Patient referred us with non-healing scar on his right thumb. In another center, amputation was suggested due to his non-healing scar. We have assessed the patient multidisciplinary with cardiovascular and plastic reconstructive esthetic surgery for non-healing scar. During the multidisciplinary surgical treatment we applied radial artery endarterectomy, cross finger flap reconstruction, after operation medically we have treated with cilostazol. Patient's scar completely healed. Follow up one year patient have no problem and radial artery in angiography was opened.

Situs inversus totalis is a rare autosomal recessive congenital anomaly. There are very few repor... more Situs inversus totalis is a rare autosomal recessive congenital anomaly. There are very few reports in the published literature of abdominal aortic aneurysm in patient with situs inversus totalis, all of whom underwent open aneurysm repair. DeBakey type III acute aortic dissection is life threatening condition with organ malperfusion. A 74-year-old male, referred our department with back pain and dyspnea. Contrast- enhanced computed tomography (CT) suggested DeBakey type III aortic dissection and situs inversus totalis. Thoracic endovascular aneurysm repair (TEVAR) were successfully performed. Postoperative control CT showed succesfull treatment of the DeBakey type III dissection with TEVAR in a situs inversus totalis patient. His postoperative course was uneventful. With situs inversus totalis, which is the first case in the literature that DeBakey type 3 dissection is treated with TEVAR. TEVAR is applicable in Situs inversus totalis patients.

The Heart Surgery Forum, 2017

Background: Alveolar-capillary membrane damage develops as a result of the inflammatory effect of... more Background: Alveolar-capillary membrane damage develops as a result of the inflammatory effect of cardiopulmonary bypass (CPB). In the presence of a healthy alveolar-capillary barrier, there is little or no surfactant in the blood. The aim of this study was to evaluate the protective effects of ultraprotective ventilation during CPB by measuring serum and bronchoalveolar lavage (BAL) surfactant protein B (SPB) values in congenital heart surgery.Methods: This prospective study was designed for 46 patients with congenital heart defects. Patients were classified into two groups: group 1 comprising pulmonary normotensive patients and group 2 consisting of pulmonary hypertensive (PH) patients. Each group was divided into two sub-groups: (a) those who received ultraprotective ventilation during CPB and (b) those who did not receive ultraprotective ventilation during CPB. Serum SPB (S-SPB) values were measured preoperatively (ST1); at the fourth hour postop (ST2); and at the 24th hour post...

Cukurova Medical Journal (Çukurova Üniversitesi Tıp Fakültesi Dergisi), 2016

In this study, we aim to report our midterm results of endovascular replacement of abdominal aort... more In this study, we aim to report our midterm results of endovascular replacement of abdominal aortic aneurysms with Anaconda stent graft. Material and Methods: Between January 2014 and June 2016, a total number of 32 patients who underwent endovascular aortic replacement (EVAR) with Anaconda stent graft electively or emergently were retrospectively analysed. Twenty-nine patients undergoing elective, 2 patients were processed as urgent. Average follow-up was 16.3 months (range, 1-28 months). Mortality, morbidity, survival rates, mean duration of operation, mean length of intensive care unit and hospital stays, the type and incidence of endoleaks, contrast nephropathy rates, the impact on leakage of the aortic diameter, complication rates and secondary intervention rates were recorded. Results: Early term hospital follow-up no mortality was observed, mortality was observed in one patient due to myocardial infarction one and a half months later. A leg thrombosis of stent occurred in two patients. Embolectomy was performed for one patient, ilio-ileal bypass applied for the other patients. Short-term results in terms of patient satisfaction with endovascular repair of aortic stent grafts anaconda and shows that good in terms of results. Conclusion: Endovascular aortic replacement (EVAR) can be selected as a treatment option in abdominal aortic aneurysm patients with co-morbidities and high mortality risk. We have received successful results in early and midterm results in our patients with abdominal aortic aneurysm endovascular treatment with Anaconda stent graft. Amaç: Bu çalışmada abdominal aort anevrizmalarının Anaconda stent greft ile endovasküler aort replasmanında orta dönem sonuçlarımızı bildirmeyi amaçladık. Gereç ve Yöntem: Ocak 2014-Mayıs 2016 tarihleri arasında abdominal aort anevrizması nedeniyle elektif veya acil olarak anaconda stent greft ile endovasküler aort replasmanı (EVAR) yapılan toplam 32 hasta retrospektif olarak incelendi. Yirmi dokuz hasta elektif olarak, 2 hasta acil olarak işleme alındı. Anevrizmaların anatomik dağılımında 18'i infrarenal ve aortoiliyak anevrizma, 14'ü izole abdominal aort anevrizması olarak bildirildi. Hastaların ortalama hastanede kalış süresi 2.2 gün (dağılım, 1-4 gün) idi. Ortalama takip süresi 16.3 ay (dağılım, 1-28 ay) idi. Mortalite, morbidite, sağkalım oranları, ortalama ameliyat süresi, ortalama yoğun bakım ünitesinde ve hastanede kalış süresi, kaçak tipi ve insidansı, kontrast nefropati oranları, aort çapının kaçak üzerindeki etkileri, komplikasyon oranları ve ikincil girişim oranları kaydedildi. Bulgular: Erken dönem hastane takiplerinde mortalite gözlenmezken, bir hastada 1.5 ay sonra miyokard infarktüsü sonrası mortalite gözlendi. İki hastada stentin bir bacağında tromboz gelişti. Bir hastaya embolektomi, diğer hastaya iliyo-iliak bypass yapıldı. Sonuçlar kısa dönemde anaconda stent greft ile endovasküler aort tamirinin hasta memnuniyeti ve sonuçlar açısından iyi olduğunu göstermektedir. Sonuç: Endovasküler aort replasmanı (EVAR), abdominal aort anevrizmalı ve eşlik eden hastalığı ve yüksek mortalite riski olan hastalarda bir tedavi seçeneği olabilir. Anaconda stent greft ile abdominal aort anevrizmasına endovasküler tedavi yaptığımız hastalarımızın erken ve orta dönem sonuçlarında başarılı sonuçlar aldık.

Polish Journal of Cardio-Thoracic Surgery, 2016

Tętniak rzekomy lewej komory jest rzadkim powikłaniem aneuryzmektomii. W pracy przedstawiono przy... more Tętniak rzekomy lewej komory jest rzadkim powikłaniem aneuryzmektomii. W pracy przedstawiono przypadek tętniaka rzekomego lewej aorty leczonego chirurgicznie, który został zdiagnozowany 3 lata po wykonaniu pomostowania aortalno-wieńcowym oraz aneuryzmektomii lewej komory. Omówiono występujące objawy, ocenę diagnostyczną oraz leczenie chirurgiczne. Słowa kluczowe: lewokomorowy tętniak rzekomy, masa płuc, aneuryzmektomia.

The Annals of Thoracic Surgery, 1999

We report a case of an aortopulmonary window with a right coronary artery arising from the pulmon... more We report a case of an aortopulmonary window with a right coronary artery arising from the pulmonary trunk. This exceedingly rare anomaly with anomalous coronary artery presented without myocardial ischemia owing to the aortopulmonary window. The correct diagnosis was made by angiography and a successful surgical correction was performed.

Turkish Journal of Clinics and Laboratory

Introduction A small number of children with repaired congenital heart defects may require a trac... more Introduction A small number of children with repaired congenital heart defects may require a tracheostomy for ongoing ventilatory support. Congenital airway anomalies, laryngomalacia, postoperative airway complications and genetic syndromes associated with airway and facial anomalies, such as DiGeorge Syndrome (22q11 deletion), can be counted among the reasons why patients are unable to be weaned from the ventilator. In this study, we aimed to define the outcomes of patients who required a tracheostomy due to chronic respiratory failure after congenital heart surgery, and the existing risk factors for in-hospital and post-discharge mortality. Materials and methods The files of 1382 patients who underwent surgery due to CHD in the Pediatric Cardiovascular Surgery Clinic in ……………., between February 2019 and February 2023, were retrospectively scanned. Patients’ age, gender, body weight, cardiac diagnosis, surgical intervention, length of stay in the intensive care unit, number of extu...

Amaç: Bu çalışmada intrakardiyak defektlerin kapatılmasında farklı dönemlerde kullanılan sığır pe... more Amaç: Bu çalışmada intrakardiyak defektlerin kapatılmasında farklı dönemlerde kullanılan sığır perikard ve Dakron yama materyalinin kısa ve orta dönem sonuçları klinik ve transtorasik ekokardiyografik olarak karşılaştırıldı. Çalışma planı: Mart 1992 - Aralık 2003 tarihleri arasında kliniğimizde intrakardiyak defekt onarımında Dakron yama (grup 1) kullanılan 498 hasta ile Ocak 2004 - Nisan 2010 tarihleri arasında sığır perikard yaması (grup 2) kullanılan 533 hastaya ilişkin kısa (ameliyat sonrası 30 gün) ve orta (ameliyat sonrası 24 ay) dönem sonuçlar karşılaştırıldı. Bulg ul ar: Her iki grupta kısa ve orta dönemde yapılan ekokardiyografik çalışmalarda yamada kalsifikasyon, trombüs, anevrizmatik dilatasyon görülmedi. Grup 1’de üç hastada, grup 2’de iki hastada yamada vejetasyon-endokardit tespit edildi. Grup 1’de 15 ve grup 2’de 14 hastada rezidüel ventriküler septal defekt görüldü. Bu komplikasyonların görülme oranı, gruplar arasında istatistiksel olarak anlamlı bulunmadı. Son...

Brazilian Journal of Cardiovascular Surgery

The presence of persistent left superior vena cava to the left atrium connection without an innom... more The presence of persistent left superior vena cava to the left atrium connection without an innominate vein may give rise to technical challenges during intracardiac repair. In this report, the end-to-side anastomosis technique of the persistent left superior vena cava to the right superior vena cava is discussed in a patient with tetralogy of Fallot associated with persistent left superior vena cava draining directly into the left atrium. A successful end-to-side anastomosis between the persistent left superior vena cava and the right superior vena cava was performed and short-term anastomosis patency was documented via angiography.

Bu çalışmada izole koroner bypass olgularında operatif mortaliteyi öngörmede EuroScore ve STS (Th... more Bu çalışmada izole koroner bypass olgularında operatif mortaliteyi öngörmede EuroScore ve STS (The Society of Thoracic Surgeons) risk belirleme sistemlerinin klinik uygulanabilirliğinin karşılaştırılması amaçlandı. Gereç ve Yöntemler: Kasım 2002-Aralık 2005 tarihleri arasında opere edilen 148 izole koroner bypass olgusunun tüm risk faktörleri, EuroScore ve STS risk belirleme sistemlerine göre prospektif olarak kaydedildi. Öngörülen ve gerçekleşen mortalite oranları her sistem için karşılaştırıldı. Bulgular: Operatif mortalite, 3 hasta ile %2.0 olarak bulundu. EuroScore için beklenen mortalite %3.4±2.2 iken STS için bu oran %3.0±2.1 idi. Beklenen ve gerçekleşen mortalite oranları arasında fark bulunamadı. EuroScore için ROC (Receiver Operating Characteristic Curve) altında kalan alan 0.83, STS için 0.82 olarak hesaplandı (p>0.05). Sonuç: Her iki sistemde mortaliteyi öngörme kuvveti açısından, kliniğimiz hasta populasyonunda yeterli olarak bulunmuştur. STS’nin operatif mortalite ya...