Canan Ayabakan - Academia.edu (original) (raw)

Papers by Canan Ayabakan

Research paper thumbnail of Çift Girişli Sol Ventrikül, Ventriküloarteriyel Diskordansı Olan Olguların Izleminde Restriktif Bulboventriküler Foramen Gelişimi

Anadolu Kardiyoloji Dergisi-the Anatolian Journal of Cardiology, 2012

Research paper thumbnail of Outcomes of Operated Partial-Intermediate Atrioventricular Septal Defect Patients

Koşuyolu Heart Journal, 2021

Introduction: Follow-up results of patients with partial-intermediate atrioventricular septal def... more Introduction: Follow-up results of patients with partial-intermediate atrioventricular septal defect (AVSD) operated in 1996-2016 at Baskent University are presented. Patients and Methods: Data obtained from hospital records consists of echocardiographic and angiographic details before surgery, age and weight at surgery, operative details, presence of Down’s syndrome, details of postoperative care, early postoperative and latest echocardiographic findings and hospitalization for reintervention. Results: One hundred seventy eight patient-files were reviewed including 41.6% (n= 74) male, 58.4% (n= 104) female patients. The mean age of patients were 47.09 ± 44.25 (median, 30; 25 and 75 percentiles, 17 and 66.5, respectively) months. The mean body weight during the operation was 15.00 ± 11.22 (median, 11; 25 and 75 percentiles, 8.27 and 17, respectively) kg. Study group included 152 patients (85.3%) with partial AVSD and 26 of patients (14.7%) with partial AVSD. A total of 39 patients (...

Research paper thumbnail of Our experience with single patch repair of complete atrioventricular septal defects

Journal of Cardiology and Cardiovascular Medicine, 2020

Background: Various surgical methods have been utilized in the management of complete atrioventri... more Background: Various surgical methods have been utilized in the management of complete atrioventricular septal defects (CAVSD). Early intervention and achievement of a competent left atrioventricular valve are the key factors for successful treatment. Methods: A total of 66 patients with complete atrioventricular septal defect have been operated in a tertiary care center. Patient group consisted of 28 males and 38 females with an average age of 6.2 ± 3.3 months. Ventricular and atrial defects were repaired generally with single-patch technique using autogenous pericardium. Results: Preoperative catheterization and angiography was performed in 41 patients. Single patch and modifi ed single patch techniques were preferred in 57 and 9 patients respectively. The average duration for respiratory support, intensive care unit stay and discharge from hospital were 36 ± 49.3 hours, 4.1 ± 1.9 days, and 10.1 ± 3.3 days respectively. In the left atrioventricular valve mild, moderate and severe regurgitation were detected in 44 (66.6%), 17 (25.7%) and 2 (3%) patients postoperatively. No regurgitation was determined in 3 patients (4.5%). Two cases ended up with mortality (3%). Conclusion: Single patch repair technique can provide satisfactory surgical outcomes in patients with complete atrioventricular septal defect.

Research paper thumbnail of Echocardiographic Follow-Up of Right Ventricular Function After Tetralogy of Fallot Operation

Journal of Integrative Cardiology Open Access, 2020

Aim: Although limited in assessing right ventricular (RV) function, echocardiography is widely us... more Aim: Although limited in assessing right ventricular (RV) function, echocardiography is widely used after correction for tetralogy of Fallot (TOF). The change in echocardiographic measurements of RV in asymptomatic patients after TOF repair over a long follow-up time is not explored yet. The variation in simple echocardiographic measurements during follow-up of our TOF patients are presented. The predictive value of those parameters in determining a future pulmonary valve replacement is sought. Method: Asymptomatic patients surviving the first year after correction for simple TOF from February 2007 to December 2019 at Başkent University, Istanbul Hospital are enrolled. Patients are followed annually with echocardiography including: RV area, volume, length, RV outflow tract (RVOT) diameter and gradient, tricuspid annulus diameter, tricuspid lateral annular tissue velocities, tricuspid annular plane systolic excursion, TEI index RV ejection fraction (EF) measurements. The change in th...

Research paper thumbnail of Determination of Factors Affecting the Results of Balloon Angioplasty in Coarctation of Aorta

Turkiye Klinikleri Cardiovascular Sciences, 2019

Aort koarktasyonunda balon anjiyoplastinin başarısını, sonuçlarını, rekoarktasyon sıklığını ve bu... more Aort koarktasyonunda balon anjiyoplastinin başarısını, sonuçlarını, rekoarktasyon sıklığını ve bunu etkileyen faktörleri saptamaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Nisan 2007-Mayıs 2012 tarihleri arasında koarktasyon tanısıyla balon anjiyoplasti yapılan 53 hastanın verileri retrospektif olarak değerlendirildi. B Bu ul lg gu ul la ar r: : Ortalama yaş 14,7±35,5 (0,1-198) ay, ağırlık 7,8±8,9 kg; 23 (%43)'ü kız, 30 (%57)'u erkek hasta idi. Yaş grupları balon öncesi ve sonrası arkus ve istmus z değerleri açısından karşılaştırıldı. Balon öncesi ve sonrası, 0-3 ay (grup 1) ile 12 ay üzeri grupta arkus Z-skorları ve istmus Z-skorları, ayrıca 4-12 ay (grup 2) ile 12 ay üzeri (grup 3) grupta yine arkus aorta ve istmus Z-skorları açısından fark anlamlı bulundu. Balon öncesi sistolik basınç gradientinin ortalama 35,8±18,2 mmHg'dan, 13,8±10 mmHg'a gerilediği, koarktasyon çapının 3,3±1,9 mm'den 4,9±2,6 mm'ye arttığı görüldü. Anjiyoplasti öncesinde çıkan aorta, istmus, distal aortik arkus ve abdominal aorta çaplarının, anjiyoplasti sonrasında anlamlı olarak arttığı belirlendi. İşlem başarısı tüm hastalarda %81; 0-3 ayda %79, 4-12 ayda %77, 12 ay üzerinde ise %92 olarak bulundu. Yaş ile rekoarktasyon arasında anlamlı ilişki belirlendi. Balon öncesi istmus çapı, çıkan aorta çapının %50'si ve altında olanlarda rekoarktasyon sıklığının anlamlı düzeyde yüksek olduğu belirlendi. Komplikasyon oranı %19 olarak saptandı. S So on nu uç ç: : Balon anjiyoplasti, koarktasyon tedavisinde cerrahiye alternatif ve güvenli bir tedavi yöntemidir. Balon öncesi ve sonrasında distal transvers arkus çapı ve Z-skoru, istmus çapı ve Z-skoru, koarktasyon bölgesinin çapı rekoarktasyon ile ilişkili önemli ölçümlerdir. Yaş ve ciddi istmus hipoplazisi, rekoarktasyon için anlamlı risk faktörleridir.

Research paper thumbnail of Le-Compte Maneuver in surgical correction of absent pulmonary valve. Does it improve severe bronchial compression?

Journal of Integrative Cardiology, 2016

Here,we present a case of absent pulmonary valve syndrome operated with Le-Compte maneuver. Altho... more Here,we present a case of absent pulmonary valve syndrome operated with Le-Compte maneuver. Although Le-Compte maneuver was performed, endobronshial stent placement was carried out in order to relieve the airway obstruction.

Research paper thumbnail of Hipoplastik Sol Kalp Sendromu mu Yoksa Sol Ventrikül Hipoplazisi mi?

Turkiye Klinikleri Cardiovascular Sciences, 2011

Research paper thumbnail of Bidirectional'' Kavopulmoner Şant Yapılmış Hastalarda Prognozu Etkileyen Faktörler

Turkiye Klinikleri Journal of Cardiovascular Surgery Special Topics, 2014

Research paper thumbnail of Complications and outcome in left-sided endocarditis in children

The Turkish journal of pediatrics

We retrospectively assessed the clinical course and outcome of left-sided endocarditis in pediatr... more We retrospectively assessed the clinical course and outcome of left-sided endocarditis in pediatric patients to find out the prognostic significance of the presence and size of echocardiographically detected vegetations. Among the children admitted to our institution with endocarditis between January 1987 and October 1999, 16 patients (mean age 9.03 +/- 4.95 years) who met the Duke criteria for the diagnosis of infective endocarditis (IE) were included in this study. Rheumatic valvular disease was the most frequent underlying heart disease (10 patients: 62.5%). Five patients were operated at a mean of 13.9 months before endocarditis, and all had residual defects. Vegetation was detected in 11 cases (69%). Ten patients had major complications (within 2 weeks in 6 patients). Three patients developed congestive heart failure (CHF), six had intracranial and one had lower extremity emboli. Among them four were operated because of complications (CHF: 3 cases, intracranial emboli: 1 case)....

Research paper thumbnail of Somatic growth after corrective surgery for congenital heart disease

The Turkish journal of pediatrics

We report the somatic growth characteristics of 60 infants who underwent corrective surgery for c... more We report the somatic growth characteristics of 60 infants who underwent corrective surgery for congenital heart disease. Patients were assigned to the following groups: Group 1, cyanosis with pulmonary hypertension (PH); Group 2, cyanosis without PH; Group 3, large left-to-right shunt and PH; and Group 4, left-to-right shunt or obstructive heart lesion and no PH. Weight, length, and head circumference measurements and z scores were obtained before the operation, at 45 days, and 3, 6, and 12 months after the operation. Details about dietary intake, socioeconomic status at presentation, length of stay in the intensive care unit, hospitalization period, and perioperative events were noted. The endpoint was reaching a z score > -1 for all anthropometric measurements. At presentation, 51 patients (85%) had malnutrition. The family income, dietary intake, and presence of preoperative chronic malnutrition were interrelated and influenced the weight of the patient at all times during th...

Research paper thumbnail of Active-fixation, steroid-eluting ventricular leads: the medium-term results in children

Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2005

Low threshold characteristics and mechanical stability are important features of an ideal pacing ... more Low threshold characteristics and mechanical stability are important features of an ideal pacing lead, especially for children. We report our experience and medium-term results with a steroid-eluting, active-fixation ventricular lead in children. Telectronics Accufix II DEC model 033-212 ventricular leads were implanted in 21 patients. Eighteen patients (11 male / 7 female; 10.6+/-4.0 years), who were followed for a mean period of 6.47 +/-1.13 years, were included in the study. Pacemaker mode was DDDR in three patients, and VVIR in the remaining 15 patients. Mean threshold value was 0.5 volts at implant, which increased to 0.7 volts in the first month (p>0.05). It remained stable (0.62-0.78 V) until 5.5 years (p>0.05), increased significantly at 5.5 years (0.99+/-0.63 V at 5.5 years, p<0.05) and remained significantly high after this time (p<0.05). Pacing lead impedance did not differ significantly throughout the study (p>0.05). Thirteen pulse generators reached end-o...

Research paper thumbnail of Role of serum cardiac troponin T in the diagnosis of acute rheumatic fever and rheumatic carditis

Research paper thumbnail of Williams sendromlu hastaların kardiyak patolojileri ve klinik izlemi

Turkish Journal of Thoracic and Cardiovascular Surgery, 2013

Ağustos 2008-Ağustos 2011 tarihleri arasında Williams sendromlu dokuz hasta (3 kız, 6 erkek; ort.... more Ağustos 2008-Ağustos 2011 tarihleri arasında Williams sendromlu dokuz hasta (3 kız, 6 erkek; ort. yaş 19±29 ay) kliniğimize başvurdu. Hastaların vücut ağırlıkları 9454±5880 g idi. Hastaların ikisinde supravalvüler aort darlığı (sAS), birinde periferik pulmoner darlık (PPS), birinde supravalvüler PS (sPS), ikisinde sAS ve sPS, üçünde sAS ve iki taraflı PPS saptandı. İki hasta ameliyat edilmedi. Dört hastaya sAS ve PPS, bir hastaya sAS ile valvüler ve sPS, bir hastaya sPS ve PPS, bir hastaya sAS ameliyatı yapıldı. Gradyanlarda azalma olmakla birlikte, izlemde artış saptanmadı. Anah tar söz cük ler: Aortik darlık; klinik seyir; pulmoner darlık; Williams sendromu. Between August 2008 and August 2011, nine patients (3 girls, 6 boys; mean age 19±29 months) were admitted to our clinic with Williams syndrome. The mean body weight of the patients was 9454±5880 g. Two patients had supravalvular aortic stenosis (sAS), one had periferal pulmonary stenosis (PPS), one had supravalvular PS (sPS), two had sAS and sPS, and three had sAS and bilateral PPS. Two patients were not operated. Four patients were operated for sAS and PPS, one patient for sAS, valvular and sPS, one patient for PPS and sPS, and one patient for sAS operation. The gradients were decreased and remained unchanged during follow-up.

Research paper thumbnail of Total correction in tetralogy of Fallot with anomalous major coronary artery : an alternative method to conduit use

Cardiovascular Journal of Africa, 2012

Introduction: A coronary artery anomaly precludes the use of a trans-annular patch in right ventr... more Introduction: A coronary artery anomaly precludes the use of a trans-annular patch in right ventricular outflow tract (RVOT) reconstruction. Herein we present three patients with coronary artery anomalies who underwent total corrective operations without using a conduit. Methods: Between 2007 and 2010, 84 patients with tetralogy of Fallot (TOF) were operated on. Nine (9.4%) of them had a coronary artery anomaly. Three (3.1%) of the patients were operated on using the double-outflow technique and two had a Blalock-Taussig shunt before the total corrective operation. In two patients, the left anterior descending artery (LAD) and in one, the right coronary artery (RCA) crossed the RVOT. Results: Postoperatively, the right-to-left ventricular pressure ratios were 0.45, 0.59 and 0.60 after cardiopulmonary bypass. No gradient was detected in the RVOT in postoperative echocardiographical measurements (< 15 mmHg gradient). In all three patients, there were moderate pulmonary insufficiencies. All were discharged home on the sixth day postoperatively. Mean follow-up duration was 9.8 ± 8 months. In the follow up of all three patients, there were moderate pulmonary insufficienciencies but no right ventricular dysfunction. Conclusion: The 'double-outflow' technique is appropriate for TOF patients with a major coronary artery anomaly since it can easily be performed without the need of a conduit.

Research paper thumbnail of Sotalol in treatment of pediatric cardiac arrhythmias

Pediatrics International, 2001

Sotalol is a compound originally developed as a noncardioselective beta-blocker. In addition to i... more Sotalol is a compound originally developed as a noncardioselective beta-blocker. In addition to its class II activity seen due to its beta-blocking effect, it also prolongs cardiac action potential duration, which is known as the class III anti-arrhythmic activity. 1,2 Early experience with sotalol dates back to the 1960s. Later in 1974 it was approved in Europe as an antihypertensive agent, however, interest in sotalol's unique anti-arrhythmic properties was delayed until the early 1980s. The combined electrophysiologic effects of sotalol (class II and class III) brought it to the attention of cardiologists as a valuable drug for treating various arrhythmias in adults. 3-10 The Food and Drug Administration approved sotalol for treatment of arrhythmias in the USA, in 1992, and marketing began in 1993. 11 Sotalol is only recently used increasingly as an antiarrhythmic agent in the pediatric age group. There is limited experience on sotalol use in the management of childhood arrhythmias, 3,12-16 and only case reports mention its serious side-effects in pediatric patients. 17 The purpose of this study is to review our experience with sotalol in pediatric patients with various arrhythmias and to determine their outcome. Methods The records of patients who are treated with sotalol from 1994 to 1999 at our institution are retrospectively reviewed. The record review identified 62 pediatric patients who received this drug for various supraventricular and ventricular arrhythmias. Demographic, clinical, echocardiographic, electrocardiographic (ECG), ambulatory ECG and electrophysiologic variables were collected. The type of the

Research paper thumbnail of İki Yönlü Kavopulmoner Anastomoz Yapılan Hastalarda Klinik Sonuçları Etkileyen Faktörler

Turkish Journal of Thoracic and Cardiovascular Surgery, 2013

Bu çalışmada iki yönlü kavopulmoner anastomoz (BCPA) yapılan farklı patolojilere sahip hastalarda... more Bu çalışmada iki yönlü kavopulmoner anastomoz (BCPA) yapılan farklı patolojilere sahip hastalarda klinik sonuçları etkileyen faktörler araştırıldı.

Research paper thumbnail of Dysrhythmia as a cause of syncope in children without neurological or cardiac morphological abnormalities

Pediatrics International, 2002

Background : Arrhythmias are among the malignant causes of syncope. This study has been undertake... more Background : Arrhythmias are among the malignant causes of syncope. This study has been undertaken to determine the relative incidence and significance of dysrhythmia in the pathogenesis of syncope among patients referred to a pediatric cardiology unit. Methods : Between March 1997 and March 1999, 105 consecutive patients (59 female, 46 male) aged 11.5 ± 3.6 years without neurologic or cardiac morphologic causes were evaluated for at least one episode of syncope. A pediatric cardiologist and a pediatric neurologist evaluated all the patients. Routine chest X‐ray, 12‐lead electrocardiogram (ECG), electroencephalography (EEG), 24‐h Holter monitoring and echocardio­graphy were carried out. When deemed necessary, further tests were undertaken for the cases of syncope which were unexplained by routine tests. Results : The cause of syncope was identified as vasovagal in 25.7% (n = 27) and related to dysrhythmia in 30.5% (n = 32). The cause was migraine‐associated syncope in two children, ...

Research paper thumbnail of Treatment of subaortic stenosis in hearts with single-ventricle physiology

Cardiovascular Journal of Africa, 2012

Background: We evaluated the patients who had had a Damus-Kaye-Stansel (DKS) operation for single... more Background: We evaluated the patients who had had a Damus-Kaye-Stansel (DKS) operation for single-ventricular physiology with the aorta originating from a hypoplastic ventricle and the pulmonary artery from the systemic ventricle. Methods: Seven patients who were operated on between May 2007 and November 2010 were evaluated retrospectively. The patients had been diagnosed with a transposed doubleinlet left ventricle and triscuspid atresia, and had been waiting for a Fontan operation. Systemic outflow stenosis was defined echocardiographically as those with a gradient greater than 20 mmHg, and angiographically those with greater than 5 mmHg in the subaortic region. Results: The mean age and weight of the patients was 15 ± 9.7 months and 8 ± 3.3 kg, respectively. The mean gradient between the systemic ventricle and the aorta was 35 ± 25 mmHg. This gradient decreased to 14.3 ± 4 mmHg postoperatively. The early hospital mortality was 14% (one patient). The mean extubation time and mean time in the intensive care unit (ICU) were 13 ± 7.3 hours and 2.2 ± 0.5 days, respectively. The mean follow-up time was 11 ± 2 months. No mortality and semi-lunar valve insufficiency were observed after discharge. Conclusions: One of the major problems that occur while waiting for a Fontan operation is systemic ventricular hypertrophy and deterioration in the compliance of the ventricle due to systemic ventricular outflow stenosis. When the disadvantages of outflow resection are encountered, a DKS proves to be a good alternative.

Research paper thumbnail of Absence of the Right Pulmonary Artery Associated With a Partial Anomalous Pulmonary Venous Connection

Pediatric Cardiology, 2011

Unilateral absence of a pulmonary artery is a rare anomaly. Patients may present with hemoptysis,... more Unilateral absence of a pulmonary artery is a rare anomaly. Patients may present with hemoptysis, recurrent respiratory infections, pulmonary hypertension, or congestive heart failure. This report describes the case of a missing right pulmonary artery associated with anomalous left pulmonary venous connection not previously described in the medical literature.

Research paper thumbnail of Noncompaction of ventricular myocardium: A study of twelve patients

Journal of the American Society of Echocardiography, 2002

We report 12 patients with ventricular noncompaction who were echocardiographically identified at... more We report 12 patients with ventricular noncompaction who were echocardiographically identified at our institution since 1991. The mean age at presentation was 3.5 years. Five patients had isolated noncompaction. Three of them had subnormal left ventricular systolic function at presentation. Noncompaction was associated with complex congenital heart defect in 3 patients. Four patients had simple congenital heart defects: pulmonary stenosis, coarctation of aorta with aberrant origin of right subclavian artery, ventricular septal defect, and partial anomalous pulmonary venous return. The observed rhythm abnormalities were Wolff-Parkinson-White syndrome and paroxysmal supraventricular tachycardia, bigemini ventricular extrasystoles, and left bundle branch block. A transvenous pacemaker was implanted in a patient because of complete heart block. Noncompaction of the ventricular myocardium is rare. Our patients clearly represent the clinical and morphological spectrum of this disorder. Distinct morphological features can be diagnosed on 2-dimensional echocardiography.

Research paper thumbnail of Çift Girişli Sol Ventrikül, Ventriküloarteriyel Diskordansı Olan Olguların Izleminde Restriktif Bulboventriküler Foramen Gelişimi

Anadolu Kardiyoloji Dergisi-the Anatolian Journal of Cardiology, 2012

Research paper thumbnail of Outcomes of Operated Partial-Intermediate Atrioventricular Septal Defect Patients

Koşuyolu Heart Journal, 2021

Introduction: Follow-up results of patients with partial-intermediate atrioventricular septal def... more Introduction: Follow-up results of patients with partial-intermediate atrioventricular septal defect (AVSD) operated in 1996-2016 at Baskent University are presented. Patients and Methods: Data obtained from hospital records consists of echocardiographic and angiographic details before surgery, age and weight at surgery, operative details, presence of Down’s syndrome, details of postoperative care, early postoperative and latest echocardiographic findings and hospitalization for reintervention. Results: One hundred seventy eight patient-files were reviewed including 41.6% (n= 74) male, 58.4% (n= 104) female patients. The mean age of patients were 47.09 ± 44.25 (median, 30; 25 and 75 percentiles, 17 and 66.5, respectively) months. The mean body weight during the operation was 15.00 ± 11.22 (median, 11; 25 and 75 percentiles, 8.27 and 17, respectively) kg. Study group included 152 patients (85.3%) with partial AVSD and 26 of patients (14.7%) with partial AVSD. A total of 39 patients (...

Research paper thumbnail of Our experience with single patch repair of complete atrioventricular septal defects

Journal of Cardiology and Cardiovascular Medicine, 2020

Background: Various surgical methods have been utilized in the management of complete atrioventri... more Background: Various surgical methods have been utilized in the management of complete atrioventricular septal defects (CAVSD). Early intervention and achievement of a competent left atrioventricular valve are the key factors for successful treatment. Methods: A total of 66 patients with complete atrioventricular septal defect have been operated in a tertiary care center. Patient group consisted of 28 males and 38 females with an average age of 6.2 ± 3.3 months. Ventricular and atrial defects were repaired generally with single-patch technique using autogenous pericardium. Results: Preoperative catheterization and angiography was performed in 41 patients. Single patch and modifi ed single patch techniques were preferred in 57 and 9 patients respectively. The average duration for respiratory support, intensive care unit stay and discharge from hospital were 36 ± 49.3 hours, 4.1 ± 1.9 days, and 10.1 ± 3.3 days respectively. In the left atrioventricular valve mild, moderate and severe regurgitation were detected in 44 (66.6%), 17 (25.7%) and 2 (3%) patients postoperatively. No regurgitation was determined in 3 patients (4.5%). Two cases ended up with mortality (3%). Conclusion: Single patch repair technique can provide satisfactory surgical outcomes in patients with complete atrioventricular septal defect.

Research paper thumbnail of Echocardiographic Follow-Up of Right Ventricular Function After Tetralogy of Fallot Operation

Journal of Integrative Cardiology Open Access, 2020

Aim: Although limited in assessing right ventricular (RV) function, echocardiography is widely us... more Aim: Although limited in assessing right ventricular (RV) function, echocardiography is widely used after correction for tetralogy of Fallot (TOF). The change in echocardiographic measurements of RV in asymptomatic patients after TOF repair over a long follow-up time is not explored yet. The variation in simple echocardiographic measurements during follow-up of our TOF patients are presented. The predictive value of those parameters in determining a future pulmonary valve replacement is sought. Method: Asymptomatic patients surviving the first year after correction for simple TOF from February 2007 to December 2019 at Başkent University, Istanbul Hospital are enrolled. Patients are followed annually with echocardiography including: RV area, volume, length, RV outflow tract (RVOT) diameter and gradient, tricuspid annulus diameter, tricuspid lateral annular tissue velocities, tricuspid annular plane systolic excursion, TEI index RV ejection fraction (EF) measurements. The change in th...

Research paper thumbnail of Determination of Factors Affecting the Results of Balloon Angioplasty in Coarctation of Aorta

Turkiye Klinikleri Cardiovascular Sciences, 2019

Aort koarktasyonunda balon anjiyoplastinin başarısını, sonuçlarını, rekoarktasyon sıklığını ve bu... more Aort koarktasyonunda balon anjiyoplastinin başarısını, sonuçlarını, rekoarktasyon sıklığını ve bunu etkileyen faktörleri saptamaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Nisan 2007-Mayıs 2012 tarihleri arasında koarktasyon tanısıyla balon anjiyoplasti yapılan 53 hastanın verileri retrospektif olarak değerlendirildi. B Bu ul lg gu ul la ar r: : Ortalama yaş 14,7±35,5 (0,1-198) ay, ağırlık 7,8±8,9 kg; 23 (%43)'ü kız, 30 (%57)'u erkek hasta idi. Yaş grupları balon öncesi ve sonrası arkus ve istmus z değerleri açısından karşılaştırıldı. Balon öncesi ve sonrası, 0-3 ay (grup 1) ile 12 ay üzeri grupta arkus Z-skorları ve istmus Z-skorları, ayrıca 4-12 ay (grup 2) ile 12 ay üzeri (grup 3) grupta yine arkus aorta ve istmus Z-skorları açısından fark anlamlı bulundu. Balon öncesi sistolik basınç gradientinin ortalama 35,8±18,2 mmHg'dan, 13,8±10 mmHg'a gerilediği, koarktasyon çapının 3,3±1,9 mm'den 4,9±2,6 mm'ye arttığı görüldü. Anjiyoplasti öncesinde çıkan aorta, istmus, distal aortik arkus ve abdominal aorta çaplarının, anjiyoplasti sonrasında anlamlı olarak arttığı belirlendi. İşlem başarısı tüm hastalarda %81; 0-3 ayda %79, 4-12 ayda %77, 12 ay üzerinde ise %92 olarak bulundu. Yaş ile rekoarktasyon arasında anlamlı ilişki belirlendi. Balon öncesi istmus çapı, çıkan aorta çapının %50'si ve altında olanlarda rekoarktasyon sıklığının anlamlı düzeyde yüksek olduğu belirlendi. Komplikasyon oranı %19 olarak saptandı. S So on nu uç ç: : Balon anjiyoplasti, koarktasyon tedavisinde cerrahiye alternatif ve güvenli bir tedavi yöntemidir. Balon öncesi ve sonrasında distal transvers arkus çapı ve Z-skoru, istmus çapı ve Z-skoru, koarktasyon bölgesinin çapı rekoarktasyon ile ilişkili önemli ölçümlerdir. Yaş ve ciddi istmus hipoplazisi, rekoarktasyon için anlamlı risk faktörleridir.

Research paper thumbnail of Le-Compte Maneuver in surgical correction of absent pulmonary valve. Does it improve severe bronchial compression?

Journal of Integrative Cardiology, 2016

Here,we present a case of absent pulmonary valve syndrome operated with Le-Compte maneuver. Altho... more Here,we present a case of absent pulmonary valve syndrome operated with Le-Compte maneuver. Although Le-Compte maneuver was performed, endobronshial stent placement was carried out in order to relieve the airway obstruction.

Research paper thumbnail of Hipoplastik Sol Kalp Sendromu mu Yoksa Sol Ventrikül Hipoplazisi mi?

Turkiye Klinikleri Cardiovascular Sciences, 2011

Research paper thumbnail of Bidirectional'' Kavopulmoner Şant Yapılmış Hastalarda Prognozu Etkileyen Faktörler

Turkiye Klinikleri Journal of Cardiovascular Surgery Special Topics, 2014

Research paper thumbnail of Complications and outcome in left-sided endocarditis in children

The Turkish journal of pediatrics

We retrospectively assessed the clinical course and outcome of left-sided endocarditis in pediatr... more We retrospectively assessed the clinical course and outcome of left-sided endocarditis in pediatric patients to find out the prognostic significance of the presence and size of echocardiographically detected vegetations. Among the children admitted to our institution with endocarditis between January 1987 and October 1999, 16 patients (mean age 9.03 +/- 4.95 years) who met the Duke criteria for the diagnosis of infective endocarditis (IE) were included in this study. Rheumatic valvular disease was the most frequent underlying heart disease (10 patients: 62.5%). Five patients were operated at a mean of 13.9 months before endocarditis, and all had residual defects. Vegetation was detected in 11 cases (69%). Ten patients had major complications (within 2 weeks in 6 patients). Three patients developed congestive heart failure (CHF), six had intracranial and one had lower extremity emboli. Among them four were operated because of complications (CHF: 3 cases, intracranial emboli: 1 case)....

Research paper thumbnail of Somatic growth after corrective surgery for congenital heart disease

The Turkish journal of pediatrics

We report the somatic growth characteristics of 60 infants who underwent corrective surgery for c... more We report the somatic growth characteristics of 60 infants who underwent corrective surgery for congenital heart disease. Patients were assigned to the following groups: Group 1, cyanosis with pulmonary hypertension (PH); Group 2, cyanosis without PH; Group 3, large left-to-right shunt and PH; and Group 4, left-to-right shunt or obstructive heart lesion and no PH. Weight, length, and head circumference measurements and z scores were obtained before the operation, at 45 days, and 3, 6, and 12 months after the operation. Details about dietary intake, socioeconomic status at presentation, length of stay in the intensive care unit, hospitalization period, and perioperative events were noted. The endpoint was reaching a z score > -1 for all anthropometric measurements. At presentation, 51 patients (85%) had malnutrition. The family income, dietary intake, and presence of preoperative chronic malnutrition were interrelated and influenced the weight of the patient at all times during th...

Research paper thumbnail of Active-fixation, steroid-eluting ventricular leads: the medium-term results in children

Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2005

Low threshold characteristics and mechanical stability are important features of an ideal pacing ... more Low threshold characteristics and mechanical stability are important features of an ideal pacing lead, especially for children. We report our experience and medium-term results with a steroid-eluting, active-fixation ventricular lead in children. Telectronics Accufix II DEC model 033-212 ventricular leads were implanted in 21 patients. Eighteen patients (11 male / 7 female; 10.6+/-4.0 years), who were followed for a mean period of 6.47 +/-1.13 years, were included in the study. Pacemaker mode was DDDR in three patients, and VVIR in the remaining 15 patients. Mean threshold value was 0.5 volts at implant, which increased to 0.7 volts in the first month (p>0.05). It remained stable (0.62-0.78 V) until 5.5 years (p>0.05), increased significantly at 5.5 years (0.99+/-0.63 V at 5.5 years, p<0.05) and remained significantly high after this time (p<0.05). Pacing lead impedance did not differ significantly throughout the study (p>0.05). Thirteen pulse generators reached end-o...

Research paper thumbnail of Role of serum cardiac troponin T in the diagnosis of acute rheumatic fever and rheumatic carditis

Research paper thumbnail of Williams sendromlu hastaların kardiyak patolojileri ve klinik izlemi

Turkish Journal of Thoracic and Cardiovascular Surgery, 2013

Ağustos 2008-Ağustos 2011 tarihleri arasında Williams sendromlu dokuz hasta (3 kız, 6 erkek; ort.... more Ağustos 2008-Ağustos 2011 tarihleri arasında Williams sendromlu dokuz hasta (3 kız, 6 erkek; ort. yaş 19±29 ay) kliniğimize başvurdu. Hastaların vücut ağırlıkları 9454±5880 g idi. Hastaların ikisinde supravalvüler aort darlığı (sAS), birinde periferik pulmoner darlık (PPS), birinde supravalvüler PS (sPS), ikisinde sAS ve sPS, üçünde sAS ve iki taraflı PPS saptandı. İki hasta ameliyat edilmedi. Dört hastaya sAS ve PPS, bir hastaya sAS ile valvüler ve sPS, bir hastaya sPS ve PPS, bir hastaya sAS ameliyatı yapıldı. Gradyanlarda azalma olmakla birlikte, izlemde artış saptanmadı. Anah tar söz cük ler: Aortik darlık; klinik seyir; pulmoner darlık; Williams sendromu. Between August 2008 and August 2011, nine patients (3 girls, 6 boys; mean age 19±29 months) were admitted to our clinic with Williams syndrome. The mean body weight of the patients was 9454±5880 g. Two patients had supravalvular aortic stenosis (sAS), one had periferal pulmonary stenosis (PPS), one had supravalvular PS (sPS), two had sAS and sPS, and three had sAS and bilateral PPS. Two patients were not operated. Four patients were operated for sAS and PPS, one patient for sAS, valvular and sPS, one patient for PPS and sPS, and one patient for sAS operation. The gradients were decreased and remained unchanged during follow-up.

Research paper thumbnail of Total correction in tetralogy of Fallot with anomalous major coronary artery : an alternative method to conduit use

Cardiovascular Journal of Africa, 2012

Introduction: A coronary artery anomaly precludes the use of a trans-annular patch in right ventr... more Introduction: A coronary artery anomaly precludes the use of a trans-annular patch in right ventricular outflow tract (RVOT) reconstruction. Herein we present three patients with coronary artery anomalies who underwent total corrective operations without using a conduit. Methods: Between 2007 and 2010, 84 patients with tetralogy of Fallot (TOF) were operated on. Nine (9.4%) of them had a coronary artery anomaly. Three (3.1%) of the patients were operated on using the double-outflow technique and two had a Blalock-Taussig shunt before the total corrective operation. In two patients, the left anterior descending artery (LAD) and in one, the right coronary artery (RCA) crossed the RVOT. Results: Postoperatively, the right-to-left ventricular pressure ratios were 0.45, 0.59 and 0.60 after cardiopulmonary bypass. No gradient was detected in the RVOT in postoperative echocardiographical measurements (< 15 mmHg gradient). In all three patients, there were moderate pulmonary insufficiencies. All were discharged home on the sixth day postoperatively. Mean follow-up duration was 9.8 ± 8 months. In the follow up of all three patients, there were moderate pulmonary insufficienciencies but no right ventricular dysfunction. Conclusion: The 'double-outflow' technique is appropriate for TOF patients with a major coronary artery anomaly since it can easily be performed without the need of a conduit.

Research paper thumbnail of Sotalol in treatment of pediatric cardiac arrhythmias

Pediatrics International, 2001

Sotalol is a compound originally developed as a noncardioselective beta-blocker. In addition to i... more Sotalol is a compound originally developed as a noncardioselective beta-blocker. In addition to its class II activity seen due to its beta-blocking effect, it also prolongs cardiac action potential duration, which is known as the class III anti-arrhythmic activity. 1,2 Early experience with sotalol dates back to the 1960s. Later in 1974 it was approved in Europe as an antihypertensive agent, however, interest in sotalol's unique anti-arrhythmic properties was delayed until the early 1980s. The combined electrophysiologic effects of sotalol (class II and class III) brought it to the attention of cardiologists as a valuable drug for treating various arrhythmias in adults. 3-10 The Food and Drug Administration approved sotalol for treatment of arrhythmias in the USA, in 1992, and marketing began in 1993. 11 Sotalol is only recently used increasingly as an antiarrhythmic agent in the pediatric age group. There is limited experience on sotalol use in the management of childhood arrhythmias, 3,12-16 and only case reports mention its serious side-effects in pediatric patients. 17 The purpose of this study is to review our experience with sotalol in pediatric patients with various arrhythmias and to determine their outcome. Methods The records of patients who are treated with sotalol from 1994 to 1999 at our institution are retrospectively reviewed. The record review identified 62 pediatric patients who received this drug for various supraventricular and ventricular arrhythmias. Demographic, clinical, echocardiographic, electrocardiographic (ECG), ambulatory ECG and electrophysiologic variables were collected. The type of the

Research paper thumbnail of İki Yönlü Kavopulmoner Anastomoz Yapılan Hastalarda Klinik Sonuçları Etkileyen Faktörler

Turkish Journal of Thoracic and Cardiovascular Surgery, 2013

Bu çalışmada iki yönlü kavopulmoner anastomoz (BCPA) yapılan farklı patolojilere sahip hastalarda... more Bu çalışmada iki yönlü kavopulmoner anastomoz (BCPA) yapılan farklı patolojilere sahip hastalarda klinik sonuçları etkileyen faktörler araştırıldı.

Research paper thumbnail of Dysrhythmia as a cause of syncope in children without neurological or cardiac morphological abnormalities

Pediatrics International, 2002

Background : Arrhythmias are among the malignant causes of syncope. This study has been undertake... more Background : Arrhythmias are among the malignant causes of syncope. This study has been undertaken to determine the relative incidence and significance of dysrhythmia in the pathogenesis of syncope among patients referred to a pediatric cardiology unit. Methods : Between March 1997 and March 1999, 105 consecutive patients (59 female, 46 male) aged 11.5 ± 3.6 years without neurologic or cardiac morphologic causes were evaluated for at least one episode of syncope. A pediatric cardiologist and a pediatric neurologist evaluated all the patients. Routine chest X‐ray, 12‐lead electrocardiogram (ECG), electroencephalography (EEG), 24‐h Holter monitoring and echocardio­graphy were carried out. When deemed necessary, further tests were undertaken for the cases of syncope which were unexplained by routine tests. Results : The cause of syncope was identified as vasovagal in 25.7% (n = 27) and related to dysrhythmia in 30.5% (n = 32). The cause was migraine‐associated syncope in two children, ...

Research paper thumbnail of Treatment of subaortic stenosis in hearts with single-ventricle physiology

Cardiovascular Journal of Africa, 2012

Background: We evaluated the patients who had had a Damus-Kaye-Stansel (DKS) operation for single... more Background: We evaluated the patients who had had a Damus-Kaye-Stansel (DKS) operation for single-ventricular physiology with the aorta originating from a hypoplastic ventricle and the pulmonary artery from the systemic ventricle. Methods: Seven patients who were operated on between May 2007 and November 2010 were evaluated retrospectively. The patients had been diagnosed with a transposed doubleinlet left ventricle and triscuspid atresia, and had been waiting for a Fontan operation. Systemic outflow stenosis was defined echocardiographically as those with a gradient greater than 20 mmHg, and angiographically those with greater than 5 mmHg in the subaortic region. Results: The mean age and weight of the patients was 15 ± 9.7 months and 8 ± 3.3 kg, respectively. The mean gradient between the systemic ventricle and the aorta was 35 ± 25 mmHg. This gradient decreased to 14.3 ± 4 mmHg postoperatively. The early hospital mortality was 14% (one patient). The mean extubation time and mean time in the intensive care unit (ICU) were 13 ± 7.3 hours and 2.2 ± 0.5 days, respectively. The mean follow-up time was 11 ± 2 months. No mortality and semi-lunar valve insufficiency were observed after discharge. Conclusions: One of the major problems that occur while waiting for a Fontan operation is systemic ventricular hypertrophy and deterioration in the compliance of the ventricle due to systemic ventricular outflow stenosis. When the disadvantages of outflow resection are encountered, a DKS proves to be a good alternative.

Research paper thumbnail of Absence of the Right Pulmonary Artery Associated With a Partial Anomalous Pulmonary Venous Connection

Pediatric Cardiology, 2011

Unilateral absence of a pulmonary artery is a rare anomaly. Patients may present with hemoptysis,... more Unilateral absence of a pulmonary artery is a rare anomaly. Patients may present with hemoptysis, recurrent respiratory infections, pulmonary hypertension, or congestive heart failure. This report describes the case of a missing right pulmonary artery associated with anomalous left pulmonary venous connection not previously described in the medical literature.

Research paper thumbnail of Noncompaction of ventricular myocardium: A study of twelve patients

Journal of the American Society of Echocardiography, 2002

We report 12 patients with ventricular noncompaction who were echocardiographically identified at... more We report 12 patients with ventricular noncompaction who were echocardiographically identified at our institution since 1991. The mean age at presentation was 3.5 years. Five patients had isolated noncompaction. Three of them had subnormal left ventricular systolic function at presentation. Noncompaction was associated with complex congenital heart defect in 3 patients. Four patients had simple congenital heart defects: pulmonary stenosis, coarctation of aorta with aberrant origin of right subclavian artery, ventricular septal defect, and partial anomalous pulmonary venous return. The observed rhythm abnormalities were Wolff-Parkinson-White syndrome and paroxysmal supraventricular tachycardia, bigemini ventricular extrasystoles, and left bundle branch block. A transvenous pacemaker was implanted in a patient because of complete heart block. Noncompaction of the ventricular myocardium is rare. Our patients clearly represent the clinical and morphological spectrum of this disorder. Distinct morphological features can be diagnosed on 2-dimensional echocardiography.