Tijen Alkan-bozkaya - Academia.edu (original) (raw)

Papers by Tijen Alkan-bozkaya

Research paper thumbnail of Impact of Pulsatile Flow on Vital Organ Recovery During Cardiopulmonary Bypass in Neonates and Infants

Research paper thumbnail of Perioperative Assessment of Cerebral Oxygenation Using Near Infrared Spectroscopy in a Two Months-Old Infant with Hemitruncus Arteriosus: Case Report

Turkiye Klinikleri Journal of Case Reports, 2014

Research paper thumbnail of Eighth Istanbul Symposium on Pediatric Extracorporeal Life Support Systems and Pediatric Cardiopulmonary Perfusion

Research paper thumbnail of Biventricular Broken Heart (Takotsubo Cardiomyopathy) in a Middle Aged Adult

Journal-Cardiovascular Surgery, 2015

Research paper thumbnail of eComment. Prompt decision making on the site of surgical approach in patients with chest trauma-a brief communication

Interactive CardioVascular and Thoracic Surgery, 2014

Research paper thumbnail of eComment. Combined surgical strategies for anomalous connection of coronary artery to pulmonary artery in adults

Interactive CardioVascular and Thoracic Surgery, 2015

Research paper thumbnail of Residual right to left shunt leading to cyanosis for thirty years following surgical closure of atrial septal defect

Journal-Cardiovascular Surgery, 2014

Research paper thumbnail of Correlation Between Cerebral-Renal Near-Infrared Spectroscopy and Ipsilateral Renal Perfusion Parameters as Clinical Outcome Predictors After Open Heart Surgery in Neonates and Infants

Artificial Organs, 2015

The objective of this clinical study is to determine whether correlation exists among cerebral an... more The objective of this clinical study is to determine whether correlation exists among cerebral and renal near-infrared spectroscopy (NIRS) measurements, renal Doppler ultrasonography parameters (resistive index, peak systolic velocity), and early postoperative clinical outcomes following cardiac surgery in neonates and infants. Thirty-seven patients undergoing surgery for congenital heart defects with an age of less than 3 months, all of whom were in the high-risk group according to Aristotle Basic Complexity risk stratification score, were enrolled in our study. Cerebral, renal NIRS values and renal Doppler ultrasonography measurements were recorded for each patient at the 4th postoperative hour. The renal resistive indices were calculated for each case, and the patients were divided into two groups according to renal resistive index (RI) values. Group I included the patients with a RI of greater than 0.8 (n = 25) and Group II included the patients with a RI of less than 0.8 (n = 12). The postoperative outcome parameters were compared in between two groups. Group I (RI >0.8) had lower postoperative mean urine output than Group II (RI <0.8) (P = 0.041). The lactate levels were significantly higher in Group I (P = 0.049), as well. The postoperative intensive care unit and hospital stay of Group I was significantly higher than Group II (P = 0.048). Both cerebral and renal NIRS values and the assessment of renal RI as well as peak systolic values can be used in order to predict the early clinical outcome in cardiac surgery patients in early infantile and neonatal period.

Research paper thumbnail of Benefits of pulsatile flow in pediatric cardiopulmonary bypass procedures: from conception to conduction

Research paper thumbnail of Translational research in pediatric extracorporeal life support systems and cardiopulmonary bypass procedures: 2011 update

World journal for pediatric & congenital heart surgery, 2011

Over the past 6 years at Penn State Hershey, we have established the pediatric cardiovascular res... more Over the past 6 years at Penn State Hershey, we have established the pediatric cardiovascular research center with a multidisciplinary research team with the goal to improve the outcomes for children undergoing cardiac surgery with cardiopulmonary bypass (CPB) and extracorporeal life support (ECLS). Due to the variety of commercially available pediatric CPB and ECLS devices, both in vitro and in vivo translational research have been conducted to achieve the optimal choice for our patients. By now, every component being used in our clinical settings in Penn State Hershey has been selected based on the results of our translational research. The objective of this review is to summarize our translational research in Penn State Hershey Pediatric Cardiovascular Research Center and to share the latest results with all the interested centers.

Research paper thumbnail of Istanbul Symposium on Neonatal and Pediatric Cardiopulmonary Bypass Procedures

Research paper thumbnail of Penn State Hershey—Center for Pediatric Cardiovascular Research

Research paper thumbnail of Impact of Pulsatile Perfusion on Clinical Outcomes of Neonates and Infants With Complex Pathologies Undergoing Cardiopulmonary Bypass Procedures

Artificial Organs, 2013

The aim of this clinical trial was to evaluate the pulsatile perfusion mode in pediatric patients... more The aim of this clinical trial was to evaluate the pulsatile perfusion mode in pediatric patients who had complex cardiac pathologies according to Jenkins stratifications (category 4) undergoing cardiopulmonary bypass procedures (CPB). Patients with transposition of great arteries (TGA) and ventricular septal defect (VSD) were included in this clinical study. Eighty-nine consecutive pediatric patients undergoing open heart surgery for repair of TGA-VSD were prospectively entered into the study and were randomly assigned to either the pulsatile perfusion group (Group P, n = 58) or the nonpulsatile perfusion group (Group NP, n = 31). There were no differences between groups in terms of demographical and intraoperative parameters. The pulsatile group needed significantly less inotropic support (P < 0.05) and had lower lactate levels (P < 0.001), higher urine output (P < 0.01), and higher albumin levels (P < 0.05). In addition, the pulsatile group had less ICU (P < 0.01) and hospital stays (P < 0.001). We conclude that the use of pulsatile flow is a better option and should be considered for repair of the complex congenital heart defects.

Research paper thumbnail of Outcomes of the Eighth International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion

Research paper thumbnail of Cardiac Surgery of Premature and Low Birthweight Newborns: Is a Change of Fate Possible?

Artificial Organs, 2010

Low birthweight (LBW) continues to be a high-risk factor in surgery for congenital heart disease.... more Low birthweight (LBW) continues to be a high-risk factor in surgery for congenital heart disease. This risk is particularly very high in very low birthweight infants under 1500g and extremely LBW infants under 1000g. From January 2005 to December 2008, 33 consecutive LBW neonates underwent cardiac surgery in our clinic in keeping with the criteria for choice of surgery. Their weight range was between 800 and 1900g. Nine of them were under 1000g. Cardiopulmonary bypass (CPB) was used in 17 patients (39.5%) and pulsatile perfusion mode was applied to patients in the CPB group. The same surgical team operated to achieve palliation (8 patients, 24.2%) or full repair (25 patients, 75.8%). Median gestational age was 36 weeks with 12 (36.4%) premature babies (≤37 weeks). Median age at operation was 5 days. Pathologies were single ventricle (n=3), pulmonary atresia-ventricular septal defect (n=3), aortic coarctation (n=10), aorticopulmonary window and interrupted aortic arch combination (n=6), patent arterial duct (n=11), critical aortic stenosis (n=8), and tetralogy of Fallot with pulmonary atresia (n=2). One infant had VATER syndrome. Selective cerebral perfusion technique was used in complex arch pathologies for cerebral protection. Median follow-up was 14 months. There were four early postoperative deaths. None of the cases showed a need for early reoperation. The acceptable early- and midterm mortality rates in this group suggest that these operations can be successfully performed. There is a need for further multicenter studies to evaluate these high-risk groups.

Research paper thumbnail of Istanbul Symposiums on Pediatric Extracorporeal Life Support Systems

Research paper thumbnail of Impact of Pulsatile Flow on Vital Organ Recovery During Cardiopulmonary Bypass in Neonates and Infants

Research paper thumbnail of Perioperative Assessment of Cerebral Oxygenation Using Near Infrared Spectroscopy in a Two Months-Old Infant with Hemitruncus Arteriosus: Case Report

Turkiye Klinikleri Journal of Case Reports, 2014

Research paper thumbnail of Eighth Istanbul Symposium on Pediatric Extracorporeal Life Support Systems and Pediatric Cardiopulmonary Perfusion

Research paper thumbnail of Biventricular Broken Heart (Takotsubo Cardiomyopathy) in a Middle Aged Adult

Journal-Cardiovascular Surgery, 2015

Research paper thumbnail of eComment. Prompt decision making on the site of surgical approach in patients with chest trauma-a brief communication

Interactive CardioVascular and Thoracic Surgery, 2014

Research paper thumbnail of eComment. Combined surgical strategies for anomalous connection of coronary artery to pulmonary artery in adults

Interactive CardioVascular and Thoracic Surgery, 2015

Research paper thumbnail of Residual right to left shunt leading to cyanosis for thirty years following surgical closure of atrial septal defect

Journal-Cardiovascular Surgery, 2014

Research paper thumbnail of Correlation Between Cerebral-Renal Near-Infrared Spectroscopy and Ipsilateral Renal Perfusion Parameters as Clinical Outcome Predictors After Open Heart Surgery in Neonates and Infants

Artificial Organs, 2015

The objective of this clinical study is to determine whether correlation exists among cerebral an... more The objective of this clinical study is to determine whether correlation exists among cerebral and renal near-infrared spectroscopy (NIRS) measurements, renal Doppler ultrasonography parameters (resistive index, peak systolic velocity), and early postoperative clinical outcomes following cardiac surgery in neonates and infants. Thirty-seven patients undergoing surgery for congenital heart defects with an age of less than 3 months, all of whom were in the high-risk group according to Aristotle Basic Complexity risk stratification score, were enrolled in our study. Cerebral, renal NIRS values and renal Doppler ultrasonography measurements were recorded for each patient at the 4th postoperative hour. The renal resistive indices were calculated for each case, and the patients were divided into two groups according to renal resistive index (RI) values. Group I included the patients with a RI of greater than 0.8 (n = 25) and Group II included the patients with a RI of less than 0.8 (n = 12). The postoperative outcome parameters were compared in between two groups. Group I (RI >0.8) had lower postoperative mean urine output than Group II (RI <0.8) (P = 0.041). The lactate levels were significantly higher in Group I (P = 0.049), as well. The postoperative intensive care unit and hospital stay of Group I was significantly higher than Group II (P = 0.048). Both cerebral and renal NIRS values and the assessment of renal RI as well as peak systolic values can be used in order to predict the early clinical outcome in cardiac surgery patients in early infantile and neonatal period.

Research paper thumbnail of Benefits of pulsatile flow in pediatric cardiopulmonary bypass procedures: from conception to conduction

Research paper thumbnail of Translational research in pediatric extracorporeal life support systems and cardiopulmonary bypass procedures: 2011 update

World journal for pediatric & congenital heart surgery, 2011

Over the past 6 years at Penn State Hershey, we have established the pediatric cardiovascular res... more Over the past 6 years at Penn State Hershey, we have established the pediatric cardiovascular research center with a multidisciplinary research team with the goal to improve the outcomes for children undergoing cardiac surgery with cardiopulmonary bypass (CPB) and extracorporeal life support (ECLS). Due to the variety of commercially available pediatric CPB and ECLS devices, both in vitro and in vivo translational research have been conducted to achieve the optimal choice for our patients. By now, every component being used in our clinical settings in Penn State Hershey has been selected based on the results of our translational research. The objective of this review is to summarize our translational research in Penn State Hershey Pediatric Cardiovascular Research Center and to share the latest results with all the interested centers.

Research paper thumbnail of Istanbul Symposium on Neonatal and Pediatric Cardiopulmonary Bypass Procedures

Research paper thumbnail of Penn State Hershey—Center for Pediatric Cardiovascular Research

Research paper thumbnail of Impact of Pulsatile Perfusion on Clinical Outcomes of Neonates and Infants With Complex Pathologies Undergoing Cardiopulmonary Bypass Procedures

Artificial Organs, 2013

The aim of this clinical trial was to evaluate the pulsatile perfusion mode in pediatric patients... more The aim of this clinical trial was to evaluate the pulsatile perfusion mode in pediatric patients who had complex cardiac pathologies according to Jenkins stratifications (category 4) undergoing cardiopulmonary bypass procedures (CPB). Patients with transposition of great arteries (TGA) and ventricular septal defect (VSD) were included in this clinical study. Eighty-nine consecutive pediatric patients undergoing open heart surgery for repair of TGA-VSD were prospectively entered into the study and were randomly assigned to either the pulsatile perfusion group (Group P, n = 58) or the nonpulsatile perfusion group (Group NP, n = 31). There were no differences between groups in terms of demographical and intraoperative parameters. The pulsatile group needed significantly less inotropic support (P < 0.05) and had lower lactate levels (P < 0.001), higher urine output (P < 0.01), and higher albumin levels (P < 0.05). In addition, the pulsatile group had less ICU (P < 0.01) and hospital stays (P < 0.001). We conclude that the use of pulsatile flow is a better option and should be considered for repair of the complex congenital heart defects.

Research paper thumbnail of Outcomes of the Eighth International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion

Research paper thumbnail of Cardiac Surgery of Premature and Low Birthweight Newborns: Is a Change of Fate Possible?

Artificial Organs, 2010

Low birthweight (LBW) continues to be a high-risk factor in surgery for congenital heart disease.... more Low birthweight (LBW) continues to be a high-risk factor in surgery for congenital heart disease. This risk is particularly very high in very low birthweight infants under 1500g and extremely LBW infants under 1000g. From January 2005 to December 2008, 33 consecutive LBW neonates underwent cardiac surgery in our clinic in keeping with the criteria for choice of surgery. Their weight range was between 800 and 1900g. Nine of them were under 1000g. Cardiopulmonary bypass (CPB) was used in 17 patients (39.5%) and pulsatile perfusion mode was applied to patients in the CPB group. The same surgical team operated to achieve palliation (8 patients, 24.2%) or full repair (25 patients, 75.8%). Median gestational age was 36 weeks with 12 (36.4%) premature babies (≤37 weeks). Median age at operation was 5 days. Pathologies were single ventricle (n=3), pulmonary atresia-ventricular septal defect (n=3), aortic coarctation (n=10), aorticopulmonary window and interrupted aortic arch combination (n=6), patent arterial duct (n=11), critical aortic stenosis (n=8), and tetralogy of Fallot with pulmonary atresia (n=2). One infant had VATER syndrome. Selective cerebral perfusion technique was used in complex arch pathologies for cerebral protection. Median follow-up was 14 months. There were four early postoperative deaths. None of the cases showed a need for early reoperation. The acceptable early- and midterm mortality rates in this group suggest that these operations can be successfully performed. There is a need for further multicenter studies to evaluate these high-risk groups.

Research paper thumbnail of Istanbul Symposiums on Pediatric Extracorporeal Life Support Systems