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Çınar B, Atik SU, Gökalp S, Çilsal E, Şahin M, Kamalı H, Onan İS, Genç SB, Yıldız O, Haydin S, Baydili KN, Ergül Y, Güzeltaş A. Predictors of prolonged pleural effusion after Fontan operation. Cardiol Young 2023; 33:2094-2100. [PMID: 36911913 DOI: 10.1017/s1047951123000264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Prolonged pleural effusion is a fairly common condition which has considerable impact on complicated and longer hospital stays after Fontan surgery. Identifying the patient population prone to have pleural effusions is still seeking for an answer. This study is to determine the variables that may predict prolonged pleural effusion according to the data of 69 patients who underwent Fontan operation between June 2018 and December 2020 and survived to date. Prolonged pleural effusion was defined as the need for a chest tube for more than 7 days. Two patient groups, with and without prolonged effusion, were compared in terms of pre-, peri-, and post-operative variables. The patients were subdivided into "high-risk" and "low-risk" groups based on the pre-operative catheterisation data. The most frequent main diagnosis was tricuspid atresia (n: 13, 19%). Among 69 patients, 28 (40%) had prolonged pleural effusion whereas 11 (16%) had effusions that lasted longer than 14 days. Ten patients among prolonged effusion group (35%) had pulmonary atresia coexistent with the main diagnosis. Fontan operation was performed in 6 patients (8.7%) over the age of 10, and 4 of these patients (67%) had prolonged pleural effusion. Among numerous variables, statistical significance between the two groups was achieved in pre-operative mean pulmonary artery pressure, post-operative albumin, C-reactive protein levels, length of hospital stay, duration of chest tube drainage, and amount of effusion per day. Early recognition and treatment strategies with routine medical protocol use remain to be the cornerstone for the management of post-operative prolonged pleural effusions after Fontan surgery.
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Affiliation(s)
- Betül Çınar
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 34303, Turkey
| | - Sezen Ugan Atik
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 34303, Turkey
| | - Selman Gökalp
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 34303, Turkey
| | - Erman Çilsal
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 34303, Turkey
| | - Murat Şahin
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 34303, Turkey
| | - Hacer Kamalı
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 34303, Turkey
| | - İsmihan Selen Onan
- Department of Pediatric Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 34303, Turkey
| | - Serhat Bahadır Genç
- Department of Pediatric Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 34303, Turkey
| | - Okan Yıldız
- Department of Pediatric Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 34303, Turkey
| | - Sertaç Haydin
- Department of Pediatric Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 34303, Turkey
| | - Kürşad Nuri Baydili
- Department of Biostatistics, University of Health Sciences, Istanbul, Turkey
| | - Yakup Ergül
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 34303, Turkey
| | - Alper Güzeltaş
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 34303, Turkey
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Şengül FS, Ayyıldız P, Türkvatan A, Yıldız O, Güzeltaş A. Total or Partial? Rare Cases of Partial Anomalous Pulmonary Venous Return: Three Pulmonary Veins Connected to the Coronary Sinus. Balkan Med J 2023; 40:226-227. [PMID: 37073373 PMCID: PMC10175882 DOI: 10.4274/balkanmedj.galenos.2023.2023-2-65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Affiliation(s)
- Fatma Sevinç Şengül
- Clinic of Pediatric Cardiology, University of Health Sciences Turkey, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Pelin Ayyıldız
- Clinic of Pediatric Cardiology, University of Health Sciences Turkey, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Aysel Türkvatan
- Clinic of Radiology, University of Health Sciences Turkey, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Okan Yıldız
- Clinic of Pediatric Cardiac Surgery, University of Health Sciences Turkey, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Alper Güzeltaş
- Clinic of Pediatric Cardiology, University of Health Sciences Turkey, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
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3
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Ozcanoglu HD, Öztürk E, Tanıdır İC, Şahin GT, Ozalp S, Yıldız O, Özcan FG, Hatemi A. The comparison of three different acute kidney injury classification systems after congenital heart surgery. Pediatr Int 2022; 64:e15270. [PMID: 36239168 DOI: 10.1111/ped.15270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/09/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND We aimed to compare the frequency of acute kidney injury (AKI) and its effects on mortality and morbidity with different classification systems in pediatric patients who had surgery under cardiopulmonary bypass for congenital heart disease. METHODS This study included children younger than 18 years old who were followed up in the pediatric cardiac intensive care unit between September 1 and December 1, 2020, after congenital heart surgery with cardiopulmonary bypass. Each case was categorized postoperatively in terms of AKI using Pediatric-Modified Risk, Injury, Failure, Loss, and End-Stage (pRIFLE), Acute Kidney Injury Network (AKIN), and Kidney Disease: Improving Global Outcomes (KDIGO). Hospital mortality (developed within the first 30 days postoperatively) and morbidity (longer than 7 days intensive care unit stay) were compared by three model classes. Results were evaluated statistically. RESULTS One hundred patients were included in the study. The median age was 3 months (1 day-180 months). Acute kidney injury was diagnosed in 49% of the cases according to the pRIFLE classification. It was diagnosed in 31% of the patients by AKIN classification. It was diagnosed in 41% of the patients with the KDIGO criteria. Morbidity was observed in 25% (n = 25) of all cases. The morbidity predictor was 0.800 for pRIFLE, 0.747 for AKIN and 0.853 for KDIGO by receiver operating characteristics analysis. All three categories predicted morbidity significantly (P < 0.001). Mortality was 10% (n = 10) for all groups. The mortality predictor was 0.783 for pRIFLE, 0.717 for AKIN and 0.794 for KDIGO by receiver operating characteristics analysis, and all three categories predicted mortality significantly (P < 0.001). CONCLUSIONS Regardless of the three methods used, AKI was commonly detected in pediatric patients undergoing congenital heart surgery. pRIFLE classification diagnosed more patients with AKI than AKIN and KDIGO. The KDIGO and pRIFLE classifications were better in predicting hospital mortality.
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Affiliation(s)
- Hatice Dilek Ozcanoglu
- Department of Anaesthesiology and Reanimation, Istanbul Saglik Bilimleri University Basaksehir Cam and Sakura Hospital, Istanbul, Turkey
| | - Erkut Öztürk
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Basaksehir Cam and Sakura Hospital, Istanbul, Turkey
| | - İbrahim Cansaran Tanıdır
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Basaksehir Cam and Sakura Hospital, Istanbul, Turkey
| | - Gulhan Tunca Şahin
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Basaksehir Cam and Sakura Hospital, Istanbul, Turkey
| | - Serife Ozalp
- Department of Anaesthesiology and Reanimation, Istanbul Saglik Bilimleri University Basaksehir Cam and Sakura Hospital, Istanbul, Turkey
| | - Okan Yıldız
- Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University Basaksehir Cam and Sakura Hospital, Istanbul, Turkey
| | - Funda Gümüş Özcan
- Department of Anaesthesiology and Reanimation, Istanbul Saglik Bilimleri University Basaksehir Cam and Sakura Hospital, Istanbul, Turkey
| | - Alican Hatemi
- Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University Basaksehir Cam and Sakura Hospital, Istanbul, Turkey
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Yıldız O, Köse B, Tanıdır IC, Pekkan K, Güzeltaş A, Haydin S. Single-center experience with routine clinical use of 3D technologies in surgical planning for pediatric patients with complex congenital heart disease. ACTA ACUST UNITED AC 2021; 27:488-496. [PMID: 34313233 DOI: 10.5152/dir.2021.20163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE This study was planned to assess the application of three-dimensional (3D) cardiac modeling in preoperative evaluation for complex congenital heart surgeries. METHODS From July 2015 to September 2019, 18 children diagnosed with complex congenital heart diseases (CHDs) were enrolled in this study (double outlet right ventricle in nine patients, complex types of transposition of the great arteries in six patients, congenitally corrected transposition of the great arteries in two patients, and univentricular heart in one patient). The patients' age ranged from 7 months to 19 years (median age, 14 months). Before the operation, 3D patient-specific cardiac models were created based on computed tomography (CT) data. Using each patient's data, a virtual computer model (3D mesh) and stereolithographic (SLA) file that would be printed as a 3D model were generated. These 3D cardiac models were used to gather additional data about cardiac anatomy for presurgical decision-making. RESULTS All 18 patients successfully underwent surgeries, and there were no mortalities. The 3D patient-specific cardiac models led to a change from the initial surgical plans in 6 of 18 cases (33%), and biventricular repair was considered feasible. Moreover, the models helped to modify the planned biventricular repair in five cases, for left ventricular outflow tract obstruction removal and ventricular septal defect enlargement. 3D cardiac models enable pediatric cardiologists to better understand the spatial relationships between the ventricular septal defect and great vessels, and they help surgeons identify risk structures more clearly for detailed planning of surgery. There was a strong correlation between the models of the patients and the anatomy encountered during the operation. CONCLUSION 3D cardiac models accurately reveal the patient's anatomy in detail and are therefore beneficial for planning surgery in patients with complex intracardiac anatomy.
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Affiliation(s)
- Okan Yıldız
- Department of Pediatric Cardiovascular Surgery, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, Turkey
| | - Banu Köse
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, Turkey
| | | | - Kerem Pekkan
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, Turkey
| | - Alper Güzeltaş
- Department of Biomedical Engineering, Koç University, Istanbul, Turkey
| | - Sertaç Haydin
- Department of Pediatric Cardiovascular Surgery, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, Turkey
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5
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Çınar B, Öztürk E, Yıldız O, Haydın S, Güzeltaş A. A Quite Rare Association: Levo-Malposition of the Great Arteries with Left Juxtaposition of the Atrial Appendages in "Double Outlet Right Ventricle". Braz J Cardiovasc Surg 2021; 36:717-719. [PMID: 34236784 PMCID: PMC8597615 DOI: 10.21470/1678-9741-2020-0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Although many anatomical variations may be encountered in children with double outlet right ventricle, coexistence of levo-malposed great vessels and left juxtaposed atrial appendages is uncommonly observed. This case report underlines the rarity of this anatomical combination and its clinical significance along with the surgical management in an infant.
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Affiliation(s)
- Betül Çınar
- Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, Istanbul, Turkey
| | - Erkut Öztürk
- Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, Istanbul, Turkey
| | - Okan Yıldız
- Department of Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, Istanbul, Turkey
| | - Sertaç Haydın
- Department of Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, Istanbul, Turkey
| | - Alper Güzeltaş
- Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, Istanbul, Turkey
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Erek E, Yalçınbaş YK, Sarıosmanoğlu N, Özkan M, Yıldız O, Şenkaya I, Özdemir F, Biçer M, Sarıtaş AB, Atay Y, Seçici S, Kutsal A, Haydin S, Bilen C, Onan IS, Tuncer ON, Citoglu G, Doğan A, Turkoz R, Temur B, Koc M, Sarıoğlu CT. First Harvest of Pediatric and Congenital Heart Surgery Multicenter Database in Turkey: Novel Application of Real-Time Online Reporting. World J Pediatr Congenit Heart Surg 2021; 12:377-386. [PMID: 33942691 DOI: 10.1177/2150135121995474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES A new congenital heart surgery database (CKCV) with real-time online reporting function was recently developed in Turkey. All standard international parameters were used, but Aristotle Comprehensive Complexity score was modified. In this study, the first analysis of the CKCV Database is reported. METHODS The CKCV Database included 2307 procedures from 12 centers between January 2018 and March 2020. All parameters, including 10 real-time online reports, which represent the number of centers, number and mortality rates of all procedures, number of extracorporeal membrane oxygenation (ECMO) and results, details of postoperative complications, age-group statistics, analysis for priority status, mean intensive care and hospital stay durations of the procedures, results of Aristotle Basic, Modified Aristotle Comprehensive (MACC) and Society of Thoracic Surgeons-European Association (STAT) Score Categories, comparison of centers were analyzed. RESULTS Most common 10 procedures were ventricular septal defect (VSD) repair (n = 273), tetralogy of Fallot (TOF) repair (n = 243), atrial septal defect (ASD) repair (n = 181), complete AVSD repair (n = 95), cavopulmonary anastomosis (n = 81), systemic to pulmonary shunt (n = 79), modified Fontan (n = 71), subaortic resection, (n = 66) PA banding (n = 66), and arterial switch operation (n = 66). Cardiopulmonary bypass was used in 84.6% of the procedures. Overall mortality rate was 6.0%. A total of 618 major and 570 minor complications were observed in 333 and 412 patients, respectively. According to six MACC categories, number of the patients and mortality rates were I (293; 0.3%); II (713; 1.4%); III (601; 3.3%); IV (607; 12%); V (84; 35.7%); and VI (9; 55.6%), respectively. Analysis of five STAT Categories showed 0.7, 3.8, 5.4, 14.9, and 54.7% mortality rates. CONCLUSIONS CKCV Database has a great potential for nationwide quality improvement studies. Users could instantly analyze and compare their results to national and international aggregate data using a real-time online reporting function. This is the first multicenter congenital database study in Turkey.
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Affiliation(s)
- Ersin Erek
- Acibadem Mehmet Ali Aydinlar University, School of Medicine, Atakent Hospital, Istanbul, Turkey.,Children Heart Foundation, Istanbul, Turkey
| | - Yusuf Kenan Yalçınbaş
- Children Heart Foundation, Istanbul, Turkey.,Acibadem Bakirkoy Hospital, Istanbul, Turkey
| | - Nejat Sarıosmanoğlu
- Health Sciences University, Dr. Behçet Uz Training and Research Hospital, Izmir
| | - Murat Özkan
- Başkent University, Ankara Hospital, Ankara, Turkey
| | - Okan Yıldız
- Health Sciences University, Istanbul Mehmet Akif Ersoy Training and Research Hospital, Istanbul, Turkey
| | | | - Fatih Özdemir
- Health Sciences University, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Mehmet Biçer
- Health Sciences University, Erzurum Training and Research Hospital, Erzurum, Turkey
| | | | | | | | - Ali Kutsal
- Health Sciences University, Dr. Sami Ulus Training and Research Hospital, Ankara, Turkey
| | - Sertac Haydin
- Health Sciences University, Istanbul Mehmet Akif Ersoy Training and Research Hospital, Istanbul, Turkey
| | - Cagatay Bilen
- Health Sciences University, Dr. Behçet Uz Training and Research Hospital, Izmir
| | - Ismihan Selen Onan
- Health Sciences University, Istanbul Mehmet Akif Ersoy Training and Research Hospital, Istanbul, Turkey
| | | | | | | | - Riza Turkoz
- Acibadem Bakirkoy Hospital, Istanbul, Turkey
| | - Bahar Temur
- Acibadem Mehmet Ali Aydinlar University, School of Medicine, Atakent Hospital, Istanbul, Turkey
| | - Murat Koc
- Health Sciences University, Dr. Sami Ulus Training and Research Hospital, Ankara, Turkey
| | - C Tayyar Sarıoğlu
- Acibadem Mehmet Ali Aydinlar University, School of Medicine, Atakent Hospital, Istanbul, Turkey.,Children Heart Foundation, Istanbul, Turkey.,Acibadem Bakirkoy Hospital, Istanbul, Turkey
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Ergün S, Çilsal E, Genç SB, Yıldız O, Tanıdır İC, Onan İS, Güzeltaş A, Haydin S. Univentricular Pulmonary Artery Banding: How Tight is Tight Enough for Successful Progress? Pediatr Cardiol 2021; 42:840-848. [PMID: 33474612 DOI: 10.1007/s00246-021-02548-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
We investigated the effects of intraoperative parameters measured during pulmonary artery banding operations and pre-discharge parameters on the completion of Fontan procedures. Fifty consecutive patients with single-ventricle anomalies and unrestricted pulmonary blood flow who underwent a PAB operation in and were discharged from our hospital were retrospectively analyzed. Patients who underwent a Fontan operation, a Glenn shunt operation, or who were eligible for a Fontan procedure were defined as the "successful group." Patients who needed rebanding prior to a bidirectional Glenn shunt, patients who were not eligible for a Glenn shunt, and those underwent a takedown due to high pulmonary arterial pressure after implantation of a Glenn shunt were defined as the "failure-to-progress group." The successful group included 34 (68%) patients and the failure-to-progress group included 16 (32%) patients. The median age was 2 months (IQR 1-4 months). There was a statistically significant difference between the groups in terms of systolic pulmonary arterial pressure, mean pulmonary arterial pressure, and pulmonary arterial pressure/systemic arterial pressure after PAB (P = 0.01, 0.03, and 0.03, respectively). While the median gradient before discharge was 60 mm Hg (IQR 50-70 mm Hg) in the successful group, it was 47.5 mm Hg (IQR 45-63.7 mm Hg) in the failure-to-progress group (P = 0.05). Mortality was observed in one (2.9%) patient in the successful group and five (31.2%) patients in the failure-to-progress group (P = 0.04). Successful pulmonary arterial banding increases long-term survival. Adequate targets should be determined, efforts should be made to achieve these targets, and patients should be followed up closely in terms of rebanding when the targets are not reached.
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Affiliation(s)
- Servet Ergün
- Department of Pediatric Cardiovascular Surgery, Erzurum Regional Training and Research Hospital, Üniversite, Çat Yolu Cd, 25240, Yakutiye/Erzurum, Turkey.
| | - Erman Çilsal
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Serhat Bahadır Genç
- Department of Pediatric Cardiovascular Surgery, Istanbul Saglik Bilimleri University Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Okan Yıldız
- Department of Pediatric Cardiovascular Surgery, Başakşehir Çam Sakura City Hospital, Istanbul, Turkey
| | | | - İsmihan Selen Onan
- Department of Pediatric Cardiovascular Surgery, Istanbul Saglik Bilimleri University Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Alper Güzeltaş
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Sertaç Haydin
- Department of Pediatric Cardiovascular Surgery, Istanbul Saglik Bilimleri University Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
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Haydin S, Genç SB, Ozturk E, Yıldız O, Gunes M, Tanidir IC, Guzeltas A. Surgical Strategies and Results for Repair of Pulmonary Atresia with Ventricular Septal Defect and Major Aortopulmonary Collaterals: Experience of a Single Tertiary Center. Braz J Cardiovasc Surg 2020; 35:445-451. [PMID: 32864922 PMCID: PMC7454616 DOI: 10.21470/1678-9741-2019-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective To evaluate surgical management and results of patients with pulmonary atresia and ventricular septal defect with major aortopulmonary collateral arteries (PA/VSD/MAPCAs). Methods We reviewed a consecutive series of patients with PA/VSD/MAPCAs between January 2012 and October 2018. Study patients were separated into Group A, efficient MAPCAs; Group B, hypoplastic MAPCAs; Group C, severe hypoplastic MAPCAs at all divisions; and Group D, distal stenosis at most MAPCAs divisions. Results Thirty-six patients were included in the study. Median age at operation time was 5.5 months (2-110 months), median weight was 8 kg (2.5-21 kg), and median number of MAPCAs was three (1-6). In Group A, 14 patients underwent single-stage total correction (TC); in Group B, 18 patients underwent unifocalization and central shunting; and in Group C, four patients had aortopulmonary window creation and collateral ligation. No patient was placed in Group D. Seventy percent of patients (n=25) had the TC operation. Early mortality was not seen in Group A, but the other two groups had a 13.6% mortality rate. At the follow-up, three patients had reintervention, two had new conduit replacement, and one had right ventricular outflow tract reconstruction. Conclusion Evaluating patients with PA/VSD/MAPCAs in detail and subdividing them is quite useful in determining the appropriate surgical approach. With this strategy, TC can be achieved in most patients. Single-stage TC is better than other surgical methods due to its lower mortality and reintervention rates. Care should be taken in terms of early postoperative intensive care complications and reintervention indications during follow-ups.
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Affiliation(s)
- Sertac Haydin
- Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Serhat Bahadır Genç
- Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Erkut Ozturk
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Okan Yıldız
- Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Mustafa Gunes
- Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Ibrahim Cansaran Tanidir
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Alper Guzeltas
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
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9
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Ergün S, Yıldız O, Ayyıldız P, Çilsal E, Öztürk E, Onan İS, Güzeltaş A, Haydin S. Parameters affecting pleural drainage and management strategy after Fontan operation. J Card Surg 2020; 35:1556-1562. [DOI: 10.1111/jocs.14691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Servet Ergün
- Department of Pediatric Cardiovascular Surgery Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital Istanbul Turkey
- Vocational School of Health Services Istanbul Aydın Universty Istanbul Turkey
| | - Okan Yıldız
- Department of Pediatric Cardiovascular Surgery Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital Istanbul Turkey
| | - Pelin Ayyıldız
- Department of Pediatric Cardiology Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital Istanbul Turkey
| | - Erman Çilsal
- Department of Pediatric Cardiology Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital Istanbul Turkey
| | - Erkut Öztürk
- Department of Pediatric Cardiology Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital Istanbul Turkey
| | - İsmihan Selen Onan
- Department of Pediatric Cardiovascular Surgery Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital Istanbul Turkey
| | - Alper Güzeltaş
- Department of Pediatric Cardiology Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital Istanbul Turkey
| | - Sertaç Haydin
- Department of Pediatric Cardiovascular Surgery Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital Istanbul Turkey
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10
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Onan İS, Timur B, Yıldız O, Öztürk E, Haydin S. Outcomes of the 10th Istanbul Symposium on pediatric extracorporeal life support systems and cardiopulmonary perfusion. Artif Organs 2019; 44:187-190. [PMID: 31782187 DOI: 10.1111/aor.13600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/05/2019] [Accepted: 11/08/2019] [Indexed: 11/29/2022]
Affiliation(s)
- İsmihan Selen Onan
- Cardiovascular Surgery, Pediatric Cardiac Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Barış Timur
- Cardiovascular Surgery, Pediatric Cardiac Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Okan Yıldız
- Cardiovascular Surgery, Pediatric Cardiac Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Erkut Öztürk
- Cardiovascular Surgery, Pediatric Cardiac Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Sertaç Haydin
- Cardiovascular Surgery, Pediatric Cardiac Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
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Öztürk E, Yıldız O, Çine N, Tüzün B, Onan S, Ergül Y, Güzeltaş A, Haydin S, Yeniterzi M, Bakır İ. The use of neonatal extracorporeal life support in pediatric cardiac intensive care unit. J Matern Fetal Neonatal Med 2016; 30:1397-1401. [PMID: 27432486 DOI: 10.1080/14767058.2016.1214706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM The aim of the study is to evaluate extracorporeal life support system (ECLS) employed in neonates in pediatric cardiac intensive care unit. MATERIAL AND METHODS Twenty-five neonates that required ECLS in between November 2010 and November 2015 were evaluated. RESULTS The median age was 12 days (range 3-28 days) and the median body weight was 3 kg (range 2.5-5 kg). Venoarterial ECLS was performed in all of the cases. Ascendan aorta-right atrial cannulation in 22 patients and neck cannulation in three patients were performed. The reason for ECLS was E-CPR in two patients, inability to wean from cardiopulmonary bypass (CPB) in seven patients, respiratory insufficiency and hypoxia in nine patients, low cardiac output (LCOS) in seven patients. Median duration of ECLS was four days (range 1-15). Hemorrhagic complications developed in 15, renal complications in 13, pulmonary complications in 12, infectious complications in 11, neurologic complications in three and mechanical complications in two of the patients. Weaning was successful in 15 of the patients. Eleven patients were successfully discharged. CONCLUSION ECLS is an important treatment option that is performed successfully in many centers around the world to maintain life support in patients unresponsive to medical treatment. The utilization of this modality especially in newborns with congenital heart disease should be taken into consideration.
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Affiliation(s)
- Erkut Öztürk
- a Department of Pediatric Cardiology , Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Research and Training Hospital , Istanbul , Turkey and
| | - Okan Yıldız
- b Department of Pediatric Cardiovascular Surgery , Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Research and Training Hospital , Istanbul , Turkey
| | - Nihat Çine
- b Department of Pediatric Cardiovascular Surgery , Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Research and Training Hospital , Istanbul , Turkey
| | - Behzat Tüzün
- b Department of Pediatric Cardiovascular Surgery , Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Research and Training Hospital , Istanbul , Turkey
| | - Selen Onan
- b Department of Pediatric Cardiovascular Surgery , Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Research and Training Hospital , Istanbul , Turkey
| | - Yakup Ergül
- a Department of Pediatric Cardiology , Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Research and Training Hospital , Istanbul , Turkey and
| | - Alper Güzeltaş
- a Department of Pediatric Cardiology , Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Research and Training Hospital , Istanbul , Turkey and
| | - Sertaç Haydin
- b Department of Pediatric Cardiovascular Surgery , Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Research and Training Hospital , Istanbul , Turkey
| | - Mehmet Yeniterzi
- b Department of Pediatric Cardiovascular Surgery , Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Research and Training Hospital , Istanbul , Turkey
| | - İhsan Bakır
- b Department of Pediatric Cardiovascular Surgery , Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Research and Training Hospital , Istanbul , Turkey
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Bayramoglu Z, Ezelsoy M, Çaynak B, Yıldız O, Sagbaş E, Yazıcıoglu N, Akpınar B. OP-174 SURGICAL PLACEMENT OF LEFT VENTRICULAR LEAD FOR CARDIAC RESYNCHRONIZATION THERAPY AFTER FAILURE OF PERCUTANEOUS ATTEMPTS. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70175-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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