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Kamalı H, Sivaslı Gül Ö, Çoban Ş, Sarı G, Sarıtaş T, Erdem A, Aldudak B. Experiences of Two Centers in Percutaneous Ventricular Septal Defect Closure Using Konar Multifunctional Occluder. Anatol J Cardiol 2022; 26:276-285. [PMID: 35435839 PMCID: PMC9366381 DOI: 10.5152/anatoljcardiol.2021.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Hacer Kamalı
- Department of Pediatric Cardiology, Faculty of Medicine, İstanbul Medipol University, İstanbul-Turkey
- Corresponding author:Hacer Kamalı ✉
| | - Özlem Sivaslı Gül
- Department of Pediatric Cardiology, Health Science University, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Şenay Çoban
- Department of Pediatric Cardiology, Faculty of Medicine, İstanbul Medipol University, İstanbul-Turkey
| | - Gizem Sarı
- Department of Pediatric Cardiology, Faculty of Medicine, İstanbul Medipol University, İstanbul-Turkey
| | - Türkay Sarıtaş
- Department of Pediatric Cardiology, İstanbul Health Science University, Ümraniye Training and Research Hospital, İstanbul, Turkey
| | - Abdullah Erdem
- Department of Pediatric Cardiology, Faculty of Medicine, İstanbul Medipol University, İstanbul-Turkey
| | - Bedri Aldudak
- Department of Pediatric Cardiology, Health Science University, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
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Kamalı H, Tanıdır İC, Erdem A, Sarıtaş T, Güzeltaş A. The Use of Chronic Total Occlusion (CTO) Wires for Perforation of Atretic Pulmonary Valve; Two Centers Experience. Pediatr Cardiol 2021; 42:1041-1048. [PMID: 33844078 DOI: 10.1007/s00246-021-02578-1] [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] [Received: 10/03/2020] [Accepted: 02/25/2021] [Indexed: 11/25/2022]
Abstract
Pulmonary valve atresia with intact ventricular septum (PA-IVS) can be treated either surgically or transcatheterly for eligible patients. Perforation of pulmonary valves using chronic total occlusion (CTO) guidewires has been reported as an alternative to radiofrequency (RF) perforation. We sought to report our experience with CTO guidewires for perforation of atretic pulmonary valves and subsequent balloon dilatation (with or without patent ductus arteriosus stenting) in patients with PA-IVS from two centers. A retrospective study was carried out on PA-IVS patients who underwent intervention between March 2014 and September 2019, in which CTO guidewire was employed for pulmonary valve perforation. A total of 26 patients were identified. The median age and weight of the patients were 5.2 days (range 1-21 days) and 3.1 kg (range 2.2-3.8 kg), respectively. All patients were situs solitus, except one patient with left atrial isomerism. The right ventricle (RV) morphology was bipartite in 22/26 patients and tripartite in 4/26 patients. Before the procedure, the mean saturation was 76% (range 70-86%) while the patients were under prostaglandin infusion. The pulmonary valve perforation attempt was performed with the Asahi Conquest Pro 9 CTO wire (n = 6) or Asahi Pro 12 CTO wire (n = 18) and/or Asahi Miracle CTO wire (n = 2). The procedure was successful in 20/26 (77%) patients using CTO wires. We analyzed the efficiency of CTO wire based on the subtypes: Conquest Pro 9 in 6/6 (100%) patients, Conquest Pro 12 in 12/18 (67%) patients, and Miracle in 2/2 (100%) patients. Before CTO wire usage in 3 patients, radiofrequency (RF) perforation was unsuccessful. Among these 3 patients, pulmonary valve perforation was successful in 2 patients with CTO wire; hence, in the remaining patient, perforation was also unsuccessful with CTO wire. After CTO wire perforation was unsuccessful in 6 patients, RF perforation was attempted in 3 patients (2 successful attempts and 1 unsuccessful attempts), and one patient as referred to surgery. Desaturation was persistent in 19 cases, which necessitated ductus arteriosus stenting. Early procedural complication was observed in 3/26 (11%) patients. Two of these patients had vascular complications due to the sheath, which was treated with heparin infusion and streptokinase, and the remaining patient had sudden bradycardia and cardiac arrest during the procedure and did not respond to cardiac resuscitation. CTO wires should be keep in mind for atretic pulmonary valve perforation as a first choice or when RF perforation is unsuccessful.
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Affiliation(s)
- Hacer Kamalı
- Department of Pediatric Cardiology, Istanbul Health Scıence University, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istasyonmahallesi Turgut Özal Bulvarı Küçükçekmece, 34303, Istanbul, Turkey.
| | - İbrahim Cansaran Tanıdır
- Department of Pediatric Cardiology, Istanbul Health Scıence University, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istasyonmahallesi Turgut Özal Bulvarı Küçükçekmece, 34303, Istanbul, Turkey
| | - Abdullah Erdem
- Department of Pediatric Cardiology, Istanbul Medipol Universıty, Istanbul, Turkey
| | - Türkay Sarıtaş
- Department of Pediatric Cardiology, Istanbul Medipol Universıty, Istanbul, Turkey
| | - Alper Güzeltaş
- Department of Pediatric Cardiology, Istanbul Health Scıence University, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istasyonmahallesi Turgut Özal Bulvarı Küçükçekmece, 34303, Istanbul, Turkey
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Aktaş D, Erdem A, Çelik N, Kamalı H, Sarıtaş T. A rare coronary anomaly with masked diagnosis: Anomalous left circumflex artery from right pulmonary artery. Turk Kardiyol Dern Ars 2015; 43:551-3. [PMID: 26363748 DOI: 10.5543/tkda.2015.94399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Anomalous origin of the circumflex coronary artery from the pulmonary artery is a rare congenital coronary anomaly. While it generally follows an asymptomatic course, if undiagnosed it may lead to severe clinical outcomes, including sudden death. The condition can be masked by associated defects, so when it is clinically suspected, diagnosis must be confirmed by conventional and/or magnetic resonance angiography, even if echocardiography clearly shows coronary roots. This report describes a patient who underwent neonatal surgery for aortic coarctation and was diagnosed with coronary artery anomaly at 15 months old.
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Affiliation(s)
- Doğukan Aktaş
- Department of Pediatric Cardiology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Abdullah Erdem
- Department of Pediatric Cardiology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Nida Çelik
- Department of Pediatric Cardiology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Hacer Kamalı
- Department of Pediatric Cardiology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Türkay Sarıtaş
- Department of Pediatric Cardiology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
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Güler E, Babur Güler G, Sarıtaş T, Boztosun B. [Case images: Right arcus aorta and Kommerell diverticulum: A rare challenge encountered as a consequence of increaesed left radial artery interventions]. Turk Kardiyol Dern Ars 2015; 43:498. [PMID: 26148090 DOI: 10.5543/tkda.2015.23934] [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] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ekrem Güler
- Department of Cardiology, İstanbul Medipol University Faculty of Medicine, İstanbul, Turkey
| | - Gamze Babur Güler
- Department of Cardiology, İstanbul Medipol University Faculty of Medicine, İstanbul, Turkey
| | - Türkay Sarıtaş
- Department of Pediatric Cardiology, İstanbul Medipol University Faculty of Medicine, İstanbul, Turkey
| | - Bilal Boztosun
- Department of Cardiology, İstanbul Medipol University Faculty of Medicine, İstanbul, Turkey
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Demir IH, Erdem A, Sarıtaş T, Demir F, Erol N, Yücel IK, Aydemir NA, Celebi A. Diagnosis, treatment and outcomes of patients with aortopulmonary window. Balkan Med J 2013; 30:191-6. [PMID: 25207099 DOI: 10.5152/balkanmedj.2013.6995] [Citation(s) in RCA: 8] [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] [Received: 05/16/2012] [Accepted: 12/27/2012] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Aortopulmonary window (APW) is a communication between the ascending aorta and the pulmonary artery in the presence of two separate semilunar valves and is the rarest of septal defects. AIMS To present our experience with the diagnosis and outcome of APW cases. STUDY DESIGN Retrospective cohort study. METHODS Between June 2003 and October 2011, thirteen patients were diagnosed with APW. Clinical features of patients, findings of echocardiographic and angiographic examination, results of surgical intervention and follow-up were reviewed retrospectively. RESULTS Eleven children (10 days to 16 years), underwent surgical correction of APW. In a 12-month-old boy, the defect was repaired by the transcatheter approach. In addition to APW repair, closure of VSD was performed in 2 patients. APW were associated with interruption in two patients; one also had a complex pathology. None of the patients died due to complications of surgical or transcatheter procedures. After a median follow-up period of 40 months, the patients were asymptomatic and none of them required additional medication, except for the patient with complex pathology including an interrupted aortic arch, who underwent balloon angioplasty for recoarctation. CONCLUSION In any infant with the findings of congestive heart failure and failure to thrive, APW must be kept in mind as a differential diagnosis. In isolated APW cases before 6 months of age, echocardiography is often sufficient for diagnosis. In complex cases, cardiac catheterisation is performed for the comprehensive evaluation of associated defects. After 6 months, cardiac catheterisation could be utilised to perform vasoreactivity testing and, if possible, to close the defect.
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Affiliation(s)
- Ibrahim Halil Demir
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Abdullah Erdem
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Türkay Sarıtaş
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Fadli Demir
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Nurdan Erol
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Ilker Kemal Yücel
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Numan Ali Aydemir
- Department of Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Ahmet Celebi
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
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Celebi A, Sarıtaş T, Demir H, Akdeniz C, Erdem A. Transcatheter treatment of interrupted arcus aorta in two adolescents. Anadolu Kardiyol Derg 2012; 12:75-76. [PMID: 22231938 DOI: 10.5152/akd.2012.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Ahmet Celebi
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey
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Erdem A, Akdeniz C, Sarıtaş T, Erol N, Demir F, Karaci AR, Yalçın Y, Celebi A. Cheatham-Platinum stent for native and recurrent aortic coarctation in children and adults: immediate and early follow-up results. Anadolu Kardiyol Derg 2011; 11:441-9. [PMID: 21712167 DOI: 10.5152/akd.2011.112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To present our institutional experience of endovascular Cheatham-Platinum stent implantation in children and adults with native and recurrent aortic coarctation. METHODS Between August 2007 and November 2009, 45 patients had aortic coarctation treated with 47 stents implantation. We preferred primarily stent implantation in adult patient with coarctation, in children more than five years-old it is preferred in cases of aneurysm, subatretic or blind coarctation and coarctation with patent ductus arteriosus or in restenosis. Files of stent-implanted patients were retrospectively analyzed in terms of patients' demographic features, echocardiographic and angiographic findings both before and after procedure. Patients were grouped as Group 1: native coarctation and Group 2: recoarctation developed after either surgery or balloon angioplasty. Findings of the cases' were compared using paired and unpaired Student's t, Mann-Whitney U and Chi-square tests. RESULTS Sixteen covered and 31 bare totally 47 balloon expandable stents were implanted in 45 patients. The mean follow up duration was 12.1 ± 7.1, median 11 months (2-29 months). There was no procedure related death. In two patients two stents were implanted in tandem. While the coarctation of the aorta was native in 26 patients (functionally interrupted aortic arch in one), recoarctation was detected in 7 patients after surgery, in 8 patients after balloon angioplasty, in 4 patients both after surgery and balloon angioplasty. One patient had functionally interrupted aortic arch perforated with guide wire and then covered stent implanted. The mean age 12.2 ± 5.9 years (5-33 years) and mean body mass index was 21 ± 3.7 kg/m2 (14.8-31 kg/m2). Considering all cases, a statistically significant decrease in both the invasive and echocardiographic gradients (p<0.001 for both) and statistically significant increase in lesion diameter (p<0.001) were detected. The decrease in invasive and echocardiographic gradients and increase in lesion diameter is statistically significant in each group also (p<0.001, <0.001 and <0.001 for both groups, respectively). Before the procedure, the invasive gradient was significantly higher and the lesion diameter was significantly lower in group I than in group II (p=0.002 and p=0.005, respectively). Also the percentage of decrease in gradient and increase in diameter was statistically higher in group 1 than in group 2 (p=0.04 and p=0.04). CONCLUSION Our early and short- term follow-up results indicate that stent implantation is safe and very effective in reducing coarctation gradient and increasing lesion diameter both in native coarctation and recoarctation.
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Affiliation(s)
- Abdullah Erdem
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, İstanbul-Turkey.
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Akdeniz C, Erdem A, Demir F, Sarıtaş T, Zeybek C, Demir H, Yalçın Y, Celebi A. [Our medium-term results with aortic balloon valvuloplasty and factors affecting development of aortic regurgitation]. Anadolu Kardiyol Derg 2011; 11:329-335. [PMID: 21561847 DOI: 10.5152/akd.2011.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The objective of this study was to assess medium-term results of aortic balloon valvuloplasty (ABV) in congenital aortic stenosis and to determine factors affecting development of aortic regurgitation (AR). METHODS Between September 2003 and January 2010, 114 ABV procedures performed on 97 patients analyzed retrospectively. Patients were evaluated in terms of transvalvular gradients before and after procedure, development of new aortic insufficiency or increase in the current insufficiency and factors affecting the procedural success and development of aortic insufficiency. In addition, follow up results were also evaluated in terms of restenosis and increase or decrease of aortic regurgitation. Student's t-test, ANOVA for repeated measurements, linear discriminant and Kaplan-Meier survival analyses were used for statistical analysis. RESULTS The mean age was 6.63±6.33 year (2 days-21 years). Mean follow-up was 32.6±25.1 months (1 to 75 months). Thirty-seven patients were infant (<1 year) and 18 of them were newborn. The peak systolic pressure gradient decreased from 77.2±24.9 mmHg to 28.5±12.9 mmHg (p=0.0001). Eighty-two procedures were optimal, 29 suboptimal and 3 were unsuccessful. AR developed in totally 53 patients, 16 of them were significant degree. Balloon /annulus ratio and the percentage of reduction in gradient was meaningfully higher in patients with significant aortic regurgitation (p=0.02 and p=0.03, respectively). Infants show more significant AR (9/37, 24%) in comparison with bigger patients (7/77, 9%) (p=0.02). Four patients died after procedure at intensive care unit, three of them were newborn. CONCLUSION ABV is safe and effective palliative method for the treatment of congenital aortic stenosis. AR, which was the most common complication, incidence was increased in infancy and was related with high balloon/annulus ratio and high reduction in gradient.
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Affiliation(s)
- Celal Akdeniz
- Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Pediyatrik Kardiyoloji Kliniği, İstanbul, Türkiye
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Erdem A, Demir F, Sarıtaş T, Karaci AR, Celebi A. [Treatment of pulmonary artery bifurcation stenosis by simultaneous implantation of Genesis XD stent]. ACTA ACUST UNITED AC 2011; 11:E13-4. [PMID: 21501984 DOI: 10.5152/akd.2011.074] [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] [Indexed: 11/22/2022]
Affiliation(s)
- Abdullah Erdem
- Dr. Siyami Ersek, Göğüs Kalp-Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Çocuk Kardiyolojisi Kliniği, İstanbul, Türkiye.
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Saylan Çevik B, Tavlı V, Sarıtaş T, Oran I, Ergene O. Transcatheter closure of congenital coronary arteriovenous fistula using detachable balloon technique. Anadolu Kardiyol Derg 2010; 10:463-464. [PMID: 20929707 DOI: 10.5152/akd.2010.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Berna Saylan Çevik
- Department of Pediatric Cardiology, Dr Behçet Uz Children's Hospital, İzmir, Turkey.
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Erdem A, Aydemir NA, Demir H, Zeybek C, Sarıtaş T, Akdeniz C, Karacı AR, Celebi A. Anomalous origin of one pulmonary artery branch from the ascending aorta: experience of our center. Turk Kardiyol Dern Ars 2010; 38:411-415. [PMID: 21200120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
OBJECTIVES Anomalous origin of one pulmonary artery branch from the aorta in the presence of separate aortic and pulmonary valves is a rare but important entity necessitating early diagnosis and surgery to prevent irreversible vascular pulmonary disease. We evaluated our experience with seven infants having this anomaly. STUDY DESIGN Between December 2003 and 2009, a total of seven infants (2 girls, 5 boys, age range 4 days to 84 days) were diagnosed as having anomalous origin of one pulmonary artery branch from the aorta. Clinical records were reviewed for clinical features, operative procedures, and postoperative follow-up. RESULTS Common symptoms were dyspnea, tachypnea, and poor feeding. All the cases were diagnosed by echocardiography. The right pulmonary artery in six cases and the left pulmonary artery in one case originated from the ascending aorta. In addition, three patients had patent ductus arteriosus (PDA), five patients had patent foramen ovale, and one patient had interruption of the aortic arch and aortopulmonary window. All patients underwent surgical re-implantation of the anomalous pulmonary artery branch to the pulmonary trunk. Associated surgical procedures included PDA ligation in three patients, and total repair of interrupted aortic arch and aortopulmonary window in one patient. There were no in-hospital deaths. Two patients had prolonged intubation (10 and 16 days). All patients were discharged in good clinical condition. During a follow-up period ranging from two months to six years, only one patient developed stenosis at the site of anastomosis. CONCLUSION Prompt diagnosis at infancy, improved surgical technique, and good patient care decrease mortality and morbidity associated with anomalous origin of the pulmonary artery from the aorta.
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MESH Headings
- Abnormalities, Multiple/diagnosis
- Abnormalities, Multiple/mortality
- Abnormalities, Multiple/surgery
- Aorta/abnormalities
- Aorta/pathology
- Aorta/surgery
- Ductus Arteriosus, Patent/diagnosis
- Ductus Arteriosus, Patent/mortality
- Ductus Arteriosus, Patent/surgery
- Female
- Foramen Ovale, Patent/diagnosis
- Foramen Ovale, Patent/mortality
- Foramen Ovale, Patent/surgery
- Humans
- Infant
- Infant, Newborn
- Male
- Postoperative Complications
- Pulmonary Artery/abnormalities
- Pulmonary Artery/pathology
- Pulmonary Artery/surgery
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Affiliation(s)
- Abdullah Erdem
- Department of Pediatric Cardiology, Siyami Ersek Cardiovascular Surgery Center, İstanbul, Turkey.
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