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    Changes in etiology, cause of death, survival, and mortality rates in cardiac transplant patients from 1998 to 2011 [1998-2011 arasi dönemde kalp nakli hastalarinda etyoloji, ölüm nedenleri, sagkalim ve mortalite oranlarindaki degişim]
    (2012) Güngör H.; Nalbantgil S.; Oguz E.; Ayik M.F.; Zoghi M.; Ertugay S.; Karakula S.; Engin Ç.; Yagdi T.; Özbaran M.
    Objectives: We retrospectively analyzed changes in heart failure etiology, causes of death, mortality and survival rates in cardiac transplant patients from 1998 to 2011. Study design: A total of 144 patients (112 men, 32 women; mean age 40.2±14.3 years) underwent cardiac transplantation between February 1998 and January 2011. The patients were divided into two groups; hence, 63 patients (group 1; mean age 42.5±12.6 years) receiving transplantation up to January 2006, and 81 patients (group 2; mean age 38.4±15.3 years) receiving transplantation from 2006 to 2011. In the latter period, a ventricular assist device was used in 17 patients before transplantation. Results: Dilated cardiomyopathy was the main cause of heart transplantation in both groups (71.4% vs. 74.1%). Overall mortality, in-hospital mortality (<30 days), and late mortality (?30 days) rates were 39.6% (n=57), 13.9% (n=20), and 25.7% (n=37), respectively. Survival rates for 1, 2, 5, and 10 years were 76%, 69%, 59%, and 46%, respectively. The second group had significantly lower rates of overall mortality and late mortality compared to group 1 (29.6% vs. 52.4%, p=0.005; 16.0% vs. 38.1%, p=0.002, respectively), whereas early mortality rates were similar. Survival rates were also higher in the second group, but these differences did not reach significance (1-year, 76.1% vs. 74.6%; 2-year, 73.0% vs. 65.1%; 5-year, 63.8% vs. 55.6%; log rank 0.33). In both groups, infections (30.3% vs. 33.3%), right ventricular failure (12.1% vs. 29.2%), and sudden cardiac death (15.2% vs. 16.7%) were the leading causes of death. Conclusion: Our data show that overall and late mortality rates show significant decreases in cardiac transplant patients from 1998 to 2011. © 2012 Türk Kardiyoloji Dernegi.
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    Psychiatric evaluation of children and adolescents with left ventricular assist devices
    (Lippincott Williams and Wilkins, 2012) Ozbaran B.; Kose S.; Yagdi T.; Engin C.; Erermis S.; Uysal T.; Ayik F.; Karakula S.; Ulger Z.; Atay Y.; Ozbaran M.
    Objectives: To evaluate the psychiatric symptoms of children equipped with a ventricular assist device (VAD) and follow them up for 6 months. With the shortage of donor hearts available for the treatment of end-stage heart failure, VADs have been used to provide temporary treatment until a heart becomes available. VADs provide external sources of power for mechanical circulatory support and are capable of sustaining life over weeks and months. This study provides preliminary details about the psychiatric symptoms and disorders of the first eight children equipped with a VAD in Turkey. Methods: Eight pediatric patients who recently underwent VAD implantation, aged 1 to 16 years, were evaluated using the Kiddie Schedule for Affective Disorders and Schizophrenia, Child Behavior Checklist, Children's Depression Inventory, Beck Depression Inventory, and State-Trait Anxiety Inventory for Children and followed up for 6 months. Results: In the first evaluation, five participants had a psychiatric disorder diagnosis. Two patients had adjustment disorder with depressive and anxiety symptoms; one had anxiety disorder, not otherwise specified; and two had major depressive disorder. The anxiety and depressive symptom levels in questionnaires were consistent with psychiatric diagnoses. Two patients had heart transplantation during the follow-up period. Conclusions: To determine and treat psychiatric symptoms and disorders at an earlier stage, it is important for children and adolescents with a VAD and those who have undergone heart transplantation to be evaluated by a multidisciplinary consultation liaison team including psychiatrists, psychologists, consultant nurses, and counselors. Abbreviations: VAD = ventricular assist deviceK-SADS = Kiddie Schedule for Affective Disorders and SchizophreniaCBCL = Child Behavior ChecklistBDI = Beck Depression InventoryCDI = Children's Depression InventorySTAI-C = State-Trait Anxiety Inventory for ChildrenMDD = major depressive disorderAD = adjustment disorderPE.I = initial psychiatric evaluationPE.II = second psychiatric evaluation © 2012 by the American Psychosomatic Society.