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Öğe Anomalous left coronary artery arising from the pulmonary artery repair with pulmonary artery reconstruction(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2012) Ayik, M. Fatih; Oguz, Emrah; Ozturk, Pelin; Atay, Yuksel; Ceylan, Naim; Levent, Erturk; Ozyurek, Ruhi; Alayunt, Emin AlpBackground: This study aims to report the clinical features, surgical management and outcome of patients with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) who underwent Takeuchi operation combined with pulmonary artery reconstruction. Methods: We retrospectively reviewed the charts of seven patients (2 females, 5 males, mean age 53.3 +/- 52.1 months; range 6 to 151 months) with the diagnosis of ALCAPA who underwent Takeuchi operation combined with pulmonary artery reconstruction between January 2007 and June 2010 in our clinic. Detailed cardiovascular examination including electrocardiography, chest X-ray, echocardiography. computed tomography coronary angiography and cardiac catheterization were performed preoperatively on all subjects. Demographic characteristics as well as pre- pen- and postoperative data were documented and evaluated. Results: The most common symptom was periodic dyspnea (57.1%), however 28.6% of the patients were asymptomatic. The mean cardiopulmonary bypass duration and mean aortic cross-clamp time were 105.8 +/- 33.0 and 69.4 +/- 35.1 min, respectively. Postoperative durations of mechanical ventilation, Intensive Care Unit stay, and normal ward stay were 15.0 +/- 14.9 hours, 1.8 +/- 0.5 days, and 6.0 +/- 2.7 days, respectively. Malignant arrhythmia was the only complication of surgery which was identified in one patient who died at the 36 hour of post cardiac surgery. Six of seven patients who underwent Takeuchi operation with pulmonary artery reconstruction (85.7%) survived and among all of the surviving patients were symptom-free within a mean follow-up of 11.7 +/- 10.3 months. Conclusion: ALCAPA is a kind of pathology which can be corrected by surgery and an early diagnosis and intervention are of utmost importance for the long-term prognosis.Öğe Frequency of acquired von Willebrand's disease in children with congenital heart disease(Acta Cardiologica, 2007) Arslani, Mehmet Tayip; Ozyurek, Ruhi; Kavakli, Kaan; Levent, Erturk; Ulger, Zulal; Gurses, Dolunay; Akyol, Bedir; Atay, YuekselObjective - Bleeding tendency of paediatric patients with congenital heart disease has been well recognized. The underlying pathologies of this bleeding tendency have been studied extensively and many causes were identified. Among these causes, we aimed to find the frequency of acquired von Willebrand's disease (AvWD) in children with congenital heart disease. Material and methods - Forty-nine children with different forms of congenital cardiopathies who were assigned for surgery, are included in the study. Serum von Willebrand factor antigen level as well as ristocetin cofactor agglutination ratios were determined preoperatively and at one week and 6 months postoperatively. Results - Six patients (12.2%) were found to have AvWD. However, we found no relation between bleeding tendency and AvWD status. Conclusion - Although frequency of von Willebrand factor deficiency is higher in children with congenital heart disease than in the normal population, this condition does not result in adverse clinical outcomes like increased bleeding tendency during operation.Öğe The Incidence of Heparin-Induced Thrombocytopenia (HIT) After Prophylactic Heparin Exposure in Pediatric Intensive Care and Congenital Cardiology Patients: A Single Center, Prospective and Phase-IV Study: Turkish Experience(Amer Soc Hematology, 2012) Kavakli, Kaan; Mursalov, Gabil; Karapinar, Bulent; Ozyurek, Ruhi; Karapinar, Deniz Yilmaz; Balkan, Can; Karadas, Nihal OzdemirÖğe PLASMA NATRIURETIC PEPTIDES LEVELS AND ECHOCARDIOGRAPHIC FINDINGS IN LATE SUBCLINICAL ANTHRACYCLINE TOXICITY(Taylor & Francis Inc, 2008) Kantar, Mehmet; Levent, Erturk; Cetingul, Nazan; Ulger, Zulal; Ozyurek, Ruhi; Aksoylar, Serap; Kansoy, SavasThe purpose of this study was to evaluate late cardiac toxicity by comprehensive echocardiographic study, and to determine whether plasma atrial natriuretic peptide and brain natriuretic peptide levels might be indicators of neurohumoral activation. The study included 49 long-term survivors and 21 controls. A wide variety of echocardiographic parameters were measured or calculated. Plasma peptide levels were determined. Patients had significant changes in different echocardiographic parameters that are suggestive of LV systolic and diastolic dysfunction. Plasma peptide levels were not increased. The authors have found significant subclinic cardiotoxicity by echocardiography. Survivors seem to have normal plasma natriuretic peptide levels in long-term period.Öğe Short- and mid-term results of resection of discrete subaortic stenosis in children(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2016) Turhan, Soysal; Ayik, Mehmet Fatih; Isik, Onur; Akyuz, Muhammet; Levent, Erturk; Ozyurek, Ruhi; Alayunt, Emin Alp; Atay, YukselBackground: In this study, we report our short-and mid-term surgical results in patients with discrete subaortic stenosis. Methods: A total of 72 patients (43 males, 29 females; mean age 4.6 +/- 4.5 years; range, 6 months to 11 years) who were surgically treated for discrete subaortic stenosis in our clinic between September 2000 and January 2012 were retrospectively analyzed. Limited myectomy in addition to the transaortic excision of the stenotic structure was performed in all patients. Left ventricular outflow tract gradient and aortic valve regurgitation were evaluated by echocardiography following the procedure. Results: The mean follow-up was 4.9 +/- 2.7 (range, 1 to 10) years. No mortality occurred during the early and late postoperative period. Heart block which necessitated the placement of a permanent pacemaker developed in one pediatric patient. The mean preoperative left ventricle systolic gradient which was measured as 48.4 +/- 13.7 mmHg (range, 32 to 70 mmHg), diminished to 8.6 +/- 5.6 mmHg (range, 4 to 15 mmHg) in the postoperative period. Reoperation was necessary due to recurrent stenosis in two patients (2.7%) during follow-up. Conclusion: Our study results show that limited myectomy in addition to membranectomy results in good mid-term results without increasing morbidity and mortality.Öğe Surgical approaches to the aberrant right subclavian artery(Texas Heart Inst, 2006) Atay, Yuksel; Engin, Cagatay; Posacioglu, Hakan; Ozyurek, Ruhi; Ozcan, Coskun; Yagdi, Tahir; Ayik, Fatih; Alayunt, Emin AlpAberrant subclavian artery (arteria lusoria) is a rare congenital anomaly that usually does not produce symptoms. Symptomatic patients require surgical intervention. The operative approach to correct this condition has been controversial. Herein, we describe surgical approaches to the aberrant right subclavian artery. From 2000 through 2004, 3 children and 1 adult with aberrant right subclavian artery underwent operation. Our surgical approach varied according to the age of the patient. A muscle-sparing right thoracotomy was used in the pediatric patients, and a supraclavicular approach was used in the adult. Patients were treated successfully by division of the aberrant right subclavian artery and translocation to the right common carotid artery, without graft interposition. There was no operative or late morbidity or death. Symptoms were completely relieved in all patients. Although an extrathoracic approach is applicable and reliable for adult patients, we believe that adequate exposure for the described procedure is best accomplished through a right thoracotomy in pediatric patients. This approach enables optimal mobilization of the distal right subclavian artery without leaving a long stump and enables direct anastomosis to the ipsilateral carotid artery.
