Various surgical techniques have been described to repair congenital supravalvular aortic stenosi... more Various surgical techniques have been described to repair congenital supravalvular aortic stenosis, but the best technique is still controversial. The three-patch repair reconstructs a symmetric aortic root and is supposed to restore a normal physiology. We present two successfully operated patients who had congenital supravalvular aortic stenosis using symmetric three-patch repair. We will discuss the decision making of surgical techniques, and its effects of postoperative course of this pathology in this case report.
Saccular aneurysms of the aorta in childhood are rare, and the low incidence of aortic aneurysms ... more Saccular aneurysms of the aorta in childhood are rare, and the low incidence of aortic aneurysms among children limits our understanding of their aetiology and surgical indications. In this case report, we describe the successful surgical treatment of a 5-year-old boy with severe aortic valvular stenosis, supra-valvular aortic stenosis, and a large saccular aneurysm in the anterior wall of the ascending aorta, without any connective tissue disorder.
Background: The port catheters are used to give long-term total parenteral nutrition, intravenous... more Background: The port catheters are used to give long-term total parenteral nutrition, intravenous fluids, blood and blood products, or to be preferred for oncology and hematological diseases. In this study, we sought to review our results concerning the subcutaneous port catheter appliance in childhood malignancies. Methods: Two hundred ten subcutaneous port catheters applied to 192 patients between November 2010 and October 2015 were examined retrospectively in a crosssectional study. Information such as demographic data, primary diagnoses, port types and implantation durations were recorded. Localization of the intervention, surgical technique, early and late complications and causes of port removal were evaluated. Results: Mean age of patients was 6.4 ± 4.9 years (1 month-17 years), 77 (40.1%) were female and 115 (59.9%) male. One hundred twenty nine ports were inserted from the right internal jugular vein, 59 to right subclavian vein, 14 to left subclavian vein and 8 to left internal jugular vein. Total duration of implantation was 55,492 days and median duration was 289 days. Early complications were: 1 (0.5%) hemothorax, 1 (0.5%) pneumothorax, 1 (0.5%) carotid artery injury, 1 (0.5%) arrhythmia and in 2 (1%) cases port mal-positioning. Late complications were: 9 (4.3%) infection and 8 (3.8%) mechanical problems, 7 (3.3%) thrombosis, and in 1 (0.5%) port fracture was detected. Port catheter was removed in 18 (8.6%) cases. No significant difference was found when jugular and subclavian vein implantation was compared in terms of all complications, especially infection and thrombosis. Conclusion: Use of port catheter is a safe option in children who are receiving a long-term chemotherapy. Education of the medical team will diminish the complication rate in port catheter insertions.
Various surgical techniques have been described to repair congenital supravalvular aortic stenosi... more Various surgical techniques have been described to repair congenital supravalvular aortic stenosis, but the best technique is still controversial. The three-patch repair reconstructs a symmetric aortic root and is supposed to restore a normal physiology. We present two successfully operated patients who had congenital supravalvular aortic stenosis using symmetric three-patch repair. We will discuss the decision making of surgical techniques, and its effects of postoperative course of this pathology in this case report.
Aim: To evaluate the effects of radial incision of the tricuspid valve in patients who had underg... more Aim: To evaluate the effects of radial incision of the tricuspid valve in patients who had undergone ventricular septal defect (VSD) closure. Methods: Overall 173 patients were included in this study between 2012 and 2019. In 44 individuals, a tricuspid valve radial incision (TVRI) was included in the surgical process. Results: There were no mortalities. The demographic data did not differ between the groups. The mean ages of the TVRI and non-TVRI groups were 2.92 ± 3.88 and 2.69 ± 2.80 years, respectively. There were no significant differences between the groups in terms of mean duration of cardiopulmonary bypass aortic cross-clamp, postoperative intubation time and intensive care unit stay. Mild tricuspid valve regurgitation was detected in only two patients in the TVRI and six patients in the non-TVRI groups. There was no tricuspid valve stenosis and all patients were in New York Heart Association functional class 1. Conclusion: This technique, which can facilitate exposure and closure of VSDs, did not compromise the tricuspid valve function at mid-term, therefore proving to be safe.
Today, congenital heart diseases may be treated without surgery through advances in interventiona... more Today, congenital heart diseases may be treated without surgery through advances in interventional cardiology. However, complications such as infection and thrombus formation may develop due to foreign materials used during these procedures. Surgical intervention may be required for the removal of the device utilized for the procedure. In this case report, we present the surgical treatment of a residual ventricular septal defect (VSD) that had developed in a 6-year-old patient with an apical muscular VSD closed with the Amplatzer muscular VSD device. The patient was admitted to the emergency room with complaints of abdominal pain and high fever 5 days after discharge without any cardiac symptoms. When she arrived at our clinic, she had a heart rate of 95 bpm, blood pressure of 110/70 mmHg, and temperature of 38.5ºC. Examinations of the other systems were normal, except for a 3/6 pan-systolic murmur at the mesocardiac focus on cardiac auscultation. Echocardiography showed a residual ...
World Journal for Pediatric and Congenital Heart Surgery, 2014
A 13-month-old boy with a diagnosis of atrial septal defect and pulmonary valve stenosis was admi... more A 13-month-old boy with a diagnosis of atrial septal defect and pulmonary valve stenosis was admitted for corrective surgery. Right juxtaposition of the atrial appendages with a tunnel between the atrial appendages was detected during the surgery. The patient was operated successfully and had an uneventful recovery. Once right juxtaposition of the atrial appendages has been identified, the possibility of a "tunnel" communication between the appendages must be considered and ruled out.
Background: The aims of the study were to analyze the importance of two different surgical proced... more Background: The aims of the study were to analyze the importance of two different surgical procedures, and to determine outcomes for neonates with coarctation of the aorta in two newly established centers. Methods: Outcomes of two different surgical repairs for coarctation of the aorta in 43 infants were evaluated retrospectively. The study was designed as a nonrandomized, crosssectional study. The subclavian flap repair was applied to 22 patients (51%) and resection with extended end-to-end anastomosis technique to 21 patients (49%). After all operative survivors were followed up with a mean follow-up of 1.8 ± 0.8 years, data analyzed with t-test and the p value < 0.05 were considered statistically significant. Results: The overall mortality rate was 4.6%. Forty mmHg gradients were determined in a patient from Resection Group postoperatively in the fifteenth month. After the balloon angioplasty, the gradient decreased to 25 mmHg. The presence of ventricular septal defect (p = 0.094) was the only significant predictor of adverse short-term outcome among the associated cardiac defects analyzed. The first-year survival rate was 100% in both groups in isolated coarctation (p = 0.965), however; such rate was found as 100% and 93.25% * Corresponding author. M. Karaçelik et al. 2 in Waldhausen Group and Resection Group, respectively in complex coarctation (p = 0.294). Conclusions: Both the subclavian flap repair and resection with extended end-to-end anastomosis for coarctation of the aorta in infants provide excellent short-term outcomes with lower recurrence rates requiring surgery or angioplasty.
Various surgical techniques have been described to repair congenital supravalvular aortic stenosi... more Various surgical techniques have been described to repair congenital supravalvular aortic stenosis, but the best technique is still controversial. The three-patch repair reconstructs a symmetric aortic root and is supposed to restore a normal physiology. We present two successfully operated patients who had congenital supravalvular aortic stenosis using symmetric three-patch repair. We will discuss the decision making of surgical techniques, and its effects of postoperative course of this pathology in this case report.
Saccular aneurysms of the aorta in childhood are rare, and the low incidence of aortic aneurysms ... more Saccular aneurysms of the aorta in childhood are rare, and the low incidence of aortic aneurysms among children limits our understanding of their aetiology and surgical indications. In this case report, we describe the successful surgical treatment of a 5-year-old boy with severe aortic valvular stenosis, supra-valvular aortic stenosis, and a large saccular aneurysm in the anterior wall of the ascending aorta, without any connective tissue disorder.
Background: The port catheters are used to give long-term total parenteral nutrition, intravenous... more Background: The port catheters are used to give long-term total parenteral nutrition, intravenous fluids, blood and blood products, or to be preferred for oncology and hematological diseases. In this study, we sought to review our results concerning the subcutaneous port catheter appliance in childhood malignancies. Methods: Two hundred ten subcutaneous port catheters applied to 192 patients between November 2010 and October 2015 were examined retrospectively in a crosssectional study. Information such as demographic data, primary diagnoses, port types and implantation durations were recorded. Localization of the intervention, surgical technique, early and late complications and causes of port removal were evaluated. Results: Mean age of patients was 6.4 ± 4.9 years (1 month-17 years), 77 (40.1%) were female and 115 (59.9%) male. One hundred twenty nine ports were inserted from the right internal jugular vein, 59 to right subclavian vein, 14 to left subclavian vein and 8 to left internal jugular vein. Total duration of implantation was 55,492 days and median duration was 289 days. Early complications were: 1 (0.5%) hemothorax, 1 (0.5%) pneumothorax, 1 (0.5%) carotid artery injury, 1 (0.5%) arrhythmia and in 2 (1%) cases port mal-positioning. Late complications were: 9 (4.3%) infection and 8 (3.8%) mechanical problems, 7 (3.3%) thrombosis, and in 1 (0.5%) port fracture was detected. Port catheter was removed in 18 (8.6%) cases. No significant difference was found when jugular and subclavian vein implantation was compared in terms of all complications, especially infection and thrombosis. Conclusion: Use of port catheter is a safe option in children who are receiving a long-term chemotherapy. Education of the medical team will diminish the complication rate in port catheter insertions.
Various surgical techniques have been described to repair congenital supravalvular aortic stenosi... more Various surgical techniques have been described to repair congenital supravalvular aortic stenosis, but the best technique is still controversial. The three-patch repair reconstructs a symmetric aortic root and is supposed to restore a normal physiology. We present two successfully operated patients who had congenital supravalvular aortic stenosis using symmetric three-patch repair. We will discuss the decision making of surgical techniques, and its effects of postoperative course of this pathology in this case report.
Aim: To evaluate the effects of radial incision of the tricuspid valve in patients who had underg... more Aim: To evaluate the effects of radial incision of the tricuspid valve in patients who had undergone ventricular septal defect (VSD) closure. Methods: Overall 173 patients were included in this study between 2012 and 2019. In 44 individuals, a tricuspid valve radial incision (TVRI) was included in the surgical process. Results: There were no mortalities. The demographic data did not differ between the groups. The mean ages of the TVRI and non-TVRI groups were 2.92 ± 3.88 and 2.69 ± 2.80 years, respectively. There were no significant differences between the groups in terms of mean duration of cardiopulmonary bypass aortic cross-clamp, postoperative intubation time and intensive care unit stay. Mild tricuspid valve regurgitation was detected in only two patients in the TVRI and six patients in the non-TVRI groups. There was no tricuspid valve stenosis and all patients were in New York Heart Association functional class 1. Conclusion: This technique, which can facilitate exposure and closure of VSDs, did not compromise the tricuspid valve function at mid-term, therefore proving to be safe.
Today, congenital heart diseases may be treated without surgery through advances in interventiona... more Today, congenital heart diseases may be treated without surgery through advances in interventional cardiology. However, complications such as infection and thrombus formation may develop due to foreign materials used during these procedures. Surgical intervention may be required for the removal of the device utilized for the procedure. In this case report, we present the surgical treatment of a residual ventricular septal defect (VSD) that had developed in a 6-year-old patient with an apical muscular VSD closed with the Amplatzer muscular VSD device. The patient was admitted to the emergency room with complaints of abdominal pain and high fever 5 days after discharge without any cardiac symptoms. When she arrived at our clinic, she had a heart rate of 95 bpm, blood pressure of 110/70 mmHg, and temperature of 38.5ºC. Examinations of the other systems were normal, except for a 3/6 pan-systolic murmur at the mesocardiac focus on cardiac auscultation. Echocardiography showed a residual ...
World Journal for Pediatric and Congenital Heart Surgery, 2014
A 13-month-old boy with a diagnosis of atrial septal defect and pulmonary valve stenosis was admi... more A 13-month-old boy with a diagnosis of atrial septal defect and pulmonary valve stenosis was admitted for corrective surgery. Right juxtaposition of the atrial appendages with a tunnel between the atrial appendages was detected during the surgery. The patient was operated successfully and had an uneventful recovery. Once right juxtaposition of the atrial appendages has been identified, the possibility of a &amp;amp;amp;amp;amp;amp;quot;tunnel&amp;amp;amp;amp;amp;amp;quot; communication between the appendages must be considered and ruled out.
Background: The aims of the study were to analyze the importance of two different surgical proced... more Background: The aims of the study were to analyze the importance of two different surgical procedures, and to determine outcomes for neonates with coarctation of the aorta in two newly established centers. Methods: Outcomes of two different surgical repairs for coarctation of the aorta in 43 infants were evaluated retrospectively. The study was designed as a nonrandomized, crosssectional study. The subclavian flap repair was applied to 22 patients (51%) and resection with extended end-to-end anastomosis technique to 21 patients (49%). After all operative survivors were followed up with a mean follow-up of 1.8 ± 0.8 years, data analyzed with t-test and the p value < 0.05 were considered statistically significant. Results: The overall mortality rate was 4.6%. Forty mmHg gradients were determined in a patient from Resection Group postoperatively in the fifteenth month. After the balloon angioplasty, the gradient decreased to 25 mmHg. The presence of ventricular septal defect (p = 0.094) was the only significant predictor of adverse short-term outcome among the associated cardiac defects analyzed. The first-year survival rate was 100% in both groups in isolated coarctation (p = 0.965), however; such rate was found as 100% and 93.25% * Corresponding author. M. Karaçelik et al. 2 in Waldhausen Group and Resection Group, respectively in complex coarctation (p = 0.294). Conclusions: Both the subclavian flap repair and resection with extended end-to-end anastomosis for coarctation of the aorta in infants provide excellent short-term outcomes with lower recurrence rates requiring surgery or angioplasty.
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Papers by Ugur Karagoz