Browsing by Author "Erek, Ersin"

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A complete case of Cantrell's Pentalogy with isolated left ventricular diverticulum
(CAMBRIDGE UNIV PRESS, 2021-01-01) Basgoze, Serdar; Ogunc, Begum; Erek, Ersin
The congenital left ventricular diverticulum is a rare cardiac malformation, and it may associate with Cantrell's Pentalogy with other cardiac defects. However, isolated ventricular diverticulum without any other cardiac defect in complete Cantrell's syndrome is very rare. We describe a 6-year-old male patient with a complete Cantrell's syndrome with isolated left ventricular diverticulum.
Aneurysmal Degeneration of Extracellular Matrix in Arterial Reconstruction
(ELSEVIER SCIENCE INC, 2019-01-01) Aydin, Selim; Erek, Ersin
Clinical and laboratory predictors of survival for pediatric patients on non-postcardiotomy extracorporeal membrane oxygenation (ECMO)
(TURKISH J PEDIATRICS, 2020-01-01) Sik, Guntulu; Demirbuga, Asuman; Annayev, Agageldi; Temur, Bahar; Aydin, Selim; Demir, Halil Ibrahim; Erek, Ersin; Citak, Agop
Extracorporeal membrane oxygenation (ECMO) is used in pediatric patients with severe cardiopulmonary failure who do not respond to conventional therapy
Collateral dependent cerebral and coronary circulation in a newborn
(SPRINGER INDIA, 2020-01-01) Suzan, Dilek; Aydin, Selim; Demir, Ibrahim Halil; Erek, Ersin
Association of interrupted aortic arch with aortic atresia as a variant of hypoplastic left heart syndrome (HLHS) is extremely rare and could not be compatible with life without a reliable source for cerebral and coronary blood flow. The patient with a large collateral artery between the descending aorta and the right subclavian artery is presented.
Comparison of different pulmonary valve reconstruction techniques during transannular repair of tetralogy of fallot
(WILEY, 2021-01-01) Temur, Bahar; Aydin, Selim; Suzan, Dilek; Kirat, Baris; Demir, Ibrahim Halil; Erek, Ersin
Background Transannular patch, which results in pulmonary insufficiency (PI), is usually required during repair of tetralogy of fallot (TOF). In this study, we compared three types of pulmonary valve reconstruction techniques during transannular repair of TOF. Methods Between February 2014 and January 2018, 50 patients with TOF underwent primary repair with transannular patch. These patients were divided into three groups. In Group 1, (n = 15), a single gluteraldehyde-treated autologous pericardial patch (standard method) was reconstructed as monocusp. In Group 2, (n = 16) Nunn's bileaflet pulmonary valve reconstruction technique was used with pericardial patch. In Group 3, (n = 19), Nunn's bileaflet technique was performed with expanded polytetrafluoroethylene membrane. The outcomes of the patients and early and midterm competency of the pulmonary valves were analyzed. Results These techniques were significantly effective in early postoperative period. Freedom from moderate to severe PI were 73.3\%
Complete sternal cleft treatment in a low birth weight patient
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2020-01-01) Temur, Bahar; Mete, Sarper; Beken, Serdar; Onalan, Mehmet Akif; Erek, Ersin
A complete sternal cleft is a very rare congenital anomaly causing severe respiratory compromise. Surgical reconstruction options are limited, particularly in low birth weight newborns. Herein, we report a case of low birth weight premature newborn with a complete sternal cleft and its surgical treatment.
Congenital heart surgery in Turkey
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2012-01-01) Undar, Akif; Bakir, Ihsan; Haydin, Sertac; Erek, Ersin; Odemis, Ender; Yivli, Perihan; Agirbasli, Mehmet; Alkan-Bozkaya, Tijen; Turkoz, Ayda; Turkoz, Riza; Sasmazel, Ahmet; Karaci, Ali Riza; Cicek, Ali Ekber; Yalcinbas, Yusuf K.; Akcevin, Atif; Sanoglu, Tayyar
Coronary artery bypass grafting in children
(WILEY, 2018-01-01) Arnaz, Ahmet; Sarioglu, Tayyar; Yalcinbas, Yusuf; Erek, Ersin; Turkoz, Riza; Oktay, Ayla; Saygili, Arda; Altun, Dilek; Sarioglu, Ayse
BackgroundWe present our clinical experience with coronary artery bypass grafting (CABG) in children. MethodsTen children who underwent CABG between July 1995 and August 2017 were retrospectively analyzed. Data including congenital cardiac malformations, previous surgical procedures, age and sex, type of coronary complications, ischemic events preceding surgery, and ventricular function before and after CABG were recorded. ResultsThe study population consisted of five males and five females with a median age of 2.5 years (range, 88 days to 15 years). Eight internal mammary arteries (IMAs) and two saphenous veins were used for grafting. Indications for bypass grafting were coronary artery (CA) complications related to the post-arterial switch operation in six, CA complications during the Ross procedure in two, and an iatrogenic CA injury during complete repair of tetralogy of Fallot with abnormal CA, crossing the right ventricular outflow tract in two patients. Six of the grafts were performed as rescue procedures. Three patients died during hospitalization. The mean follow-up time was 6.8 years (range, 3 months to 18 years). Anastomoses were evaluated by coronary angiography in four patients, and were all patent. Echocardiography revealed normal myocardial function in all patients. ConclusionOur study suggests that the IMA should be the graft of choice in children due to its growth potential and long-term patency.
Exclusion of a Huge Left Ventricular Outflow Tract Pseudoaneurysm with Konno's Procedure
(WILEY-BLACKWELL, 2015-01-01) Oz, Kursad; Erek, Ersin; Onan, Burak; Oner, Ender; Yildirim, Aydin
We present the use of Konno's procedure for the reconstruction of a huge left ventricular outflow tract pseudoaneurysm formed after aortic valve replacement.
Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest in children after cardiac surgery
(TURKISH SOC CARDIOLOGY, 2017-01-01) Erek, Ersin; Aydin, Selim; Suzan, Dilek; Yildiz, Okan; Altin, Firat; Kirat, Baris; Demir, Ibrahim Halil; Odemis, Ender
Objective: Extracorporeal membrane oxygenation (ECMO) is used to provide cardiorespiratory support during cardiopulmonary resuscitation (extracorporeal cardiopulmonary resuscitation
Extracorporeal membrane oxygenation for the support of pediatric patients with acute fulminant myocarditis
(TURKISH J PEDIATRICS, 2019-01-01) Sik, Guntulu; Annayev, Agageldi; Demirbuga, Asuman; Deliceo, Elif; Aydin, Selim; Erek, Ersin; Demir, Halil Ibrahim; Citak, Agop
Acute fulminant myocarditis, is a severe, rapidly progressive disease. The clinical outcomes of children with severe acute myocarditis who are resist to medical treatment is not well known. We studied the clinical courses of patients with acute fulminant myocarditis supported by extracorporeal membrane oxygenation (ECMO). We performed a retrospective chart review of six children with acute fulminant myocarditis who were treated with ECMO. Demographic information, clinical and vital signs, as well as laboratory results were investigated. The median age of 63 months (13-140 months), the mean ECMO duration was 164 hours (79-402 hours), and median intensive care unit stay was 24 days. The most common symptoms were chest pain (66\%) and fever (66\%). Severe arrhythmia were seen in two patients. One patient received extracorporeal cardiopulmonary resuscitation. In two patients, right femoral arteries and right femoral veins were used, in others, right common carotid artery and right internal jugular veins were used. Five patients (83.3 \%) survived to discharge. ECMO can be used effectively in pediatric patients with acute fulminant myocarditis to support the circulation while awaiting myocardial recovery. Timely use of ECMO can improve the survival rate and may be associated with better outcomes.
Incidence and treatment of pulmonary vein stenosis after repair of total anomalous pulmonary venous connection
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2019-01-01) Erek, Ersin; Suzan, Dilek; Aydin, Selim; Hesenov, Ramal; Temur, Bahar; Kirat, Bans; Yildiz, Okan; Demir, Ibrahim Halil; Odemis, Ender
Background: In this study, we aimed to investigate the incidence and treatment of pulmonary vein stenosis after repair of total anomalous pulmonary venous connection. Methods: Between December 2010 and December 2016, a total of 40 patients (25 males, 15 females
Kompleks Kalp Anomalisi ile Birlikte Protein C Eksikliği Bulunan Çocukta Aşamalı Tam Düzeltme Operasyonu
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2018-01-01) Suzan, Dilek; Aydın, Selim; Kırat, Barış; Demir, İbrahim Halil; Ödemiş, Ender; Erek, Ersin
ÖZET Kalp cerrahisi uygulanacak, koagulopati tanısı olan hastalar, yüksek oranda kanama ve tromboz riski ile karşı karşıya kalabilirler. Bu çalışmada kompleks kalp anomalisi ile birlikte Protein C eksikliği tanısı bulunan ve 4 yaşında, aşamalı Rastelli operasyonu uyguladığımız hastamız sunulmaktadır. Protein C eksikliği tanısı, hastamız 1.5 yaşında iken modifiye-BT şant uygulanmasının ardından erken dönem şant trombozu oluşumu nedeniyle yapılan tetkikler sonucunda konulmuştu. Şant ameliyatı sonrasında 2.5 yıl antikoagülan ve antiagregan tedaviyle şantı açık olarak izlenmiş ve 4 yaşında başarılı Rastelli operasyonu uygulanmıştır. Olgumuzu paylaşmaktaki amacımız kalp cerrahisi sonrası tromboembolik olaylara yol açabilen predispozan faktörlerin önemine dikkat çekmektir
Management of a primary cardiac leiomyosarcoma in a young woman
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2021-01-01) Onalan, Mehmet Akif; Demirkaya, Ahmet; Behzatoglu, Kemal; Erek, Ersin
Cardiac leiomyosarcoma is an extremely rare tumor with a poor prognosis. An 18-year-old female patient was admitted to our clinic with a left atrial leiomyosarcoma extending to the right lower pulmonary veins. We performed complete tumor excision by the right anterolateral mini-thoracotomy approach using minimally invasive techniques. After pathological confirmation of the tumor, right lower lobectomy was performed with the same incision one week later to prevent recurrence. Although no tumor remnant was found in the lobectomy specimen, adjuvant chemotherapy was started. No recurrence was detected during the 12-month follow-up. In conclusion, the right submammarian minithoracotomy approach has the advantages of its less invasive nature and suitability for complete tumor resection with lobectomy.
Management of aortic arch hypoplasia in neonates and infants
(WILEY, 2021-01-01) Onalan, Mehmet A.; Temur, Bahar; Aydin, Selim; Basgoze, Serdar; Guzelmeric, Fusun; Odemis, Ender; Erek, Ersin
Objectives Surgical management of aortic arch hypoplasia (AAH) with associated intracardiac anomalies is a challenge in newborns. We reviewed the characteristics and outcomes of neonates and infants who underwent pulmonary artery banding concomitant to arch repair and single-stage total repair at our institution. Methods Medical records of 60 patients undergoing aortic arch reconstruction for AAH from 2014 to 2019 were retrospectively reviewed. Twenty-five patients were female (41.6\%), and the age of the patients ranged from 4 to 120 days (median, 19.5 days). The patients were divided into two groups: Group 1 (23 patients) underwent pulmonary artery banding concomitant to arch repair, and Group 2 (37 patients) underwent single-stage total repair in addition to arch repair. All arch repair procedures consisted of an extended (to the midportion of the ascending aorta) patch aortoplasty. Results Postoperative early mortality occurred in 12 patients, eight in Group 1 (34.8\%) and four in Group 2 (10.8\%). There was an early survival advantage in Group 2 (p = .019). Recoarctation occurred in 13 cases (21.6\%), and 11 (18.3\%) of them required reintervention (balloon angioplasty: 7, reoperation: 4). On univariate analysis, risk factors associated with death were pulmonary artery banding (hazard ratio {[}HR], 0.44
Mediastinal vacuum-assisted closure therapy following pediatric congenital cardiac surgery
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2017-01-01) Aydin, Selim; Temur, Bahar; Suzan, Dilek; Kirat, Baris; Demir, Ibrahim Halil; Ozen, Metehan; Erek, Ersin
Background: In this study, we report nine pediatric cases who developed sternal wound complications following complex congenital cardiac surgery and treated with mediastinal vacuum-assisted closure technique. Methods: Between January 2014 and December 2015, a total of 473 congenital heart operations were performed in our hospital. Of these patients, nine (8 males, 1 females
Outcomes of arterial switch operation for Taussig-Bing anomaly versus transposition of great arteries and ventricular septal defect
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2019-01-01) Erek, Ersin; Suzan, Dilek; Aydin, Selim; Yildiz, Okan; Kirat, Baris; Demir, I. Halil; Odemis, Ender
Background: This study aims to present the outcomes of arterial switch operation for Taussig-Bing anomaly versus transposition of the great arteries and ventricular septal defect. Methods: Between November 2010 and December 2 016, a total of 100 consecutive arterial switch operations in 42 pediatric patients (25 males, 17 females
Outcomes of home mechanical ventilation with tracheostomy after congenital heart surgery
(CAMBRIDGE UNIV PRESS, 2021-01-01) Temur, Bahar; Emre, Ismet E.; Aydin, Selim; Onalan, Mehmet A.; Basgoze, Serdar; Ozcan, Esra; Dogruoz, Alper; Erek, Ersin
Objective: After congenital heart surgery, some patients may need long-term mechanical ventilation because of chronic respiratory failure. In this study, we analysed outcomes of the patients who need tracheostomy and home mechanical ventilation. Methods: Amongst 1343 patients who underwent congenital heart surgery between January, 2014 and June, 2018, 45 needed tracheostomy and HMV. The median age of these patients was 6.4 months (12 days-6.5 years). Nineteen patients underwent palliation while 26 patients underwent total repair. Post-operative diaphragm plication was performed in five patients (11\%). Median duration of mechanical ventilation before tracheostomy was 32 days (8-154 days). The patients were followed up with their home ventilators in ward and at home. Mean follow-up time was 36.24 +/- 11.61 months. Results: The median duration of ICU stay after tracheostomy was 27 days (range 2-93 days). Follow-up time in ward was median 30 days (2-156 days). A total of 12 patients (26.6\%) were separated from the ventilator and underwent decannulation during hospital stay. Thirty-two patients (71.1\%) were discharged home with home ventilator support. Of them, 15 patients (46.9\%) were separated from the respiratory support in median of 6 weeks (1 week-11 months) and decannulations were performed. Total mortality was 31.1\%. in which four patients are still HMV dependent. There was no significant difference for decannulation between total repair and palliation patients. Conclusion: HMV via tracheostomy is a useful option for the treatment of children who are dependent on long-term ventilation after congenital heart surgery although there are potential risks.
Outcomes of hybrid and Norwood Stage I procedures for the treatment of hypoplastic left heart syndrome and its variants
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2020-01-01) Erek, Ersin; Aydin, Selim; Temur, Bahar; Onalan, Mehmet Akif; Suzan, Dilek; lyigun, Muzeyyen; Demi, lBrahim Halil; Odemis, Ender
Background: In this study. we present the outcomes of hybrid and Norwood Stage I procedures for the treatment of hypoplastic left heart syndrome and its variants. Methods: In this study, a total of 97 pediatric patients who were operated due to hypoplastic left heart syndrome and its variants between March 2011 and October 2018 were retrospectively analyzed. Thirty-two of the patients (28 males, 4 females: median age 5 days: range, 1 to 25 days) underwent Norwood Stage I operation (Group N). while the remaining 65 patients (44 males, 21 females: median age 6 days: range, 1 to 55 days) underwent a hybrid procedure (Group H). Both treatment strategies were compared. Results: The median body weight in Group H was significantly lower and the number of patients with a low birth weight (<2,500 g) was significantly higher than Group N (p=0.002 and 0.004. respectively). The postoperative early mortality rate was similar between the groups. Univariate and multivariate analyses revealed that the need for preoperative mechanical ventilation was a significant factor for mortality (p=0.004 and 0.003, respectively). Syndromic appearance was also a significant factor the multivariate analysis (p=0.03). There was a statistically significant difference between the groups in terms of the inter-stage mortality rates (p=0.0045). Second-stage procedure was performed in 32 patients. The early mortality rate after the Glenn operation was 7.6\%. Six patients died after comprehensive Stage II operation. Five patients underwent biventricular repair and 8 patients had third-stage fenestrated extracardiac Fontan operation (Group N, n=7 and Group H. n=1). The Kaplan-Meier survival curve demonstrated that Group N had a higher survival rate at both one and five years than Group II. although the difference was not statistically significant (p=0.15). Subgroup analysis showed that the Norwood procedure with Sano modification had the highest survival rate with 40\% at five years. Conclusion: Our study results show that patients undergoing the Norwood procedure have a more uneventful course of inter-stage period and Stage II and III. despite drawbacks early after Stage I procedure. Based on our experiences, we recommend performing the hybrid intervention in patients with a poor clinical condition and a body weight of <2.500 g.
Outcomes of truncus arteriosus repair with bovine jugular vein conduit
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2018-01-01) Erek, Ersin; Temur, Bahar; Suzan, Dilek; Aydin, Selim; Yildiz, Okan; Kirat, Bans; Demir, Ibrahim Halil; Odemis, Ender
Background: In this study, we aimed to evaluate the outcomes of truncus arteriosus repair in patients undergoing Rastelli type truncus arteriosus. Methods: A total of 13 patients (7 males, 6 females