Browsing by Author "Saygili, Arda"

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An Easy Modification of Tube Graft Interposition During Fenestration in Borderline Fontan Circulation
(ELSEVIER SCIENCE INC, 2015-01-01) Sarioglu, C. Tayyar; Sisli, Emrah; Yalcinbas, Yusuf Kenan; Saygili, Arda
One of the options for the management of borderline/ failing extracardiac Fontan circulation is surgical creation of an atrial fenestration to decompress the systemic venous compartment and improve cardiac output. Depending on the body surface area of the patient, a 5- to 10-mm polytetrafluoroethylene (PTFE) tube graft can be used. When fenestration is required in a patient with failing Fontan circulation, particularly in redo cases, application of a side-biting clamp may be challenging because of adhesions and a thickened atrial wall. In this article, we present our off-pump technique of atrial-side anastomosis of PTFE graft interposition between an extracardiac Fontan conduit and the atrium without using a side-biting clamp. (C) 2015 by The Society of Thoracic Surgeons
Assessment of cardiovascular risk in paediatric peritoneal dialysis patients: a Turkish Pediatric Peritoneal Dialysis Study Group (TUPEPD) report
(OXFORD UNIV PRESS, 2009-01-01) Bakkaloglu, Sevcan A.; Saygili, Arda; Sever, Lale; Noyan, Aytul; Akman, Sema; Ekim, Mesiha; Aksu, Nejat; Doganay, Beyza; Yildiz, Nurdan; Duzova, Ali; Soylu, Alper; Alpay, Harika; Sonmez, Ferah; Civilibal, Mahmut; Erdem, Sevcan; Kardelen, Firat
Methods. We aimed to clarify arteriosclerotic risk and to document possible relationships between cardiovascular risk factors and echocardiographic parameters in paediatric peritoneal dialysis (PD) patients. M-mode/Doppler/tissue Doppler echocardiographic studies and lipid/lipoproteins, homocysteine, high-sensitivity C-reactive protein (HS-CRP) levels and carotid intima-media thickness (CIMT) were determined in 59 patients (age: 14.2 +/- 4.5 years) and in 36 healthy subjects. Results. Structural and functional cardiac abnormalities were observed in patients on maintenance dialysis. Increased left ventricular mass index (LVMI, P = 0.000), relative wall thickness (P = 0.000), myocardial performance index (MPI, P = 0.000) were documented in the patients. Lipoprotein (a) (P = 0.000), homocysteine (P = 0.001), HS-CRP (P = 0.000) and CIMT (P = 0.000) were significantly elevated in the patients. Left ventricular hypertrophy (LVH) was prevalent in 68\% of the patients. Patients with LVH had higher levels of HS-CRP (P = 0.001) and CIMT (P = 0.028) than those without LVH. Haemoglobin was an independent predictor of LVMI (beta: -8.9, P = 0.001), while residual diuresis and CIMT were independent predictors of diastolic dysfunction (beta: -0.45, P = 0.034 and beta: 5.90, P = 0.008, respectively). Albumin (beta: -0.72, P = 0.018) and Kt/V urea (beta: -0.48, P = 0.012) were significant predictors of CIMT. There were positive correlations between LVMI and CIMT. HS-CRP was positively correlated with LVMI as well as CIMT. Conclusions. Elevated levels of atherosclerotic/inflammatory risk factors, low haemoglobin levels and loss of residual renal function and their negative effects on heart are of remarkable importance in paediatric patients on maintenance peritoneal dialysis. Achieving recommended targets for haemoglobin, blood pressure and Kt/V urea, preserving residual renal function as well as managing inflammation and subsequent arteriosclerosis is obviously essential to improve the patients' prognosis.
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.
Double covered stent closure of extracardiac Fontan multiple fenestrations
(TURKISH SOC CARDIOLOGY, 2012-01-01) Saygili, Arda; Tokel, Kursad; Kocyigit, Ozgen Ilgan; Sarioglu, Tayyar
Ebstein's Anomaly
(GAZI UNIV, FAC MED, 2018-01-01) Arnaz, Ahmet; Dogan, Abdullah; Oktay, Ayla; Yalcinbas, Yusuf; Turkoz, Riza; Saygili, Arda; Sarioglu, Ayse; Sarioglu, Tayyar
Objectives: In this study, it is aimed to evaluate the operations performed for Ebstein `s anomaly retrospectively. Study design: Between July 2003 and February 2018, the medical records of 13 patients who were operated on with the diagnosis of Ebstein's anomaly were reviewed retrospectively according to the clinical symptoms, surgical procedure, and postoperative follow-up. Results: Of the thirteen patients, 46.2\% (n = 6) were female and 53.8\% (n = 7) were male. The mean age of the cases is 13,15 +/- 11,07 years (2-31 years). Preoperative echocardiographic evaluations revealed severe tricuspid regurgitation in 92.3\% (n = 12) of the patients. In these patients, tricuspid valve replacement was performed in 4, tricuspid valve plasty in 5, Cone reconstruction in 2, and cava-pulmonary shunt with tricuspid valve plasty in 2 were performed. Patients were followed for an average of 6.31 +/- 3.40 (1-14 years). Atrial septal defect closure in 53.8\% (n = 7) patients and mitral valve replacement in 7.7\% (n = 1) patients were performed due to additional anomalies. Atrial fibrillation/flutter was present in 23.1\% of the patients and ablation procedure was applied to these three patients. Conclusion: Long-term clinical follow-up is required for the signs and symptoms of heart failure, arrhythmia, cyanosis and other related findings both in operated and non-operated patients with Ebstein's anomaly.
Impact of peritoneal transport characteristics on cardiac function in paediatric peritoneal dialysis patients: a Turkish Pediatric Peritoneal Dialysis Study Group (TUPEPD) report
(OXFORD UNIV PRESS, 2010-01-01) Bakkaloglu, Sevcan A.; Saygili, Arda; Sever, Lale; Aksu, Nejat; Noyan, Aytul; Akman, Sema; Ekim, Mesiha; Doganay, Beyza; Yildiz, Nurdan; Akalin, Figen; Caliskan, Salim; Kara, Orhan D.; Duzova, Ali; Soylu, Alper; Atalay, Semra
Methods. One hundred and ten PD patients (13 +/- 5 years, PD vintage: 31 +/- 27 months) were enrolled into the study. Four-hour dialysate/plasma creatinine ratio was used for differentiating PET groups. Thirty-eight patients were high transporters, 29 were high-average transporters and 43 were low-average/low transporters. Echocardiography was performed in all subjects. Results. Age, PD vintage, dialysate glucose concentration, ultrafiltration volume, urine volume and blood pressure levels were similar in all PET groups. No biochemical or echocardiographic data (ejection fraction, fractional shortening, left ventricular mass index, myocardial performance index, power Doppler E/tissue Doppler E ratio reflecting diastolic function) were different among PET groups except lower albumin (P = 0.025) levels in high transporters and higher high-sensitivity C-reactive protein (P = 0.026) levels in high and high-average transporters compared to other transport groups. Conclusions. Cardiac structural and functional abnormalities are highly prevalent among paediatric PD patients. Transport rates did not have a significant effect on biochemical parameters or cardiac structural/functional parameters. It might be suggested that being a high transporter does not provide a disadvantage in terms of atherogenic tendency and cardiac disease in paediatric PD patients. Oligoanuria, anaemia and hypertension were independent predictors of cardiac disease.
Late Cardiac Rupture after Amplatzer Septal Occluder Implantation
(TEXAS HEART INST, 2016-01-01) Arnaz, Ahmet; Turkekul, Yasemin; Yalcinbas, Yusuf; Saygili, Arda; Sarioglu, Tayyar
Transcatheter device implantation has become an attractive alternative to surgery in the closure of atrial septal defects in selected patients. However, it can lead to early and late sequelae, some of them life threatening. For example, 79 days before her admission to our emergency department with sudden-onset respiratory distress and respiratory arrest (leading to cardiac tamponade and rupture), a 22-year-old woman had undergone percutaneous closure of an atrial septal defect. We describe the damage and its treatment. Although the adverse effects of transcatheter device implantation are rare, physicians should know that these events can be life threatening. Further data are needed to prevent such sequelae and to design new devices. It is of utmost importance that patients and their family members be informed both of possible sequelae and of life-saving interventions to be administered at early diagnosis.
Pulmonary valve replacement in patients with repaired tetralogy of Fallot: early results for recovery of right ventricular dilatation and QRS duration
(TUBITAK SCIENTIFIC \& TECHNICAL RESEARCH COUNCIL TURKEY, 2018-01-01) Arnaz, Ahmet; Oktay, Ayla; Akansel, Serdar; Altun, Dilek; Dogan, Abdullah; Serban, Piotr; Saygili, Arda; Yalcinbas, Yusuf; Sarioglu, Ayse; Sarioglu, Tayyar
Background/aim: Although pulmonary valve replacement (PVR) improves ventricular function and symptoms, the benefit and optimal timing of PVR are controversial. This study aimed to evaluate early response to PVR for right ventricle (RV) dilatation and QRS duration. Materials and methods: Retrospective analysis was performed for 32 patients with repaired tetralogy of Fallot (TOF) between March 2005 and October 2017. The differences between preoperative and postoperative changes in echocardiographic parameters, clinical symptoms, and QRS duration were evaluated. Results: There were no in-hospital or late deaths. Mean age at the time of PVR was 16.57 +/- 7.97 years. The interval between TOF: repair and PVR was 12.99 +/- 7.06 years. Postoperative echocardiographic findings showed significant reduction in indexed RV end-diastolic diameter (RV-EDDI) and the ratio of RV/LV-EDDI (P = 0.001 and P = 0.001, respectively). Higher preoperative RV-EDDI was associated with decreased change in RV-EDDI after PVR (r = 0.63
Successful percutaneous removal of broken umbilical vein catheter in a very low-birth-weight preterm infant
(TURKISH SOC CARDIOLOGY, 2016-01-01) Demirel, Atalay; Guven, Gulsah; Okan, Fusun; Saygili, Arda
A 28-week-old preterm infant with a birth weight of 1250 g had a broken segment of umbilical vein catheter (UVC) lodged in the right atrium. It was observed that a 7-cm fragment of catheter had migrated to the right atrium through the inferior vena cava. The catheter was successfully retrieved by fluoroscopically guided percutaneous cardiac catheterization, using a cobra catheter and snare wire, without complication. Fracture and embolization of UVC is a rare but serious complication. Presently described was a case of fractured and embolized UVC in a very low-birthweight preterm infant, and its successful retrieval via percutaneous endovascular approach.
Surgical procedures for coronary arteries in pediatric cardiac surgery: Risk factors and outcomes
(WILEY, 2021-01-01) Sarioglu, Tayyar; Dogan, Abdullah; Yalcinbas, Yusuf; Erek, Ersin; Arnaz, Ahmet; Turkoz, Riza; Oktay, Ayla; Saygili, Arda; Altun, Dilek; Yuksek, Adnan; Boz, Murat; Sarioglu, Ayse
Background Limited data exist regarding the coronary revascularization procedures needed during the repair of several congenital and pediatric cardiac malformations. We aimed to determine risk factors for in-hospital mortality and long-term outcomes of various pediatric coronary revascularization procedures. Methods We retrospectively reviewed the records of 32 consecutive pediatric patients who underwent coronary revascularization procedures at our institution between May 1995 and June 2020. In-hospital mortality, risk factors, surgical indications, revascularization patency, and mid- and long-term follow-up data were investigated. Patients were categorized into the coronary artery bypass grafting (n = 11) and other coronary artery procedure (n = 21) groups. Results The median age and weight of patients at the time of surgery were 9 months and 4.8 kg, respectively. There were five in-hospital deaths (5/32, 15.6\%). The mortality rates were 27.2\% (3/11) in the coronary artery bypass grafting group and 9.5\% (2/21) in the other coronary artery procedure group (p = .206
Transcatheter Closure of Left Ventricular Pseudoaneurysm After Mitral Valve Replacement
(ELSEVIER SCIENCE INC, 2020-01-01) Arnaz, Ahmet; Akansel, Serdar; Yalcinbas, Yusuf; Saygili, Arda; Sarioglu, Tayyar
Left ventricular pseudoaneurysm (LVPA) is a rare but lethal complication of mitral valve replacement (MVR) or myocardial infarction. Early correction is necessary for patients with extensive and expanding LVPA. We report a transcatheter closure of LVPA after MVR. A 63-year-old woman presented with an LVPA 2 months afterMVR. The repeated computed tomographic scan and transthoracic echocardiography showed enhancement of pseudoaneurysm. The LVPA was closed successfully with Amplatzer Vascular Plug using a transcatheter approach. (C) 2020 by The Society of Thoracic Surgeons.
Valve-sparing repair with skeletonization of the pulmonary annulus for tetralogy of Fallot
(WILEY, 2019-01-01) Turkoz, Riza; Dogan, Abdullah; Oktay, Ayla; Saygili, Arda
Pulmonary valve preservation in tetralogy of Fallot (TOF) repair is one of the most challenging issues. Herein, we describe a novel valve-sparing technique for TOF repair that primarily consists of skeletonization of the anterior part of the pulmonary annulus and gentle dilatation by preserving the pulmonary valve and annulus integrity. With encouraging early results, this technique is suggested to prevent severe pulmonary regurgitation and provide acceptable relief of pulmonary stenosis in patients with TOF.