Browsing by Author "Temur, Bahar"

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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
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.
Double Aortic Arch Mimics the Clinical Characteristics of Severe Reactive Airway Disease in a Pediatric Patient
(GEORG THIEME VERLAG KG, 2020-01-01) Yesilbas, Osman; Kus, Hazar Dogus; Sik, Guntulu; Citak, Agop; Temur, Bahar; Yozgat, Can Yilmaz; Temur, Hafize Otcu; Cakir, Erkan; Yozgat, Yilmaz
Reactive airway disease is a prevalent condition that can be detected in the early infancy period. The condition might also deteriorate into asthma in some cases. If infants do not respond to the treatment of persistent wheeze and coughing, other rare causes should be investigated. The complete form of vascular ring is an extremely uncommon congenital cardiovascular abnormality. Double aortic arch constitutes the most significant portion of the complete vascular ring anomalies. Clinical manifestations of the anomaly are mainly respiratory due to the tracheal compression and mimicking the conditions of asthma. There have not been many reports about the clinical presentations of double aortic arch being remarkably similar to the same clinical manifestations of asthma in the literature. As far as we can be sure, there have not been any reported cases about severe reactive airway disease that caused a patient to have a life-threatening condition in the pediatric intensive care unit. Herein, we present a 5-month-old girl who had double aortic arch. Her anatomical aberration was diagnosed by three-dimensional computed tomography angiography of thorax, and the anomaly mimicked the clinical characteristics of life-threatening severe reactive airway disease.
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
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 Endovenous Cyanoacrylate Closure Using Venaseal System for Chronic Venous Insufficiency
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2021-12-01) Temur, Bahar; Aydın, Selim
ABSTRACT Purpose: Endovenous cyanoacrylate closure of saphenous veins is a nonthermal, nonsclerosant ablation technique with satisfactory results. The objective of this study is to indicate the impact of Venaseal closure system in chronic venous insufficiency. Methods: Between March 2014- March 2019, 27 patients underwent a total of 40 procedures with the VenaSeal closure system for symptomatic saphenous vein reflux in our hospital. Beside glue ablation procedures, 16 patients underwent concomitant mini phlebectomy, 3 patients underwent perforan vein ligation and 1 patient underwent anterior accessory saphenous vein ligation. The mean age of the patients were 44.4±13.8 (19-67). Doppler ultrasound of the target vein was performed one and 12 months after treatment. Tumescent anesthesia and compression stockings were not used. Results: Mean follow up time was 34.3 ±17 months. The anatomical success rate was 100% at 1 month and 100% at 1 year and there was no recanalization in treated vein segment. All procedures were well tolerated with a median visual analog scale (VAS) pain score of 3.0 (range: 2–5) on a 10-point scale. The mean pre-operative revised venous clinical severity score was 7.5±2.6, which improved to 2.6±0.7, p< 0.001 at one month follow-up. Deep vein thrombosis and pulmonary thromboembolism were not detected. Phlebitis was seen in 2 (7,4%) patients and hypersensitivity reaction occured in one patient (3,7%). Conclusion: Endovenous cyanoacrylate closure of refluxing saphenous veins offers a safe and effective treatment with reduced side effects.
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
Repair of ventricular septal defect and pulmonary stenosis with right lateral mini-thoracotomy
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2020-01-01) Temur, Bahar; Erek, Ersin
Successful Repair of Infantile Scimitar Syndrome with Contralateral Pulmonary Vein Stenosis in an Infant
(SOC BRASIL CIRURGIA CARDIOVASC, 2021-01-01) Onalan, Mehmet Akif; Temur, Bahar; Erek, Ersin
Infantile scimitar syndrome (SS) is a rare congenital heart disease and has high mortality. Guidelines have not been established, but surgery is indicated in symptomatic patients. Despite the various surgical approaches, outcomes continue to be disappointing. We present our surgical experience with an infantile SS patient who had stenotic pulmonary veins contralateral to the hypoplastic lung with complicated anatomy. There are few cases with this complex pathology in the literature. Moreover, our patient was the first transplant-free survivor with this complexity in the literature.
The impact of pulmonary valve-sparing techniques on postoperative early and midterm results in tetralogy of Fallot repair
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2018-01-01) Aydin, Selim; Suzan, Dilek; Temur, Bahar; Kirat, Bans; Iyigun, Muzeyyen; Demir, Ibrahim Halil; Odemis, Ender; Erek, Ersin
Background: In this study, we analyzed the impact of pulmonary valve-sparing techniques on early and midterm postoperative results of tetralogy of Fallot repair. Methods: A total of 64 patients diagnosed with tetralogy of Fallot, who underwent total correction operation by the same surgeon between November 2010 and September 2015 were included in this retrospective study. Mean age of the patients was 20.0 +/- 14.2 months (5.5-96 months). Forty patients (62.5\%) were male. Thirty two of the patients (50\%) were under one year of age. Pulmonary valve-sparing techniques were performed in 29 patients (Group 2), while transannular patch was applied in the remaining 35 patients (Group 1). Pericardial monocusp valve was constructed in 15 patients in Group 1. In Group 2, pulmonary valve-sparing techniques were transatrial repair in nine patients
Toward Routine Minimally Invasive Ventricular Septal Defect Closure Via Right Lateral Minithoracotomy
(FRONTIERS MEDIA SA, 2021-01-01) Aydin, Selim; Temur, Bahar; Basgoze, Serdar; Guzelmeric, Fusun; Guvenc, Osman; Erek, Ersin
Background: Improving the surgical results and recent advancement of transcatheter techniques for closure of ventricular septal defect (VSD) increased the demand for minimally invasive approaches. In this study, we analyzed the results of the patients who underwent VSD closure with right lateral minithoracotomy (RLMT). Methods: Between September 2014 and February 2021, 24 patients underwent minimally invasive VSD closure with RLMT. The median age of the patients was 16 months (range, 4-84 months). Fifteen patients (62.5\%) were female. The median weight of the patients was 9.75 kg (range, 4.6-30 kg). The types of VSD were perimembranous in 19 patients, subaortic in three patients, inlet in one patient, and subpulmonic in one patient. Five patients had low-lying pulmonary stenosis in addition to VSD. Results: No perioperative death or major complication occurred during follow-up. All defects were repaired through RLMT. The median cardiopulmonary bypass time was 81 min (range, 44-163 min), and the aortic cross-clamp time was 65 min (range, 33-131 min). The median hospital stay was 6 days (range, 5-21 days). One patient had minimal (2 mm) residual left-to-right shunt. All families were satisfied with the cosmetic results during the follow-up. Conclusions: The RLMT method is a safe and effective alternative to standard median sternotomy for VSD closure and can be performed with favorable cosmetic and clinical results.
Utility of Cervical Cannulation During Difficult Resternotomy in Congenital Heart Surgery
(SAGE PUBLICATIONS INC, 2020-01-01) Temur, Bahar; Davutoglu, Arda; Dogruoz, Alper; Aydin, Selim; Suzan, Dilek; Kirat, Baris; Odemis, Ender; Erek, Ersin
Background: Adhesions due to previous surgeries and some anatomical difficulties may make resternotomy dangerous in children. Femoral vessels are usually small and may not be suitable for cannulation. The aim of this report is to describe our experience with cervical cannulation during risky resternotomy in children. Methods: Between January 2014 and January 2018, cervical cannulation was performed in eight pediatric patients during sternal reentry. Their ages were between 3 months and 17 years (mean: 5.4 years). Three patients underwent stage III extracardiac Fontan operation with the diagnosis of hypoplastic left heart syndrome. Three patients had supravalvular aortic and/or pulmonary stenosis after previous arterial switch operation. One patient had proximal aortic arch stenosis and subvalvular aortic stenosis after interrupted aortic arch repair. The last patient had aortic root pseudoaneurysm and aortic insufficiency due to endocarditis. Through a separate cervical incision, a polytetrafluoroethylene graft was anastomosed to the common carotid artery and the arterial cannula was inserted into the graft. Antegrade selective cerebral perfusion (ASCP) was used in two patients. Results: During resternotomies, no major injury or bleeding occurred. Three-month-old patient who had previous interrupted aortic arch repair died despite extracorporeal membrane oxygenation support due to sepsis and multi-organ failure. Median intensive care unit stay and hospital stay were 3 days (1-40 days) and 17 days (7-60 days), respectively. Mean follow-up was 17.9 +/- 15.8 months. All patients were in good clinical condition. Conclusions: Cervical cannulation may be a useful and safe technique during high-risk resternotomy in children. This technique may also simplify the performance of ASCP if necessary.