Browsing by Author "Turkoz, Riza"

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Atrial septal defect closure via mini-thoracotomy in pediatric patients: Postoperative analgesic effect of intercostal nerve block
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2020-01-01) Altun, Dilek; Dogan, Abdullah; Amaz, Ahmet; Yuksek, Adnan; Yalcinbas, Yusuf Kenan; Turkoz, Riza; Asar, Sinan; Saneglu, Tayyar
Background: In this study, we evaluated the efficacy of intercostal nerve block for postoperative pain management in pediatric patients undergoing atrial septal defect closure through a right lateral mini-thoracotomy. Methods: Between January 2016 and January' 2019. a total of 63 pediatric patients (37 males, 26 females: mean age 34.8 +/- 26.8 months
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.
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.
In vitro validation of a self-driving aortic-turbine venous-assist device for Fontan patients
(MOSBY-ELSEVIER, 2018-01-01) Pekkan, Kerem; Aka, Ibrahim Basar; Tutsak, Ece; Ermek, Erhan; Balim, Haldun; Lazoglu, Ismail; Turkoz, Riza
Background: Palliative repair of single ventricle defects involve a series of open-heart surgeries where a single-ventricle (Fontan) circulation is established. As the patient ages, this paradoxical circulation gradually fails, because of its high venous pressure levels. Reversal of the Fontan paradox requires an extra subpulmonic energy that can be provided through mechanical assist devices. The objective of this study was to evaluate the hemodynamic performance of a totally implantable integrated aortic-turbine venous-assist (iATVA) system, which does not need an external drive power and maintains low venous pressure chronically, for the Fontan circulation. Methods: Blade designs of the co-rotating turbine and pump impellers were developed and 3 prototypes were manufactured. After verifying the single-ventricle physiology at a pulsatile in vitro circuit, the hemodynamic performance of the iATVA system was measured for pediatric and adult physiology, varying the aortic steal percentage and circuit configurations. The iATVA system was also tested at clinical off-design scenarios. Results: The prototype iATVA devices operate at approximately 800 revolutions per minute and extract up to 10\% systemic blood from the aorta to use this hydrodynamic energy to drive a blood turbine, which in turn drives a mixed-flow venous pump passively. By transferring part of the available energy from the single-ventricle outlet to the venous side, the iATVA system is able to generate up to approximately 5 mm Hg venous recovery while supplying the entire caval flow. Conclusions: Our experiments show that a totally implantable iATVA system is feasible, which will eliminate the need for external power for Fontan mechanical venous assist and combat gradual postoperative venous remodeling and Fontan failure.
Measuring potassium level in packed red blood cells before using: Word of caution for congenital cardiac surgery
(WILEY, 2022-01-01) Altun, Dilek; Arnaz, Ahmet; Dogan, Abdullah; Yalcinbas, Yusuf; Turkoz, Riza; Yuksek, Adnan; Altun, Demet; Abdullah, Taner; Ozgen, Serpil Ustalar; Toraman, Fevzi; Sarioglu, Tayyar
Background and Aim of the Study Transfusion-associated hyperpotassemia is a serious complication of packed red blood cell (PRBC) transfusion after congenital cardiac surgery. Our study aimed to identify risk factors and potential preventive measures of transfusion-associated hyperpotassemia in neonates and infants after congenital cardiac surgery. Methods Pediatric patients who underwent congenital cardiac surgery and need transfusion were enrolled in this prospective study. The potassium concentration of PRBC was checked from the sample taken from the segment. The volume of transfusion, age of PRBC, potassium concentration of unit were recorded. The estimated increment of potassium level in patients after PRBC transfusion was calculated. Results Seventy-four individual patients, 95 distinct transfusions, 112 blood products were evaluated. The mean age of the blood unit was 3.8 +/- 1.4 days. The mean potassium concentration in the PRBCs was 9.9 +/- 2.4 mmol/L. A weak correlation was observed between the potassium value of the PRBC and the age of PRBC (p = 0.049, r = 0.2, y = 0.24 x x + -0.68). There was a weak correlation between the potassium value of PRBCs and the age of the unit (p < 0.001, r = 0.37, y = 2.8 x x + -3.6). Conclusions Before transfusion, even PRBC is fresh, measuring the potassium level of PRBC and the potassium that will be given to the pediatric patient with transfusion can prevent transfusion-related hyperpotassemia and related complications. Otherwise, high potassium levels, which may be overlooked despite being fresh, may cause serious complications, even cardiac arrest, especially in neonates and infants.
Noninvasive monitoring of central venous oxygen saturation by jugular transcutaneous near-infrared spectroscopy in pediatric patients undergoing congenital cardiac surgery
(TUBITAK SCIENTIFIC \& TECHNICAL RESEARCH COUNCIL TURKEY, 2020-01-01) Altun, Dilek; Dogan, Abdullah; Arnaz, Ahmet; Yuksek, Adnan; Yalcinbas, Yusuf Kenan; Turkoz, Riza; Sarioglu, Tayyar
Background and aim: In patients undergoing congenital cardiac surgery, it is crucial to maintain oxygen demand-consumption balance. Central venous oxygen saturation (ScvO(2)) is a useful indicator of oxygen demand and consumption balance which is an invasive method. Near-infrared spectroscopy (NIRS) is a noninvasive, continuous monitoring technique that measures regional tissue oxygenation. NIRS that is placed over the internal jugular vein cutaneous area (NIRSijv) has the potential to show ScvO(2) indirectly. In this study, we aimed to determine the correlation between ScvO(2) with NIRSijv in pediatric patients undergoing congenital cardiac surgery. Materials and methods: Fifty children participated in the study. Four patients were excluded for the inability of internal jugular vein (IJV) catheterization due to technical difficulties. After anesthesia induction, NI RS probes were placed on the IJV site with ultrasound guidance for the measurement of continuous transcutaneous oxygen saturation. The catheter insertion was also done through the IJV from the other side using ultrasound guidance. Cerebral oxygenation monitoring was done using NI RS with a single pediatric probe placed on the right forehead. Values of NIRSijv, cerebral NI RS (NIRSc) and ScvO(2), were recorded at certain times until postoperative 24th hour. Results: Data were collected at 8 different time points. There was a significant correlation between ScvO(2) and NIRSijv in all measurement time points (r = 0.91), (p = 0.001). The mean bias between ScvO(2) and NIRSijv was 2.92\% and the limits of agreement were from 11\% to -5.2\%. There was a moderate correlation between ScvO(2) and NIRSc (r = 0.45), (13= 0.001). The mean bias between ScvO(2) and NIRSc was 2.7\% and the limits of agreement were from +26\% to -20\%. Conclusion: In this study, we found a strong correlation between ScvO(2) and NI RS measurements taken from the internal jugular vein site. Accordingly, continuous noninvasive monitoring with transcutaneous NIRSijv can be an alternative method as a trend monitor for the central venous oxygen saturation in pediatric cardiac patients undergoing congenital cardiac surgery.
Recommendations for the selection of techniques and components used in congenital heart surgery in Turkey
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2012-01-01) Undar, Akif; Haydin, Sertac; Erek, Ersin; Yivli, Perihan; Odemis, Ender; Agirbasli, Mehmet; Alkan-Bozkaya, Tijen; Turkoz, Ayda; Turkoz, Riza; Sasmazel, Ahmet; Karaci, Ali Riza; Cicek, Ali Ekber; Yalcinbas, Yusuf; Akcevin, Atif; Sarioglu, Tayyar; Bakir, Ihsan
There is no standard for the selection of technical and mechanical components (heart-lung machine system, oxygenator, arterial and venous cannulae, arterial filter and other specifically-designed components and devices) used in cardiopulmonary bypass in Turkey. The cost of the component plays a significant role in the selection, as well as the preference of the facility. Only a limited number of hospitals decide which components to be used based on scientific data. Studies have confirmed that selected novel techniques and components having no basis of scientific justification may pose risk for the life of the patient in the short- and long-term. The objectives of this study are to show how to use quality-control procedures and scientific data for the selection of novel techniques and components and to share, also, recent techniques experienced to minimize the complication risk after surgery.
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
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.