Araştırma Çıktıları

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    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\%
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    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.
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    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
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    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
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    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.
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    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.
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    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
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    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.
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    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
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    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