Arda Saygili

Acute Renal Failure and Mortality After Open-Heart Surgery in Infants

Acute renal failure (ARF) is a major complication in infants who undergo cardiac surgery. The aim of this investigation was to identify possible risk factors for ARF and mortality in this patients group. Out of 64 patients, 21 (32.8%) cases developed acute renal failure and overall mortality rate was 25%. The mortality rate was higher in the infants who developed ARF than those who did not (66.7% and 4.7%, respectively, p < 0.05). Also, ARF was positively correlated with mortality (r:0.70, p < 0.0001). The nonsurvivors had lower mean serum albumin than did the survivors (p < 0.05), and serum albumin level was negatively correlated with mortality (r = − 0.34, p < 0.05). For the patients with serum albumin level < 3.5 g/dL, the unadjusted odds ratio for mortality was 4.3 (CI 95%:1.05 − 17.86). Total bypass time and aorta clamping time were significantly longer in the nonsurvivor group than in the survivor group (p < 0.05 for both). In conclusion, the significant risk factors for mortality in these patients were development of ARF, low serum albumin level, and long total bypass and aorta clamping times, which may be predictive of poor prognosis.

Cardiac tamponade in a newborn because of umbilical venous catheterization: is correct position safe?

Cardiac tamponade is a rare but life‐threatening complication of umbilical venous catheterization in the newborn. Most complications from central venous catheters are related to incorrect position of the catheter and it is emphasized to confirm the position of the catheter tip after placement in order to avoid possible complications. We present an unusual complication of cardiac tamponade because of umbilical venous catheterization in a term newborn which is extremely rare with correct location of the catheter tip at the junction of inferior vena cava and right atrium. We suggest that correct position never guarantees uneventful catheterization in the newborn. In any infant with a central venous catheter in situ who deteriorates clinically, pericardial effusion/cardiac tamponade must be considered and appropriate action taken.

Peripheric stem cell transplantation in children with dilated cardiomyopathy: Preliminary report of first two cases

Olguntürk R, Kula S, Sucak GT, Özdoğan ME, Erer D, Saygili A. Peripheric stem cell transplantation in children with dilated cardiomyopathy: Preliminary report of first two cases.
Pediatr Transplantation 2010:14:257–260.

Mayer-Rokitansky-Küster-Hauser syndrome associated with pulmonary stenosis.

Two siblings with Mayer‐Rokitansky‐Küster‐Hauser (MRKH) syndrome associated with pulmonary valvular stenosis are reported. Although the syndrome is well documented, the genetic background and familial occurrence is not known and the association with cardiac anomalies has not previously been reported. This report is the first report which describes the combination of cardiac anomaly with MRKH syndrome.

Assessment of left ventricular diastolic function by Doppler tissue imaging in children with end-stage renal disease

AIM To evaluate left ventricular (LV) diastolic function in children with end-stage renal disease (ESRD) using conventional pulsed-Doppler echocardiography and Doppler tissue imaging (DTI), and to compare the findings with these two modalities. METHODS Twenty-four children with ESRD and 22 healthy age- and sex-matched control subjects were assessed with conventional Doppler echocardiography and DTI. The scans of the renal disease patients were done after a dialysis session. Parameters related to LV systolic and diastolic function were compared in the ESRD and control groups. RESULTS The ESRD patients had lower mean mitral E/A ratio both according to conventional Doppler echocardiography and TDI than the control subjects. The ESRD group also had significantly longer isovolumetric relaxation time (116+/-31 ms vs 97+/-3.1 ms, respectively; p<0.001), and significantly longer deceleration time (235+/-44 ms vs 202+/-35 ms, respectively; p<0.01) than the control group. CONCLUSION DTI findings correlate well with conventional Doppler echocardiography findings. Children with ESRD show, after dialysis, echocardiographic signs of LV diastolic dysfunction.

Late Cardiac Rupture after Amplatzer Septal Occluder Implantation.

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.

Accessory Miniature Mitral Valve Causing Subaortic Obstruction

M IS C E L L A N E O U S one; (3) the mechanism can fail (twice in our experience, in more than 200 implantations); (4) it costs approximately

Double covered stent closure of extracardiac Fontan multiple fenestrations.

1,000. However, it carries the considerable advantage that a single-step procedure can be performed for aortic punching and anastomosis in just a few seconds. Both systems have advantages and drawbacks, and we cannot be sure that the reported results in limiting, or possibly avoiding, stroke in myocardial revascularization can be exclusively ascribed to their use. However, clampless OPCAB seems to overcome any other surgical strategy, including non-anaortic OPCAB, in preventing postoperative stroke and its consequences to patients’ health and hospital costs.

Assessment of left ventricular diastolic function by Doppler tissue imaging in children with end-stage renal disease: Left ventricular diastolic function in end-stage renal disease

all patients had their high molecular weight vWF multimers levels and platelet function brought to normal conditions, which proves the relationship between valve disease and hematological abnormality (5). When valve surgery cannot be performed, for high surgical risk, authors suggest performing colectomy after identification of the bleeding site as an initial treatment option, knowing that recurrence of bleeding could occur at another site (6). Today, percutaneous prosthesis can be performed (7).

A case of arrhythmogenic right ventricular dysplasia presenting with symptoms of right-sided heart failure secondary to constrictive pericarditis

Aim: To evaluate left ventricular (LV) diastolic function in children with end‐stage renal disease (ESRD) using conventional pulsed‐Doppler echocardiography and Doppler tissue imaging (DTI), and to compare the findings with these two modalities. Methods: Twenty‐four children with ESRD and 22 healthy age‐ and sex‐matched control subjects were assessed with conventional Doppler echocardiography and DTI. The scans of the renal disease patients were done after a dialysis session. Parameters related to LV systolic and diastolic function were compared in the ESRD and control groups. Results: The ESRD patients had lower mean mitral E/A ratio both according to conventional Doppler echocardiography and TDI than the control subjects. The ESRD group also had significantly longer isovolumetric relaxation time (116±31 ms vs 97±3.1 ms, respectively; p<0.001), and significantly longer deceleration time (235±44 ms vs 202±35 ms, respectively; p<0.01) than the control group.