Onur Işık

Cor triatriatum sinister: a case series.

OBJECTIVE As a highly rare congenital defect, cor triatriatum sinister represents only 0.1% of congenital cardiac anomalies. Depending on the degree of obstruction and the accompanying symptoms, cor triatriatum can be diagnosed at any age. This case series described 5 patients with cor triatriatum sinister who underwent operation. METHODS Five patients with cor triatriatum sinister were seen at our institution between 2007 and 2013. The demographic characteristics and surgical results of these patients are outlined in this retrospective review. RESULTS The surgical approach consists of left or right atriotomy, excision of the obstructing membrane, and repair of the associated intracardiac anomalies. After an uneventful postoperative hospital stay, all patients were discharged 5-10 days postoperatively. There were no instances of recurrent constriction after surgical treatment of the cor triatriatum membrane. Patients were followed up for a median of 4 years and were symptom free. CONCLUSION In the surgical management of this easily and fully treatable congenital cardiac anomaly, it is difficult to determine which atriotomy approach is comparatively more advantageous. However, in the management of cor triatriatum sinister, priority should be given to confirmation of the diagnosis and full resection of the membrane. Thus, the surgeon should not hesitate to perform additional incisions if deemed necessary.

Right Anterolateral Thoracotomy in the Repair of Atrial Septal Defect: Effect on Breast Development

The aim of this study was to assess the cosmetic results and the impact on the breast development of a right anterolateral thoracotomy (RALT) in pre‐pubertal children who underwent RALT for correction of atrial septal defects.

Early and mid-term outcomes after surgical repair of congenital supravalvular aortic stenosis with the Doty technique

OBJECTIVE The aim of this study was to evaluate the efficacy and safety of the Doty surgical approach in pediatric patients with congenital supravalvular aortic stenosis (SVAS) by examining early and mid-term outcomes. METHODS Surgical repair using the Doty technique was performed in a total of 10 pediatric patients with SVAS between January 2005 and July 2015 at this clinic. These patients were evaluated retrospectively. Demographic characteristics, echocardiographic findings, and clinical outcomes were analyzed. RESULTS The mean patient age was 4.8±3.9 years. Williams-Beuren syndrome was diagnosed in 4 of the patients. Early mortality was observed in 1 patient with diffuse SVAS. At the final follow-up (mean follow-up: 3.7±1.2 years; range: 6-61 months), echocardiograms revealed a mean pressure gradient of 14±4.2 mmHg. Two patients displayed minimal aortic insufficiency during the follow-up period. No reoperation or reintervention was required. CONCLUSION The Doty technique is an anatomically and technically effective surgical approach to treating SVAS.

Subtotal cor triatriatum sinister associated with bilateral partial anomalous pulmonary venous return

Cor triatriatum sinister is a rare congenital cardiac pathology, representing only 0.1% of congenital cardiac anomalies, and often associated with other cardiac defects. In classic cor triatriatum sinister, the pulmonary venous chamber receives all pulmonary veins and drains into the left atrium through a variable-sized orifice. The case of a 4-month-old male patient who had subtotal cor triatriatum sinister associated with right and left upper anomalous pulmonary venous return is presented.

Konjenital kalp cerrahisi sonrası şilotoraks tanı ve tedavisine güncel yaklaşım

Şilotoraks, torasik duktusun hasarina bagli olarak plevral boslukta siloz olarak bilinen sutumsu bir sivi birikimi olup, cocuklarda plevral efuzyonun nispeten nadir bir nedenidir. Cocukluk cagindaki postoperatif silotoraks ciddi bir komplikasyon olup, yonetimi zorludur. Gorulme sikligi dusuk olmasina ragmen enfeksiyon, malnutrisyon, immunsupresyona sebep olabilmesinden dolayi ciddi bir komplikasyon olarak karsimiza cikabilmektedir. Şilotoraks gelismesi sonrasinda sivi dengesinin de bozulmasi postoperatif donemde hasta yonetimini daha da komplike hale sokabilir. Bu baglamda pediyatrik kalp cerrahisi sonrasi gelisen silotoraks daha yuksek morbidite ve mortaliteye neden olabilir. Bu yazimizin amaci pediyatrik kalp cerrahisi sonrasi gelisen silotoraks kapsaminda kalarak anatomi, etiyoloji, tani, insidans, patofizyoloji ve guncel yaklasima deginmektir.

Late development of double-chambered right ventricle after repair of a ventricular septal defect

Double-chambered right ventricle is a rare heart defect causing right ventricular outflow tract (RVOT) obstruction. In this malformation, the right ventricle is divided into two chambers by a fibromuscular band. A 12-year old female patient who had undergone repair of a ventricular septal defect at 5 months old was admitted to our hospital with complaints of dyspnea and fatigue. The patient was diagnosed with an isolated double-chambered right ventricle and surgical correction was successfully performed. Post-operative transesophageal echocardiography showed no residual gradients across the RVOT. Following an uneventful recovery, the patient was discharged five days after surgery.

Total Correction without Cardiopulmonary Bypass of Isolated Left Hemitruncus Arteriosus

Hemitruncus is an uncommon congenital defect, accounting for only 0.12% of all congenital cardiac defects, in which a pulmonary artery (PA) branch originates abnormally from the ascending aorta (1). Diagnosis and surgery at very early ages are important to prevent irreversible vascular pulmonary disease. This defect should be suspected in newborns with heart failure and increased left pulmonary flow, as in the present case. We present herein a case of a neonate with isolated left hemitruncus, in which surgical correction without cardiopulmonary bypass (CPB) was performed successfully. Case Report

High postoperative serum levels of surfactant type B as novel prognostic markers for congenital heart surgery

Objective Congenital heart diseases are observed in 5 to 8 of every 1000 live births. The presence of a valuable biomarker during the surgical periods may aid the clinician in a more accurate prognosis during treatment. Methods For this reason, surfactant protein B plasma levels may help to evaluate patients with cardiac problems diminishing the alveolocapillary membrane stability. In this study, plasma levels of this biomarker were measured in the preoperative and postoperative periods. This study was conducted to detect the differences between pulmonary hypertensive and normotensive patients. The differences before and after cardiopulmonary bypass were examined. Results The differences in cardiopulmonary bypass time, cross-clamp time , inotropic support dose, and duration of intensive care of patients with and without pulmonary hypertensive were found to be statistically significant (P<0.05). The results revealed that this pathophysiological state was related to other variables that were studied. We believe that the differences in preoperative and postoperative SPB levels could be attributed to alveolocapillary membrane damage and alveolar surfactant dysfunction. We found that this pathophysiological condition was significantly associated with postoperative parameters. Conclusion The findings of the current study showed that surfactant protein B was present in the blood of patients with a congenital heart disease during the preoperative period. Long by-pass times may exert damage to the alveolocapillary membrane in patients with pulmonary hypertension and preoperative heart failure, and it is recommended to keep the option of surfactant therapy in mind during the postoperative course at the intensive care unit before preparing the patients for extubation.