Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital

İstanbul, Turkey

Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital

İstanbul, Turkey
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Onan I.S.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital | Ozturk E.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital | Yildiz O.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital | Altin H.F.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital | And 4 more authors.
Interactive Cardiovascular and Thoracic Surgery | Year: 2016

OBJECTIVES To investigate the effects of intravenous iloprost on pulmonary artery hypertension (PAH) in infants undergoing congenital heart surgery. METHODS In this prospective, randomized study, the study group (n = 15) received a continuous infusion of iloprost (2.0 ng/kg/min) that was delivered immediately after weaning from cardiopulmonary bypass and continued for 72 h postoperatively. Patients in the control group (n = 12) were managed conventionally. The groups were compared in terms of postoperative data, including systolic and mean pulmonary artery (PA) pressures, PA/systemic pressure ratio, lactate level, PAH crisis, ventilation time, reintubation and lengths of intensive care unit (ICU) and hospital stay. Transthoracic echocardiography was used to assess PA pressures at 1 day, 7 days and 30 days after surgery. RESULTS No mortality occurred. PAH crisis occurred in 2 (16.6%) patients in the control group and 4 (26.7%) patients in the study group (P = 0.53). Postoperative PA pressures and PA/systemic pressure ratios were similar between the groups (P > 0.05). The durations of ICU (P = 0.40) and hospital (P = 0.98) stays were similar between the groups. Echocardiographic studies demonstrated a significant decrease in postoperative PA pressures in the control (P = 0.001) and study (P = 0.0001) groups. However, no significant change was observed between the groups (P > 0.05). The Tukey multiple comparison test showed a significant decrease in PA pressures at each follow-up in both groups (P < 0.05). CONCLUSIONS Intravenous iloprost demonstrated no additional benefit over the conventional management of infants with PAH after repair of intracardiac defects. Clinicians may prefer other alternative agents in infants with a high risk of PAH crisis. © The Author 2015.


Onan I.S.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital | Erek E.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital | Haydin S.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital | Onan B.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital | And 5 more authors.
Artificial Organs | Year: 2013

This study summarizes the clinical outcome data of a start-up congenital heart surgery program in Turkey. Between December 2009 and February 2012, 616 operations have been performed in 132 newborns (22%), 260 infants (42%), and 224 children/adolescents (36%). Risk adjustment analysis was performed using the risk adjustment in congenital heart surgery (RACHS-1) risk assessment model. There were 66 mortalities (10.7%). According to the RACHS-1 categories, there were 51 cases in level I (8.2%) with no mortality (0%), 250 in level II (40.6%) with 11 (4.4%) mortalities, 199 in level III (32.3%) with 33 (16.5%) mortalities, 53 in level IV (8.6%) with 10 (18.8%) mortalities, 14 in level V and VI (2.2%) with 11 (78.5%) mortalities, and 49 cases (7.9%) out of the RACHS-1 categories with one (2.0%) mortality. Mortality was higher in neonates compared to infants, and in infants compared to children/adolescents. Mortality was higher in palliative procedures compared to corrective procedures. The data demonstrate that a start-up program with a relatively loaded surgical volume may achieve acceptable clinical results with a good teamwork. Collaboration of anesthesiologists, perfusionists, pediatric cardiologists, intensivists, and cardiovascular surgeons is necessary to provide a better outcome in congenital heart surgery. © 2013, The Authors. Artificial Organs © 2013, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.


PubMed | Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital
Type: Case Reports | Journal: Annals of vascular surgery | Year: 2014

A 12-year-old boy with a family history of hereditary multiple exostosis presented with a 3-week history of progressive knee swelling. The clinical examination revealed drop foot and a loss of extension in his right knee. Evaluation with color duplex ultrasonography, computed tomography angiography, and magnetic resonance imaging revealed a popliteal artery pseudoaneurysm associated with exostosis from the distal femur. This patient was diagnosed as having peroneal neuropathy caused by popliteal artery pseudoaneurysm compressing the nerve in the right popliteal fossa. The pseudoaneurysm was repaired primarily, and the exostosis was excised during the operation. Pain and knee contracture resolved after surgery. The patient was then referred to physical therapy for the management of drop foot.


Onan B.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital | Onan I.S.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital | Guner Y.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital | Yeniterzi M.,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital
Annals of Vascular Surgery | Year: 2014

A 12-year-old boy with a family history of hereditary multiple exostosis presented with a 3-week history of progressive knee swelling. The clinical examination revealed drop foot and a loss of extension in his right knee. Evaluation with color duplex ultrasonography, computed tomography angiography, and magnetic resonance imaging revealed a popliteal artery pseudoaneurysm associated with exostosis from the distal femur. This patient was diagnosed as having peroneal neuropathy caused by popliteal artery pseudoaneurysm compressing the nerve in the right popliteal fossa. The pseudoaneurysm was repaired primarily, and the exostosis was excised during the operation. Pain and knee contracture resolved after surgery. The patient was then referred to physical therapy for the management of drop foot. © 2014 Elsevier Inc. All rights reserved.


PubMed | Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital and Mehmet Akif Ersoy University
Type: Journal Article | Journal: Interactive cardiovascular and thoracic surgery | Year: 2016

To investigate the effects of intravenous iloprost on pulmonary artery hypertension (PAH) in infants undergoing congenital heart surgery.In this prospective, randomized study, the study group (n = 15) received a continuous infusion of iloprost (2.0 ng/kg/min) that was delivered immediately after weaning from cardiopulmonary bypass and continued for 72 h postoperatively. Patients in the control group (n = 12) were managed conventionally. The groups were compared in terms of postoperative data, including systolic and mean pulmonary artery (PA) pressures, PA/systemic pressure ratio, lactate level, PAH crisis, ventilation time, reintubation and lengths of intensive care unit (ICU) and hospital stay. Transthoracic echocardiography was used to assess PA pressures at 1 day, 7 days and 30 days after surgery.No mortality occurred. PAH crisis occurred in 2 (16.6%) patients in the control group and 4 (26.7%) patients in the study group (P = 0.53). Postoperative PA pressures and PA/systemic pressure ratios were similar between the groups (P > 0.05). The durations of ICU (P = 0.40) and hospital (P = 0.98) stays were similar between the groups. Echocardiographic studies demonstrated a significant decrease in postoperative PA pressures in the control (P = 0.001) and study (P = 0.0001) groups. However, no significant change was observed between the groups (P > 0.05). The Tukey multiple comparison test showed a significant decrease in PA pressures at each follow-up in both groups (P < 0.05).Intravenous iloprost demonstrated no additional benefit over the conventional management of infants with PAH after repair of intracardiac defects. Clinicians may prefer other alternative agents in infants with a high risk of PAH crisis.

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