Makale Arama

The aim of this study is to evaluate our experience of patients with their clinical presentations and treatment approaches followed and underwent atrial septal defect surgery in Cardiovascular Surgery Department. Between 2010-2013, 28 patients (20 females, 8 males) mean age 58 months (range 5 month to 14 year-old) who underwent atrial septal defect surgery were included in the study retrospectively. In two patients, there were sinus venosus atrial septal defects with partially abnormal pulmonary venous drainage. In one patient, there was primum atrial septal defect. 25 patients had secundum atrial septal defects. Mean pulmonary artery pressure was 18.6 mmHg(8- 39 mmHg) and mean Qp/Qs ratio was 2.2 (1.4-4.5) in patients who underwent cardiac catheterization. Atrial septal defects were closed with synthetical patch in all of the patients. The mean of intensive care unit hospitalization was 3.2 (1-12) days. The mean of cardiovascular surgery clinical hospitalization was 4.1 (1-17) days. The mean discharge time was 7.4 (4-29) days. No mortality was observed and no hemodinamically significant residual was observed. The average postoperative follow-up period of patients was 24 months (1 month-3.5 years). Surgically closure of atrial septal defect, one of the most common forms of congenital heart disease, is performed safely in many medical center with low mortality and complication rates. If atrial septal defect remains untreated, significant complications such as cardiac failure, pulmonary vascular obstructive disease and atrial arrhythmias may occur.

Nowadays, interventional treatment is one of the indispensable methods of treatment for pediatric cardiology centers. The results of interventional treatment of our center were presented within two years. The results of 40 patients who underwent interventional procedure in our center between February 2011-November 2012 were retrospectively reviewed. Interventional therapy was applied to 40 patients. Fifty-five percent (n:22) of these patients were female, 45% (n:18) were male. Their age is from 10 days to 15 years, their weight is between 3.7 and 60 kg. Pulmonary balloon valvuloplasty was performed to nine patients with valvular pulmonary stenosis. Angioplasty was performed to 10 patients with the coarctation of aorta. Transcatheter ASD closure was performed to 12 patients with atrial septal defect. The five patients’ ductus with a wide range closed by transcatheter. Mitral balloon valvuloplasty was performed to 14-year-old patient with mitral stenosis. In our hospital,angiography was performed since June 2010 until November 2012, with total of 155 patients with angio process and interventional procedure was applied to 40 of these patients (25.8%). At first,diagnostic angiography is performed in our angiography unit. Subsequently, interventional procedures were performed such as balloon angioplasty to the coarctation of the aorta and pulmonary balloon valvuloplasty, respectively. Recently, processes that are complicated and requires experience such as transcatheter closure of ASD and PDA, and aortic stent implantation transactions began to be performed in our clinic. Considering the last 6 months, the rate of invasive procedures increased to 50% compared with diagnostic procedures.

Our surgical results have been reported after repair of complete atrioventricular septal defects (CAVSD). Between 2001 and 2009, 29 patients with CAVSD underwent operation at our institution. Double patch repair of CAVSD were performed in all patients. All attempts to close the cleft of the left atrioventricular valve (LAVV) were conducted as completely as possible. Early mortality occurred in three cases (% 10.3) after repair. Twenty patients could be followed-up for a mean of 3.5 years. Reoperation wasn’t needed for LAVV insufficiency, residual atrial septal defect or ventricular septal defect. Repair for CAVSD can be performed in early infancy. The double - patch repair in a safe surgical method that can achieve low mortality and good midterm outcomes.

Our study was performed to compare the effects of general and spinal anesthesia on the hemodynamic values of the mother, APGAR and umbilical vein blood gases of the newborns. 128 term, pregnant volunteer womwn who were planned for cesarean section and in group ASA I-II were included in the study. The subjects randomly devided into two groups. In group I (n=60), induction was performed with iv. propofol per 2 mg kg-1 and the maintenance dose was provided with the mixture of 1% sevofluran, 50% air and 50% O2 . In group II (n=68), spinal anestesia was performed in left lateral position, by injecting 7.5 mg (1.5 ml) hyperbaric bupivacain intrathecally, through L3-L4 intervertebral space, with 24 gauce spinal needle. Spinal anesthesia elevated to T6-7 level. Both groups preloaded with 10 mL/kg-1h-1 % 0.9 NaCL solution. Systolic and diastolic blood pressures, meanterial pressures, pulse rates and peripheric oxygen saturations reported in all subjects of group I, before the induction and in 1., 2., 3., 4., 5., 10., 15. and 30. Minutes after endotracheal entubation. In spinal anesthesia group it is reported in 1., 2., 3., 4., 5., 10., 15. and 30. Minutes after the anesthesia. When we compared the pulse rates and mean arterial pressures of both groups, these values were low in spinal anesthesia group which were found to be statistically significant (p<0.05). The arterial blood gases (pCO2, pO2), pH of the mother and APGAR (1., 5., 10. minutes) scores of the newborns were better in spinal anesthesia group, and statistically significant (p<0.005). As a result, regarding the undesired effects of the spinal anesthesia on mother’s hemodynamic parameters like hypotension and bradycardia; in cesarean secion cases it must be used carefully. We can advice its safely use regarding to the results of the arterial blood gases and APGAR scores of the newborns after taking preventive measures especially against deep hypotension

Introduction: Our aim is to evaluate the cardiac involvement of Neurofibromatosis type 1  patients in our region and to compare them with other clinical findings. In this study, we wanted to show the frequency and variety of cardiac involvement.

Material and Methods: Patients diagnosed with Neurofibromatosis type 1  in Hatay Mustafa Kemal University Medical Faculty Pediatric Neurology Clinic between 01/09/2019 and 01/09/2020 were included in the study. The patients included in the study were examined by a Pediatric Cardiology Specialist, and echocardiography and electrocardiography were taken. Demographic information, examination findings, brain magnetic resonance images were collected from the files of the patients. Electrocardiography and echocardiography were examined and recorded by the Pediatric Cardiology Specialist.

Results: We accepted 17 patients from our center to the study. Six patients (35.3%) were diagnosed with sporadic Neurofibromatosis type 1, while 11 patients (64.7%) had familial Neurofibromatosis type 1. All of our patients had cafe au late spots on the skin. In addition, 10 (58.8%) patients also had axillary and / or inguinal freckles. We detected optic glioma in 3 of our patients with ocular involvement, and lish nodules in 3 of them with papillary edema. When we looked at central nervous system involvement, we encountered various involvements in brain MRIs of 8 (47%) patients. In our cardiac examination, we found QT length in 1 patient’s electrocardiography. In the echocardiography we performed for the detection of cardiac structural pathologies, we detected nodular appearance compatible with subendocardial neurofibroma in 3 patients, mitral insufficiency in 3 patients, patent foramen ovale in 1 patient, atrial septal defect in 1 patient, and bicuspid aorta in 1 patient.

Discussion: In our study, unlike the literature, subendocardial nodular hyperechogenic appearance was present in 3 patients. Although these findings are quite rare, subendocardial nodular hyperechogenic images in 3 of our 17 patients suggest that this pathology may be more common. In addition, one of our patients had a long QT. As far as we know, this is the first case of Neurofibromatosis type 1 and Long QT syndrome. In conclussion; Cardiac involvement in patients with Neurofibromatosis type 1 could more common than mentioned in the literature.

\r\n Atrial septal defect (ASD) is also responsible for 30-33% of adult defects. . Transcatheter treatment is the first-line treatment for secuncum ASD treatment. A 36-year-old ASD patient that had a successful transcatheter closure. The occluder  embolization became, within the first 24 hours after procedure, to the aortic arcus. It is known that the devices with embolism are taken by snare and biopsy catheter, but differently, a case involving surgical removal after retraction of femoral artery by another ASD occluder device. Hybrid approach should always be mindful when removing embolized device with high success rate using different methods.

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Three hundred seventy patients with congenital heart defects (CHD) who were admitted to Pediatric Cardiyology Unit of Selçuk University, Meram Medical School Hospital, between September 1999 and September2001, were evaluated. Ventricular septal defect was the most common type of CHD and it was follovved by atrial septal defect as in literatüre. Consanguinity marriage was detected as 30.0 % among the parents of the patients with CHD. This ratio was significantly higher than the ratio detected from the healthy control group. As we Investigated the degree of relativity among the parents of the patients with CHD, we found that the first cousin marriage was higher than the far consanguinity marriage. These findings indicated that first cousin marriage could increase the occurence of CHD among the offsprings.