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Biomedical subjects

S Ozkutlu

Publications and source records attributed to S Ozkutlu.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Preliminary pediatric transesophageal echocardiography experiences.

With transesophageal echocardiography (TEE), a new echocardiographic window is obtained which enables cardiologists to explore the heart from the esophagus and stomach. However, the procedure, when first undertaken, may present certain difficulties for the cardiologist in interpreting the anatomical findings and approaching a diagnosis. We thus convey our first experiences and results of TEE in 107 pediatric patients. Transesophageal echocardiography (TEE) was performed in 107 pediatric patients at our institution between December 1998-February 2001, using the standard techniques and following the standard criteria suggested by the American heart Association. The mean age of 54 male (50.5%) and 53 female (49.5%) patients was 7.8 years. Intubation difficulty was experienced in four cases. In one case, while drawing the transducer back from the esophagus, it kinked at the hypopharynx. None of the cases had major hemorrhage or esophageal rupture, and only a few cases had minor pharyngeal injuries or hemorrhages. We used TEE in detecting vegetations in patients with possible endocarditis, and evaluating the prosthetic valves and abnormal pulmonary venous return. We also used TEE to clarify preooperative anatomical details, postoperative complications and residual defects of complex congenital cardiac anomalies. Transcattheter closure of 47 secundum atrial septal defects (ASD)'s and a muscular ventricular septal defect (VSD) (both during patient selection and during the procedure) were accomplished under TEE guidance. As the pediatric cardiologists gain more experience in performing TEE, this technique will have a wider and more effective use in the pediatric population.

Adolescent↗
PubMedDate not supplied

Severe hemolytic anemia after repair of primum septal defect and cleft mitral valve.

Two cases are described in which severe mechanical hemolytic anemia developed after surgical repair of primum atrial septal defect (ASD) and cleft mitral valve. In both cases there was residual mitral regurgitation after repair. Moderate mitral regurgitation and collision of the regurgitant jet with the teflon patch used for repair of the primum ASD were detected by color-Doppler echocardiography imaging. Laboratory tests showed normochromic normocytic anemia, increased indirect serum bilirubin, decreased plasma haptoglobin and hemoglobinuria. The peripheral blood smear contained numerous fragmented red cells. Following another surgical correction of the mitral valve (repair or mitral valve replacement), there was no more hemolysis. The two presented cases show that foreign materials in association with localized intracardiac turbulence may cause severe hemolysis.

Anemia, Hemolytic↗
PubMedDate not supplied

Two-dimensional and Doppler echocardiography in the diagnosis of absent pulmonary valve syndrome (surgery without catheterization).

The majority of severely affected infants with absent pulmonary valve syndrome develop varying degrees of respiratory distress. Cardiac catheterization and angiocardiography are still performed in the diagnosis of these infants prior to surgery. However, considering the high risks of these invasive investigations for severely symptomatic infants, diagnosis using only noninvasive methods becomes important. In this regard, we present three cases of absent pulmonary valve syndrome, diagnosed pre-operatively by both two-dimensional and Doppler echocardiography. The diagnosis was confirmed by cardiac catheterization and angiocardiography in two cases and by surgery in a symptomatic infant. Therefore, we are of the opinion that the two-dimensional and Doppler echocardiographic methods are most reliable in diagnosing absent pulmonary valve syndrome, and that severely symptomatic infants can be referred for surgery without catheterization.

Angiocardiography↗
PubMedDate not supplied

Two-dimensional and Doppler echocardiographic findings of congenital coronary artery fistula.

Three patients with coronary artery fistula confirmed by coronary angiography and surgery were studied using two-dimensional and Doppler echocardiography. Two of these patients had left coronary artery-right ventricle fistula. The proximal dilatation of the coronary arteries was visualized in all three patients by two-dimensional echocardiography. The course of the dilated right coronary artery and left circumflex artery was demonstrated by two-dimensional echocardiography in two patients. We were able to detect the disturbed flow at the drainage site in one patient by using the conventional Doppler echocardiography. In conclusion, it should be emphasized that two-dimensional and Doppler echocardiography can be useful methods in diagnosing coronary artery fistula.

Child, Preschool↗
PubMedDate not supplied

Creation of right ventricle-pulmonary artery continuity without cardiopulmonary bypass.

A closed technique was applied successfully in a patient with Fallot's tetralogy in whom total correction had been previously performed, for creation of continuity between the right ventricle and left pulmonary artery without the use of cardiopulmonary bypass. A surgical approach was achieved by an anterolateral thoracotomy incision in the left third intercostal space. A Dacron non-valved tubular graft, 10 mm. in diameter, was anastomosed to the proximal end of the left pulmonary artery. The proximal end of the graft was anastomosed to the pericardial outflow tract patch with a running technique using a monofilament suture. The peripheral arterial oxygen saturation increased postoperatively, and the patient's condition improved dramatically.

Angiography↗
PubMedDate not supplied

Experience with propafenone for the treatment of cardiac arrhythmias in children.

The aim of this prospective study was to evaluate the efficacy of propafenone in suppressing various arrhythmias in a group of children who were patients in the Pediatric Cardiology Unit of Hacettepe University Children's Hospital. Seven of the 13 children (53.8%) with ventricular ectopics, all three children with paroxysmal re-entry atrioventricular tachycardia, and two of the three children with paroxysmal atrial tachycardia were treated successfully with propafenone. The drug did not cause any side effects or arrhythmogenesis. The median dosage of propafenone at discharge was 300 mg/m2/day (range 250-400 mg/m2/day) every eight hours. Our findings confirm the efficacy and safety of propafenone for the treatment of childhood arrhythmias.

Adolescent↗
PubMedDate not supplied

Detection of intracardiac left-to-right shunts in children by contrast echocardiography and the radionuclide technique.

This study was carried out in the Departments of Pediatrics and Nuclear Medicine at Hacettepe University Faculty of Medicine between April 1986 and March 1988 with the aim of detecting left-to-right shunts in 70 patients with isolated ventricular septal (VSD) defect, isolated atrial septal defect (ASD) and patent ductus arteriosus, by using the radionuclide technique together with contrast echocardiography. In some patients, the results were confirmed by both cardiac catheterization and angiocardiography. Most of the data were confirmed during surgery. A good correlation was found between the results of contrast echocardiography and radionuclide angiography. The difference between the QP/QS value and the grade of positive contrast effect was tested statistically and "p" was found to be less than 0.001. Therefore, we conclude that these methods could be applied together to determine the indication for surgery in cases with ASD or VSD.

Adolescent↗
PubMedDate not supplied

Percutaneous transluminal balloon pulmonary valvuloplasty: immediate and medium-term results.

Ten patients with pulmonary stenosis, (six males and four females) whose ages ranged between five and ten years (mean age 7 years) underwent cardiac catheterization and balloon valvuloplasty. Right ventricular systolic pressure before valvuloplasty ranged from 90 to 200 mm Hg (mean 133.5 +/- 33.3 mm Hg). It fell to 50-90 mm Hg (mean 64.5 +/- 13.8 mm Hg) immediately after the procedure. The peak systolic gradient across the pulmonary valve before valvuloplasty ranged from 70 to 180 mm Hg (mean 114.5 +/- 35.4 mm Hg) and decreased significantly to 30-70 mm Hg (mean 43.0 +/- 13.8 mm Hg) immediately after dilation. Doppler echo studies confirmed these results. At repeat cardiac catheterization in three patients, five to 15 months after valvuloplasty, restenosis was noted in one patient while there was no change in the others. All patients had been followed up by Doppler echocardiography. Patients with isolated valvular pulmonary stenosis can be adequately and safely treated with balloon valvuloplasty which results in excellent immediate and medium-term results.

Catheterization↗
PubMedDate not supplied

Peripheral vein contrast echocardiography in atrial septal defect.

This study was carried out on 233 children suspected clinically of having atrial septal defect with the aim of investigating the diagnostic capability of peripheral venous contrast echocardiography. The transfer of contrast material from the right atrium into the left atrium was evaluated as "positive contrast", while noncontrast blood, passing from the left atrium into the right atrium was termed "negative contrast". Positive contrasts were quantitated in four grades. A significant negative contrast effect was graded 3- or 4-. Three positive, 4+ and/or 3-, 4- contrast effects were considered definite evidence of an atrial septal defect. Among the cases with the above findings 92 underwent surgical closure of atrial septal defect. The procedure was successful in all patients operated; the size of the defect was large. This result demonstrates that the method applied is a safe and reliable one. However, in a group of cases without the above echocardiographic findings the presence of an atrial septal defect was detected by cardiac catheterization and angiocardiography. Therefore, we can conclude that the method applied is not a sensitive, but a specific one, for definite detection of atrial septal defect.

Adolescent↗
PubMedDate not supplied

Cardiac rhabdomyosarcoma diagnosed by echocardiography.

Primary, malignant, cardiac tumors are extremely rare in infants and children. Only a few cases of cardiac rhabdomyosarcoma have been reported in childhood. Echocardiography greatly increases the rate of correct diagnosis of cardiac tumors. There are some cases in the literature which were diagnosed by echocardiography and confirmed histopathologically. In this report, a 13-year-old girl with the clinical findings of cardiac tamponade and who was diagnosed as having a cardiac tumor by two-dimensional echocardiogram is presented An echodense, solid tumor with irregular borders extending especially toward the left ventricular cavity from the apex was demonstrated on echocardiography. The diagnosis was confirmed histopathologically on postmortem examination.

Adolescent↗
PubMedDate not supplied

Kawasaki disease associated with gallbladder hydrops.

Kawasaki disease is an acute, febrile, systemic syndrome of unknown etiology which principally affects young children. We present a five-year-old boy, who developed an unusual finding, acute hydrops of the gallbladder, in addition to the characteristic signs and symptoms of Kawasaki disease. Clinical features of the disease and treatment regimens, including early administration of intravenous gamma globulin (IVGG), which prevents cardiac complications, are discussed.

Child, Preschool↗
PubMedDate not supplied

Left ventricular size following shunt operation in tetralogy of Fallot.

This study was performed in 24 patients with tetralogy of Fallot in whom shunt operation was performed instead of total correction because of small left ventricular end-diastolic dimension. Left ventricular end-diastolic dimension was measured using M-mode and two-dimensional echocardiography pre- and at least one year postoperatively. There was no change in the postoperative left ventricular size in two patients. However, in the other 22 patients, the left ventricular dimension was increased to 70 to 103 percent of normal left ventricular size. According to the findings of this study, we can conclude that the patients in whom shunt operation was performed would most likely have an increased left ventricular size over time.

Anastomosis, Surgical↗