Publications (3)2.52 Total impact
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Article: Two challenging translocation procedures for intramural coronary arteries in the setting of transposition of great arteries.
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ABSTRACT: Translocation of the coronary arteries remains a technical challenge in anatomic correction of transposition of great arteries. Myocardial ischemia related to the difficulties with coronary relocation is an important factor in perioperative and postoperative morbidity and mortality, particularly in the patients with complex coronary artery anatomy. Intramural coronary artery is a rare anatomic variety which may complicate the arterial switch operation in 2% to 4.6% of the reported cases. Even in the hands of experts, the mortality rate may be in twofold in this subset of patients compared with simple transposition of great artery procedures. In this report, 2 successful translocation techniques for intramural coronary arteries in the setting of arterial switch operation are described.Congenital Heart Disease 10/2008; 3(5):352-4. · 0.90 Impact Factor -
Article: Intermediate-term results of Medtronic freestyle valve for right ventricular outflow tract reconstruction in the Ross procedure.
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ABSTRACT: The Ross procedure has become the first choice for aortic valve replacement in children and young adults at many institutions. Since 1997, a lack of availability of homograft valves in Turkey has prompted the use of alternative substitutes for right ventricular outflow tract (RVOT) reconstruction during the Ross procedure. Before April 2005, among 20 patients (age range: 14 months to 45 years) at the present authors' institution, the Ross procedure was performed in 14 and a Ross-Konno procedure in six. Sixteen patients underwent RVOT repair using alternative methods for homograft valve replacement. Fourteen patients received a Medtronic Freestyle valve and one patient a Medtronic Contegra bovine jugular vein conduit. An autologous RVOT repair was used in one patient. Ten of the Medtronic Freestyle valve patients were aged <16 years. In all patients who received a Medtronic Freestyle valve echocardiographic evaluations were conducted shortly after surgery and during follow up. There was no early mortality. One patient died from pneumonia after six months, and another (asymptomatic) patient died suddenly at 34 months after surgery. Before hospital discharge the mean peak pressure gradient across the Freestyle valve was 12.1 +/- 11.0 mmHg, and this increased to 24.1 +/- 20.0 mmHg after a mean follow up of 51.2 +/- 6.9 months (range: 6 to 101 months) (p <0.002). Mild pulmonary regurgitation was seen in two patients. One asymptomatic adult patient was reoperated on at another center because of a 60-mmHg echocardiographic peak gradient at four years postoperatively. Although long-term follow up is required to explain the durability of the Medtronic Freestyle valve, the present results show that the valve can be used with intermediate-term success in the Ross procedure - and even in children as an alternative - if homograft valves are not available.The Journal of heart valve disease 10/2006; 15(5):696-701. · 0.81 Impact Factor -
Article: Ross-Konno procedure and ostial plasty in a child with homozygous hypercholesterolemia: case report.
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ABSTRACT: Although the Ross procedure is preferred for aortic valve replacement in young and female patients, there are no reported cases of hypercholesterolemic aortic pathology due to homozygous familial hypercholesterolemia. Long-term durability of the pulmonary autograft in patients with postoperative high blood cholesterol levels is of interest. A 14-year-old girl with homozygous familial hypercholesterolemia who underwent the Ross-Konno procedure and left coronary artery ostial plasty was followed for 57 months, with pulmonary autograft function, coronary arteries and lipid profile being monitored. There were no signs of narrowing, insufficiency or calcification of the pulmonary autograft; neither was there any narrowing in the left main coronary ostium. The patient's total cholesterol level was reduced from 897 to 262 mg/dl by use of anti-lipidemic medication and weekly lipid apheresis. Follow up data suggest that a pulmonary autograft may be preferable in children with hypercholesterolemic aortic valvular pathology, as well as in children with aortic valvular diseases of other etiologies.The Journal of heart valve disease 12/2005; 14(6):855-8. · 0.81 Impact Factor
