The Retrospective Evaluation of the Patients in Pediatric Cardiac Intensive Care Unit of Cardiac Surgery Center

Introduction:In this study, demographic and epidemiologic features, clinic and prognosis of patients admitted to the pediatric cardiac intensive care (PCICU) unit of a cardiac surgery center were analysed retrospectively.Methods:Patients followed in the PCICU between January 2017 and January 2018 were included in the study. Patient files were analysed for medical data. The patients were divided into 4 major categories as postoperative patients (group 1), patients followed after cardiac catheterization (group 2), patients followed due to arrythmias (group 3), and others (myocarditis, pneumonia, tamponade) (group 4). The demographic variables, such as age and gender, echocardiographic diagnosis, kind and condition of the transfer, reason for PCICU follow-up, and discharge status were evaluated in detail.Results:Eighty hundred ninety five patients were followed in the PCICU during the study period.The median age was 5.5 months (1 day-18 years). 53% of patients (n=474) were male and 47% (n=421) were female. The ortanca weight of the patients was 7.2 kg (1.8-80 kg). 16% of the patients were younger than 1 month of age and 54% of the patients were under the age of 6 months. 12% (n=107) of the patients had a diagnosis of a genetic condition such as Down syndrome, DiGeorge syndrome, etc. 40% of the patients were non-residents. 25% was transferred by air ambulance or ground ambulance. 22% of the patients were foreigners. There were 610 patients in group 1, 130 patients in group 2, 55 patients in group 3, and 100 patients in group 4. The RACHS-1 scores in group 1 were as follows: 0.8% undetermined, 11.2% category 1, 42.9% category 2, 29.6% category 3, 12.6% category 4,(-) category 5, and 2.6% category 6. Overall mortality was 5.9% (n=53) and morbidity was 22% (n=197).Conclusion:We believe that by the means of this kind of epidemiological studies, we may detect the types of cardiac problems in children who needed intensive care follow-up and help to decrease mortality and morbidity in childhood due to congenital cardiac diseases in our country

Single-center experience with routine clinical use of 3D technologies in surgical planning for pediatric patients with complex congenital heart disease

PURPOSEThis study was planned to assess the application of three-dimensional (3D) cardiac modeling in preoperative evaluation for complex congenital heart surgeries.METHODSFrom July 2015 to September 2019, 18 children diagnosed with complex congenital heart diseases (CHDs) were enrolled in this study (double outlet right ventricle in nine patients, complex types of transposition of the great arteries in six patients, congenitally corrected transposition of the great arteries in two patients, and univentricular heart in one patient). The patients’ age ranged from 7 months to 19 years (median age, 14 months). Before the operation, 3D patient-specific cardiac models were created based on computed tomography (CT) data. Using each patient’s data, a virtual computer model (3D mesh) and stereolithographic (SLA) file that would be printed as a 3D model were generated. These 3D cardiac models were used to gather additional data about cardiac anatomy for presurgical decision-making.RESULTSAll 18 patients successfully underwent surgeries, and there were no mortalities. The 3D patient-specific cardiac models led to a change from the initial surgical plans in 6 of 18 cases (33%), and biventricular repair was considered feasible. Moreover, the models helped to modify the planned biventricular repair in five cases, for left ventricular outflow tract obstruction removal and ventricular septal defect enlargement. 3D cardiac models enable pediatric cardiologists to better understand the spatial relationships between the ventricular septal defect and great vessels, and they help surgeons identify risk structures more clearly for detailed planning of surgery. There was a strong correlation between the models of the patients and the anatomy encountered during the operation.CONCLUSION3D cardiac models accurately reveal the patient’s anatomy in detail and are therefore beneficial for planning surgery in patients with complex intracardiac anatomy

Congenital heart surgery in Turkey: today and tomorrow

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Bu makaleyi yazmamızdaki amacımız: Ülkemizde doğuştan kalp cerrahisinin iyileştirilmesi ve çeşitli nedenlerle açık kalp ameliyatı olamayan binlerce hastanın tedavi edilebilmesi için kısa ve uzun vadede yapılabilecek uygulamalarla ilgili önerileri sunmaktır

Eighth Istanbul symposium on pediatric extracorporeal life support systems and pediatric cardiopulmonary perfusion

To improve the outcomes of pediatric extracorporeal life support (ECLS) and cardiopulmonary bypass (CPB) procedures in Turkey, we have established a series of conferences, called “Istanbul Symposiums.” Since the first symposium in June of 2011, we have organized seven additional symposiums in Istanbul (1–3). The objective of this editorial is to share the latest results on pediatric ECLS and CPB patients with the Artificial Organs community