Pediyatrik vakalarda sürekli akım sağlayan ventrikül destek cihazi implantasyonu: Tek merkez deneyimi

Aim: Heart transplantation is the gold standard of treatment for patients with medical therapy resistant end-stage heart failure. Particularly in the pediatric age group use of ventricular asist device (VAD) is mandatory, due to donor organ limitation and prolonged waiting lists. Materials and Methods: This retrospective review of fourteen patients under 19 years of age who underwent continuous flow left VAD implantation between August 2012 and March 2018. All patients have met the criteria for heart transplantation. HeartWare (HeartWare Inc. Medtronic) HVAD was implanted to all patients. Results: There were eight girls and six boys with a mean overall age of 15.4 (minimum11-maximum 18) years and mean body weight of 42.4 kg and body surface area (BSA) is 1.4 kg/cm². The mean follow-up was 549 days. Survival rate at six months was 90%. Six patients (42.9%) are still waiting for transplantation on VAD support. Six patients (42.9%) underwent heart transplantation successfully. Two patients died while they were waiting for transplantation on device support. Conclusion: The use of continuous flow ventricular assist devices became more popular because reduced dimensions along with technological advances. In this article, we wanted to share our experience about continuous flow ventricular assist device implantation as bridge to transplantation in pediatric patients.Amaç: Kalp transplantasyonu medikal tedaviye dirençli hastalarda altın standart tedavi yöntemidir. Tüm dünyada olduğu gibi ülkemizde de özellikle pediatrik yaş grubunda donör organ kısıtlılığı ve uzayan bekleme listeleri ventrikül destek sistemlerinin kullanımını zorunlu kılmıştır. Gereç ve Yöntem: Bu çalışmada, kliniğimizde Ağustos 2012 ile Mart 2108 tarihleri arasında 19 yaş altı olgularda devamlı akım sağlayan ventriküler destek cihazı implante edilmiş olgular retrospektif olarak değerlendirildi. Hastaların tümü kalp nakli kriterlerine uygundu. Tüm hastalara HeartWare (HeartWare inc. Medtronic) HVAD cihazı implante edildi. Bulgular: Yaş ortalaması 15,4 (minimum11-maksimum 18) olan 8 kız, 6 erkek olgunun, ortalama kilosu 42,4 kg, vücut yüzey alanı ise 1,4 kg/cm², ortalama takip süresi 549 gün, 6 aylık survi %90 olarak değerlendirildi. Altı (%42,9) olgu halen destek altında takibimizde iken, 6 olguya başarılı şekilde kalp transplantasyonu yapıldı. Destek altında iken 2 olgu kaybedildi. Sonuç: Teknolojik ilerlemeler ile büyük ve pulsatil akım sağlayan pompalardan sonra son yıllarda boyutları oldukça küçülen sürekli akım sağlayan ventrikül destek sistemlerinin kullanımı yaygınlık kazanmıştır. Bu yazımızda kliniğimizde pediatrik yaş grubunda nakile köprü amaçlı sürekli akım sağlayan ventrikül destek cihazı implantasyonu deneyimlerimiz paylaşılacaktır

Success of Tricuspid Valve Detachment for Ventricular Septal Defect Closure: An Assessment of Midterm Tricuspid Valve Function

Introduction: Ventricular septal defect (VSD) is the most common congenital heart anomaly. In surgical treatment, the transatrial approach is frequently utilized because of causing less right bundle block and ventricular scarring. However, some VSDs are obscured by the chordae tendineae or a pouch formation of the septal leaflet; therefore, alternative techniques are required. In such cases, tricuspid valve detachment (TVD) provides a complete visualization and ease to access to ventricular septal defects. In this study, we evaluated the results of the patients of whom we performed TVD

Long Term Outcomes of Arterial Switch Operation At The Transposition of the Great Arteries

Purpose: In this study, we present an assessment of late term outcomes of patients with the diagnosis of transposition of the great arteries of who were applied arterial switch operation between 2007 and 2017 in our clinic

Requirement for repetitive surgical approaches at supravalvular aortic stenosis

Supravalvular aortic stenosis, which is a rare congenital cardiac anomaly, is associated with several lesions and has a progressive nature. Herein, we report a five-year-old girl with bicuspid aorta who underwent initial Doty operation at the age of nine months. A combined redo Doty operation and an aortic valve commissurotomy were performed two years later. Due to the rapidly progressing aortic regurgitation and both valvular and supravalvular gradient, a repeated surgery was required at the age of five years and an aortic homograft was successfully inserted with an annulus enlargement and the patient was discharged uneventfully. In conclusion, although Doty repair yields satisfactory results in most patients, certain cases with identified risk factors may require reoperations due to the progressive nature of the disease. Therefore, these patients should be kept under a close follow-up lifelong