Treatment of a patient with congenitally corrected transposition of great arteries associated with ascending aortic hypoplasia and type A interrupted aortic arch without aortic cross clamping leading to myocardial ischemia

İnterrupted aortik ark tedavisi karmaşık bir süreçtir. Cerrahi rekonstrüksiyon genellikle myokard iskemisine neden olan aortik kros klempleme, kalbin durdurulması ve hatta kansız operasyon sahası için derin hipotermi gerektirir.Bu yazıda, normotermik şartlarda, kalbi durdurmadan çıkan aort, aortik ark ve proksimal desendan aort replasmanını selektif kanülasyon ve tüm vücut perfüzyonunu sağlayan cerrahi teknik ile tedavi ettiğimiz konjenital düzeltilmiş büyük arter transpozisyonu, tip A kesintili aortik ark ve hipoplazik asendan aortu olan hastamızı sunuyoruz.Treatment of interrupted aortic arch is complex. Surgical reconstruction consists of procedures that cause myocardial ischemia, such as aortic cross clamping, cardioplegia, and hypothermia. In this article, we present a patient with congenitally corrected transposition of great arteries together with Type A interruption as well as hypoplastic ascending aorta and the aortic arch. The replacement of the aorta, aortic arch, and the proximal descending aorta was performed under normothermic conditions without cardioplegia, which was achieved with a technique that preserves the systemic blood supply by using selective cannulation

Low oxygen saturation following total correction in a patient with tetralogy of fallot and persistant left superior caval vein - How did we diagnose and manage?

Association of tetralogy of Fallot (TOF) with the other intracardiac pathologies such as atrial septal defect (ASD), atrioventricular canal defect or persistent left superior vena cava (PLSVC), absent pulmonary valve are well known pathologies. The associated pathologies require specifi c attention during surgical treatment. In this manuscript, we present management of a four-month-old girl who was diagnosed with TOF and PLSVC but the diagnosis of unroofed coronary sinus was missed in her. Association of unroofed coronary sinus with TOF is a very rare variant of TOF pathology.Souvislost mezi Fallotovou tetralogií (tetralogy of Fallot, TOF) a jinými intrakardiálními patologiemi, jako jsou defekt septa síní (atrial septal defect, ASD), defekt síňokomorového kanálu nebo perzistentní levostranná horní dutá žíla (persistent left superior vena cava, PLSVC) i absence plicní chlopně, je dobře známa. Během chirurgického výkonu vyžadují přidružená onemocnění obzvláštní pozornost. V tomto článku popisujeme léčbu čtyřměsíční dívky s diagnózou TOF a PLSVC, u níž však byl přehlédnut nezastřešený koronární sinus. Nezastřešený koronární sinus se vyskytuje současně s TOF velmi vzácně

Determination of The Relationship Between Hopelessness-Depression Frequency and SocioDemographic Features in Students of School of Medicine, Suleyman Demirel University

Amaç Depresyon ve umutsuzluk kişinin verimliliğini kaybetmesine, yaşam kalitesinin bozulmasına neden olan önemli problemlerdir. Bu çalışmanın amacı tıp fakültesi öğrencilerinde depresyon ve umutsuzluk sıklığını ve sosyodemografik özelliklerle arasındaki ilişkiyi araştırmaktır. Materyal ve Metod Kesitsel-analitik tipte olan bu çalışma 02–04 Mart 2009 tarihleri arasında yürütüldü. Süleyman Demirel Üniversitesi Tıp Fakültesi birinci, ikinci ve üçüncü sınıf öğrencileri çalışmaya dahil edildi. Çalışmaya 330 öğrenciden 226’sı (% 68,5) katıldı. Öğrencilere, sosyodemografik özelliklerini saptamaya yönelik anket formu, Beck Depresyon Ölçeği, Beck Umutsuzluk Ölçeği gözlem altında uygulandı. Beck depresyon ölçeğine göre 17 ve üzeri puan alanlar olası depresif olarak sınıflandırıldı. Veriler istatistiksel olarak değerlendirildi. Bulgular Öğrencilerin Beck umutsuzluk ölçeği puan ortalamaları 5,3±4,6 bulundu. Beck depresyon ölçeğine göre 64’ü (%28,3) olası depresif bulundu. Olası depresif olanlarda Beck umutsuzluk ölçeği puan ortalaması normal olanlara göre daha yüksekti (p=0.00). Birinci sınıf öğrencilerinde diğer sınıflardaki öğrencilere göre (p=0.03), kızlarda erkeklere göre (p=0.02), yurtta kalan öğrencilerde ise yurtta kalmayanlara göre (p=0.001) depresyon puanları daha yüksek bulundu. Öğrencilerin yaşları, ailenin aylık gelir düzeyleri, ebeveynlerinin öğrenim durumları ile umutsuzluk ve depresyon oranları karşılaştırıldığında aralarında istatistiksel olarak anlamlı bir ilişki bulunmadı. Sonuç Sonuç olarak, temel tıp öğrencilerinde depresyon oranı yüksek olmakla birlikte, olası depresif öğrencilerde umutsuzluk puanları da yüksek bulunmuştur. Tıp öğrencilerine rehberlik ve danışmanlık hizmetlerinin verilmesi, mezuniyet sonrası depresyon ve umutsuzluğun mesleki yaşantılarına olabilecek etkilerini azaltmaya yönelik etkili önleme ve izleme programlarının geliştirilmesi uygun olacaktır.Aim Depression and hopelessness, cause impairment in the quality of life and leads to the loss of one's efficiency are important problems. The purpose of this study is to search the frequency of depression and hopelessness and its relations with socio-demographic characteristics among medical students. Materials and Methods This is a cross sectional analytical study. It was conducted 2-4 March 2009 between. 1st, 2nd, and 3rd year students from the Faculty of Medicine, Suleyman Demirel University were included in the study. 236 of a total 330 students (68.5 %) participated in the study. A questionnaire which aims to determine the students’ socio-demographic characteristics, Beck depression inventory and Beck hopelessness scale were applied under observation to the participants. According to the Beck depression inventory, those who scored 17 and over were classified as possible depressive. Data were evaluated statistically. Results The average score of the students according to Beck hopelessness scale was found 5.3±4.6. According to Beck depression inventory 64 of the students (28.3%) were found to be possible depressive. The average Beck hopelessness scale score was higher for possible depressive students compared to the others (p=0.00). Depression scores was higher among the first year students compared to the others (p=0.03), higher among the females compared the males (p=0.02) and higher among dwelling in dorm compared to not dwelling in dorm (p=0.001). When the age of students, monthly income of family, the educational status of the parents were compared with hopelessness and depression rates there was no statistically significant relation. Conclusion As a result, depression rates were high in basic medical students, furthermore hopelessness scores were found high among possible depressive students. Medical students should be given guidance and counseling service. Effective monitoring and prevention programs should be developed in order to lower the possible effects of depression and hopelessness on their future professional lives

Determination of The Relationship Between Hopelessness-Depression Frequency and Socio- Demographic Features in Students of School of Medicine, Suleyman Demirel University

Aim:Depression and hopelessness, cause impairment in the quality of life and leads to the loss of one's efficiency are important problems. The purpose of this study is to search the frequency of depression and hopelessness and its relations with socio-demographic characteristics among medical students.Materials and Methods:This is a cross sectional analytical study. It was conducted 2-4 March 2009 between. 1st, 2nd, and 3rd year students from the Faculty of Medicine, Suleyman Demirel University were included in the study. 236 of a total 330 students (68.5 %) participated in the study. A questionnaire which aims to determine the students’ socio-demographic characteristics, Beck depression inventory and Beck hopelessness scale were applied under observation to the participants. According to the Beck depression inventory, those who scored 17 and over were classified as possible depressive. Data were evaluated statistically.Results:The average score of the students according to Beck hopelessness scale was found 5.3±4.6. According to Beck depression inventory 64 of the students (28.3%) were found to be possible depressive. The average Beck hopelessness scale score was higher for possible depressive students compared to the others (p=0.00). Depression scores was higher among the first year students compared to the others (p=0.03), higher among the females compared the males (p=0.02) and higher among dwelling in dorm compared to not dwelling in dorm (p=0.001). When the age of students, monthly income of family, the educational status of the parents were compared with hopelessness and depression rates there was no statistically significant relation.Conclusion:As a result, depression rates were high in basic medical students, furthermore hopelessness scores were found high among possible depressive students. Medical students should be given guidance and counseling service. Effective monitoring and prevention programs should be developed in order to lower the possible effects of depression and hopelessness on their future professional lives

Giant aneurysm of non-coronary sinus of valsalva in a patient with marfan sendrom

Valsalva sinüslerinin anevrizmaları, aort anulusu ile sinotubüler bileşke arasındaki aort kök bölgesinin dilatasyonu olarak tanımlanır. Valsalva sinüsünün izole anevrizmaları nadir görülen kardiovasküler patolojilerdir. Sinüs valsalva anevrizması, konjenital veya edinsel kökenli olabilir. Konjenital, özellikle bağ dokusu bozukluklarına sekonder ve konjenital kardiyak defektlerle birlikte görülebilir. Edinsel anevrizmalar ise enfeksiyonlara ve travmaya sekonder olarak oluşabilir. Küçük boyutlu rüptüre olmamış anevrizmalar cerrahi müdahalesiz takip edilebilirken bunun dışındaki tüm hastalarda müdahale gerekir ve cerrahi altın standart tedavi yöntemidir. Bu yazıda, aort yetmezliği ile birlikte non-koroner valsalva sinüsünün dev anevrizması olan ve uygun tedavisi yapılan 12 yaşında Marfan sendromlu hasta anlatılacaktır.Aneurysms of the sinuses of Valsalva are defined as dilatation of the aortic root region be-tween the aortic annulus and the sinotubularjunction. Isolated aneurysms of the sinus of Valsalva are rare cardiovascular pathologies. Sinus valsalva aneurysm may be of congenital or acquired origin. It can occur congenital, secondary to connective tissue disorders or in associa-tion with congenital cardiac defects. Acquired aneurysms may occur secondary to infections and trauma. Small-sized unruptured aneurysms may be followed without surgical treatment; however, surgery may be required in all other patients and surgery is the gold standard treat-ment method. In this article, a 12 -year-old patient with Marfan syndrome who had aortic regurgita-tion and giant aneurysm of the non-coronary sinus of valsalva and was treated appropriately will be presented

New variation of scimitar syndrome with tracheal bronchus, upper lobe agenesis, and ventricular septal defect in a child

Scimitar syndrome (SS) is a rare and complex disease charac-terized by cardiovascular and bronchopulmonary malforma-tions. In typical SS, anomalous pulmonary drainage of part orall of the right lung into the inferior vena cava, anomaloussystemic arterial supply of the right lung from either the tho-racic or abdominal aorta, and hypoplasia of the right lungoccur.1Abnormal bronchial anatomy, abnormal diaphragm,hemivertebrae, and genitourinary tract anomalies can alsomanifest in SS.2,3Generally, the symptoms of this syndromeappear 7 months after birth.4According to the literature, therehave been numerous cases where additional features of thetypical syndrome have been reported with Scimitar variants

Co-occurrence of interrupted aortic arch and Apert syndrome: A case report

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Balanced double aortic arch causing persistent respiratory symptoms mimicking asthma in an infant

Double aortic arch (DAA) is a common form of complete vascular ring. The condition leads to airway obstruction and compression of the esophagus. A balanced type of DAA is an extremely rare anomaly. The anatomical aberration cannot be easily distinguished by transthoracic echocardiography when an infant has chronic respiratory distress. Herein we presented a case of an 11-month-old infant who had chronic respiratory distress and a balanced type of DAA

Evaluation of executive functions in children with rheumatic heart diseases

Background Acute rheumatic fever (ARF) is a multisystemic inflammatory disease in children and young adults. The most notable complications of ARF are rheumatic heart disease (RHD) and Sydenham's chorea (SC). There have been many reports about executive dysfunctions with children who have SC. "Executive function" is an umbrella term that is used to describe higher level cognitive functions. The aim of this study is to determine the executive functions of children with RHD. We evaluated executive functions in healthy children with the same sociodemographic characteristics as children with RHD. Methods Our study was designed as a cross-sectional randomized study, including children with RHD aged between 12 and 18, and healthy controls. The difference between the patient and control group participants in terms of age, gender, education level, education level of the parents, family income level, and executive functions were investigated. Executive functions composed of Digit Sequence Test, Verbal Fluency Test, Trail-Making Test, Stroop Test, Wisconsin Card Sorting Test. Results In our study, a total of 30 children with RHD were followed up at the pediatric cardiology outpatient clinic of Bezmialem Vakif University Hospital composed the patient group. The control group was made up of 30 healthy children of the same sex and age group as the patient group. The mean age of the case group was 14.73 +/- 1.84 years. The Digit Span Test, Verbal Fluency Test, Trail-Making Test, Wisconsin Card Sorting Test, and Stroop Test produced no statistically significant differences between the RHD patients and the controls. Conclusions No statistically significant difference was found between the RHD patients and control patients in any executive function test. It was suggested that executive dysfunction might not develop in RHD patients before developing SC

Development of myocardial infarction in a 12-year-old female after the use of inhaled salbutamol

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) accounts for 0.023% of all cases reported in pediatric patients. According to literature, only a handful of ALCAPA patients are able to reach adulthood. Clinical manifestations of ALCAPA range from fatigue during exercise to sudden death in adulthood. Herein, we described a 12-year-old symptomatic patient with ALCAPA who had severe chest pain after using salbutamol treatment for presumed asthma. ALCAPA is one of the curable versions of myocardial ischemia and infarction in childhood. Due to clinical findings in conjunction with electrocardiogram and echocardiography, a computed tomography scan with coronary angiography was performed and the diagnosis of ALCAPA was confirmed. We presented this case because ALCAPA-related myocardial ischemia and infarction in children are rare with only sporadic cases reported. This case illustrated the need for close monitoring and surgery as the best treatment for ALCAPA associated with myocardial infarction