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    Experience of the small size (25 mm) sorin bicarbon bileaflet prosthetic valve in patients with small mitral annuli
    (Blackwell Futura Publishing, Inc, 2003) Erdil, N; Cetin, L; Demirkilic, U; Tatar, H; Uzun, M
    Background. Currently, there is a tendency to use large-size prosthetic valves in mitral position in order to achieve better hemodynamic performance. We aimed to evaluate hemodynamic performance of 25 mm prosthetic valves in mitral position. Methods: Between August 1998 and May 2000, a total of 40 patients, 34 women and 6 men (mean age 42 12 years), underwent mitral valve replacement with 25 mm bileaflet mechanical valve. Preoperative functional capacity was New York Heart Association classes III and IV in 31 patients. Major indication for surgery was severe mitral stenosis in all patients. Results: Total hospital mortality was 5% (two patients). Mean follow-up period was 14.7 +/- 4.9 months (2 to 23 months). No thromboembolic event, paravalvular leak, mechanical failure, endocarditis were observed during the follow-up period. Postoperatively 92.5% of the patients were in the functional capacity of New York Heart Association class I. Postoperative echocardiographic observations have given an average pulmonary artery pressure of 29 +/- 2 mmHg, effective orifice area as 2.95 +/- 0.1 cm(2), and mean prosthetic gradient as 6.5 +/- 2.7 mmHg. Conclusion: In short- and mid-term, small-size (25 mm) Sorin mechanical mitral valves had excellent hemodynamic performance in patients with severe mitral stenosis, moderate or serious pulmonary hypertension, and small mitral annuli, whose body surface area was smaller than 1.6 m(2).
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    Frequency of left atrial myxoma with concomitant coronary artery disease
    (Springer, 2003) Erdil, N; Ates, S; Cetin, L; Demirkilic, U; Sener, E; Tatar, H
    Purpose. Simultaneous coronary artery bypass grafting with a resection of left atrial myxoma has been rarely reported. The ages and the symptoms of patients who have left atrial myxomas and coronary artery disease are similar. In this report, we present our cases of left atrial myxoma with concomitant coronary artery disease who were all treated surgically. Methods. Between September 1998 and January 2001, 11 patients were surgically treated after being diagnosed to have left atrial myxoma. Routine coronary angiography was performed on all patients preoperatively. In four patients concomitant coronary artery disease was identified. At surgery we performed coronary artery bypass grafting after a resection of left atrial myxoma in three patients. Results. All patients were weaned from cardiopulmonary bypass without any difficulty. The postoperative course was uneventful. The follow-up period was 17 +/- 10 months (range 3-32 months). All patients were symptom-free and no recurrence of myxoma was detected. Conclusion. Based on our experience, cardiovascular surgeons should be aware of the concomitance of these diseases. It is therefore recommended that coronary angiography should be performed on all patients who present with left atrial myxomas.
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    Midterm experience with the Sorin Bicarbon heart valve prosthesis for rheumatic disease
    (Edizioni Minerva Medica, 2003) Erdil, N; Cetin, L; Ates, S; Demirkilic, U; Sener, E; Tatar, H; Cakir, B
    Background In this study, we present a single center experience with Bicarbon bileaftet valve in 307 patients with rheumatic heart disease. Methods. Between August 1998 and September 2000, 307 patients underwent heart valve replacement using the Bicarbon bileaflet valve (Sorin Biomedica, Saluggia, Italy) with an average age of 47.19+/-13.21 years (range 14 to 80 years), consisting of 147 males and 160 females at Alkan Hospital, Cardiovascular Surgery Department. Aortic valve replacement (AVR) was performed in 77 patients, mitral valve replacement (MVR) in 156 patients and double valve replacement (DVR) in 74 patients. Results. The early mortality rate was 3.3% (10/307) and there was no late mortality. The actuarial survival rate, including hospital mortality, was 96.74+/-1.01% for the whole group, 96.5+/-1.5% for the MVR group, 97.4+/-1.8% for the AVR group and 97.3+/-1.9% for the DVR group at 35 months. One patient had obstructive valve thrombosis with MVR. The 35 months actuarial freedom from valve thrombosis was 99.58+/-0.4% for the whole group. Four patients were reoperated and the 35 months actuarial freedom from reoperation was 98.53+/-0.7% for the whole group, 98.65+/-0.9% for the MVR group, 96.73+/-02% for the DVR group and 100% for the AVR group. No instances of perivalvular leak, hemolysis, endocarditis or embolism were observed during the entire follow-up period. Mean follow-up duration was 16.5+/-7.9 months (ranged 4 to 35 months). Conclusions. We have presented our mid-term results with the Sorin Bicarbon bileaflet valve in patients with rheumatic heart disease, which provided good clinical performance combined with meticulous patient care and advanced surgical techniques.