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Öğe Closure of patent ductus arteriosus in children small infants and premature babies with Amplatzer duct occluder II additional sizes multicenter study(Catheter Cardiovasc Interv, 2013) Sungur, Metin; Karakurt, Cemşit; Özbarlas, Nazan; Başpınar, OsmanObjectives: To evaluate safety and efficacy of closure of patent ductus arteriosus (PDA) with Amplatzer duct occluder II Additional Sizes (ADO II AS) and to report early and midterm results of the device in children and very young symptomatic infants. Methods: Retrospective analysis of angiographic data of 60 children from four pediatric cardiology centers. Results: The median patient age and weight were 6.5 (0.5–168) months and 6.8 (1.19–57) kg, respectively. In the study, 26 children had a body weight of 6 kg. Of these 26 children, 9 had a body weight of 3 kg. The median narrowest diameter of PDA was 2 (1.2–4) mm. Ductal anatomy was Type A in 29, Type B in 2, Type C in 11, Type D in 1, and Type E in 16 patients, and a residual PDA after surgery in 1 patient. Closure with ADO II AS was achieved in 58 (96.6%) of 60 attempted cases. In two infants, the device was not released because of significant residual shunt. ADO II was used in one, and the other was sent to surgery. Complete closure was observed in all ADO II AS deployed children by the next day on echocardiography. Median follow-up was 12 (1–18) months. Neither death nor any major complications occurred. Conclusions: Our study shows that closure of medium and small sized PDA by using ADO II AS device is effective and safe in children. The use of the device will expand the field of application of PDA closure in small infants.Öğe Closure of Patent Ductus Arteriosus in Children, Small Infants, and Premature Babies with Amplatzer Duct Occluder II Additional Sizes: Multicenter Study(Wiley-Blackwell, 2013) Sungur, Metin; Karakurt, Cemsit; Ozbarlas, Nazan; Baspinar, OsmanObjectivesTo evaluate safety and efficacy of closure of patent ductus arteriosus (PDA) with Amplatzer duct occluder II Additional Sizes (ADO II AS) and to report early and midterm results of the device in children and very young symptomatic infants. MethodsRetrospective analysis of angiographic data of 60 children from four pediatric cardiology centers. ResultsThe median patient age and weight were 6.5 (0.5-168) months and 6.8 (1.19-57) kg, respectively. In the study, 26 children had a body weight of 6 kg. Of these 26 children, 9 had a body weight of 3 kg. The median narrowest diameter of PDA was 2 (1.2-4) mm. Ductal anatomy was Type A in 29, Type B in 2, Type C in 11, Type D in 1, and Type E in 16 patients, and a residual PDA after surgery in 1 patient. Closure with ADO II AS was achieved in 58 (96.6%) of 60 attempted cases. In two infants, the device was not released because of significant residual shunt. ADO II was used in one, and the other was sent to surgery. Complete closure was observed in all ADO II AS deployed children by the next day on echocardiography. Median follow-up was 12 (1-18) months. Neither death nor any major complications occurred. ConclusionsOur study shows that closure of medium and small sized PDA by using ADO II AS device is effective and safe in children. The use of the device will expand the field of application of PDA closure in small infants. (c) 2013 Wiley Periodicals, Inc.Öğe Congenital partial pericardial defect and herniated right atrial appendage a rare anomaly(Echocardiography, 2006) Karakurt, Cemşit; Deniz, Oğuz; Karademir, Selmin; Sungur, Metin; Öcal, Burhancongenital partial defect of the right-sided pericardium is a rare cardiac anomaly and it representsdefective formation of the pleuropericardial membrane. Patients can be asymptomatic, but they mayexperience chest pain, myocardial ischemia, emboli, arrhythmia, and sudden death. In this report,we present an 8-month-old boy with pericardial defect and right atrial appendage herniation. It wasdiagnosed by echocardiography and cardiac magnetic resonance imaging. (ECHOCARDIOGRAPHY,Volume 23, October 2006)Öğe Congenital partial pericardial defect and herniated right atrial appendage a rare anomaly(Echocardiography, 2006) Karakurt, Cemşit; Oğuz, Deniz; Karademir, Selmin; Sungur, Metin; Öcal, BurhanA congenital partial defect of the right-sided pericardium is a rare cardiac anomaly and it represents defective formation of the pleuropericardial membrane. Patients can be asymptomatic, but they may experience chest pain, myocardial ischemia, emboli, arrhythmia, and sudden death. In this report, we present an 8-month-old boy with pericardial defect and right atrial appendage herniation. It was diagnosed by echocardiography and cardiac magnetic resonance imaging.Öğe Plasma endothelin 1 and nitrate levels in Down s syndrome with complete atrioventricular septal defect associated pulmonary hypertension a comparison with non Down s syndrome children(European Journal of Pediatrics, 2009) Sungur, Metin; Öcal, Burhan; Oğuz, Deniz; Karademir, Selmin; Karakurt, Cemşit; Şenocak, FilizAbstract Children with Down’s syndrome (DS)-associated complete atrioventricular septal defect (AVSD) have rapid and aggressive development of pulmonary vascular disease when compared with non-Down’s syndrome (ND) children. We aimed to evaluate the role of plasma endothelin-1 (ET-1) and nitrate levels in DS children with complete AVSD-associated pulmonary hypertension (PH) and compare this to ND patients. The study included 20 patients (11 males, nine females) who had complete AVSD associated with PH. Comparisons were made between DS patients (n=12) aged 4 to 8 months (median 5 months) and ND patients (n=8) aged 4 to 12 months (median 7 months). Blood samples were drawn from the inferior vena cava, pulmonary artery, pulmonary vein, and aorta. The plasma ET-1 concentrations of the two groups were compared to the peripheral venous and arterial ET-1 levels, and pulmonary vein nitrate was compared to the peripheral arterial nitrate levels of ten healthy infants. The mean pulmonary artery (PA) pressure and pulmonary vascular resistance (Rp) were significantly higher in the DS group than ND patients, and the pulmonary blood flow (Qp) in ND patients was higher than DS patients. There were no differences between the two study groups in regard to plasma ET-1 and nitrate levels obtained from matched sampling sites. The plasma ET-1 and nitrate levels were significantly higher in both study groups compared to the control subjects. The plasma ET-1 and nitrate levels in DS patients with PH were not different when compared to those of ND patients.Öğe Plasma endothelin 1 and nitrate levels in Down s syndrome with complete atrioventricular septal defect associated pulmonary hypertension a comparison with non Down s syndrome children(Eur J Pediatr (2009) 168:593–597., 2009) Sungur, Metin; Öcal, Burhan; Oğuz, Deniz; Karademir, Selmin; Karakurt, Cemşit; Şenocak, FilizChildren with Down’s syndrome (DS)-associated complete atrioventricular septal defect (AVSD) have rapid and aggressive development of pulmonary vascular disease when compared with non-Down’s syndrome (ND) children. We aimed to evaluate the role of plasma endothelin-1 (ET-1) and nitrate levels in DS children with complete AVSD-associated pulmonary hypertension (PH) and compare this to ND patients. The study included 20 patients (11 males, nine females) who had complete AVSD associated with PH. Comparisons were made between DS patients (n=12) aged 4 to 8 months (median 5 months) and ND patients (n=8) aged 4 to 12 months (median 7 months). Blood samples were drawn from the inferior vena cava, pulmonary artery, pulmonary vein, and aorta. The plasma ET-1 concentrations of the two groups were compared to the peripheral venous and arterial ET-1 levels, and pulmonary vein nitrate was compared to the peripheral arterial nitrate levels of ten healthy infants. The mean pulmonary artery (PA) pressure and pulmonary vascular resistance (Rp) were significantly higher in the DS group than ND patients, and the pulmonary blood flow (Qp) in ND patients was higher than DS patients. There were no differences between the two study groups in regard to plasma ET-1 and nitrate levels obtained from matched sampling sites. The plasma ET-1 and nitrate levels were significantly higher in both study groups compared to the control subjects. The plasma ET-1 and nitrate levels in DS patients with PH were not different when compared to those of ND patients.Öğe Prognostic value of hart rate turbulence and heart rate variability in children with dilated cardiomyopathy(Acta Cardiologica, 2007) Karakurt, Cemşit; Aytemir, Kudret; Karademir, Selmin; Sungur, Metin; Oğuz, Deniz; Öcal, Burhan; Şenocak, FilizThe aim of our study is to evaluate the prognostic value of heart rate turbulence and heart rate variability in children with dilated cardiomyopathy (DCM). Twenty-five children with DCM and 24 age- and sex-matched healthy children who were admitted between January 2002 and September 2004, enrolled in this prospective study at our hospital. After the echocardiographic examination, three-channel 24-ambulatory ECG recordings were obtained in all patients with DCM and in the control group. Time domain heart rate variability parameters were obtained in both groups. Heart rate turbulence was measured in DCM patients, but we could not calculate heart rate turbulence in the control group since no ventricular ventricular premature complexes (PVC) were found in the 24-hour ECG monitoring in the control group. The mean follow-up period of the DCM group was 13.4months (3-26months). Five patients died (20%) during the follow-up period.Triangle index, turbulence slope (TS), age and availability of nonsustained ventricular tachycardia (VT) on 24-hour ECG monitoring were prognostic factors according to the correlation analyses. Only triangle index was detected as an independent risk factor among the prognostic factors according to the logistic regression analyses. This study assessed the prognostic value of heart rate turbulence and heart rate variability in children with dilated cardiomyopathy. Further studies are needed to investigate the prognostic value of heart rate turbulence.Öğe Respiratory syncytial virus and effect of palivizumab prophylaxis in patients with congenital heart disease(2020) Ayzit Kilinc, Ayse; Aygun, Canan; Sungur, Metin; Baysal, KemalAim: We evaluated the prevalence of Respiratory syncytial virus (RSV), the rates of hospitalization and intensive care unit (ICU) admission due to RSV infection, the need for mechanical ventilation, and the efficacy of palivizumab prophylaxis in children with congenital heart disease (CHD).Material and Methods: A total of 419 patients under 2 years old who were hospitalized with lower respiratory tract infection (LRTI) were included in this study. Patients were divided into two groups according to the presence of CHD. 241 patients had unstable CHD and 178 patients had no underlying conditions. Palivizumab prophylaxis was administered to 29 of the patients with CHD and RSV infection; 22 of these patients were followed for 1 year.Results: RSV infection was detected in 19.5% of the patients with CHD and in 20% of those without CHD. Among the 241 patients with CHD and LRTIs, the rate and duration of hospitalization for RSV were 14% and 9.9 days, respectively. The rate of admittance to the ICU was 32% and that of mechanical ventilation was 19% in the CHD patients with RSV infection. Of the patients without CHD, 12% were admitted to the ICU and 8% received mechanical ventilation. These rates were significantly higher among the RSV-infected patients with CHD. The rates of hospitalization for RSV before and after palivizumab prophylaxis were 59% and 14%, respectively; the difference was significant. Conclusion: RSV infection is a common cause of mortality and morbidity in patients with CHD; palivizumab prophylaxis is effective in these patients.
