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    Alterations in the dimensions of aortopulmonary septum in hypertensive subjects
    (Nature Publishing Group, 2003) Irmak, MK; Erinc, K; Yazar, F; Uzun, M; Fadillioglu, E; Ozer, M
    The neural crest origin of the aortopulmonary septum has led us to investigate the septum for a special function, and we designed the present study to assess the alteration, if any, in the dimensions of the aortopulmonary septum in hypertension. The dimensions of the aortopulmonary septum were measured by echocardiography in 36 hypertensive and 36 age- and sex-matched normotensive subjects. Echocardiographic examination included measurement of the cross-sectional area of the aortopulmonary septum with standard two-dimensional views from the parasternal windows. Standardization of this dimension with appropriate cardiac measurements such as aortic and internal left ventricular diameters was also performed to provide growth-independent estimates of septal size. The average area of the septum in the hypertensive group was 2.18+/-30.391 cm(2), significantly lower than that in the normotensive group (2.370+/-0.415 cm(2)). There were also significant differences in the area of the aortopulmonary septum between the groups when the values were standardized with internal left ventricular diameters. In conclusion, these data confirm that the aortopulmonary septum is smaller in hypertensive than in normotensive humans. This difference might be the result of a possible function of the aortopulmonary septum in blood pressure regulation.
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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).