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Biomedical subjects

E Onursal

Publications and source records attributed to E Onursal.

18 recordsLinked to original sources

Anomalous dual drainage of the right pulmonary veins in a patient with cor triatriatum: report of a case without scimitar sign.

The majority of patients with partial anomalous drainage of pulmonary veins are asymptomatic during infancy and childhood. Patients with significant left-to-right shunt develop symptoms and benefit from early corrective surgery. Anomalous pulmonary veins draining into inferior vena cava is very rare and frequently encountered in association with scimitar syndrome. The purpose of this case report is to describe a non-scimitar patient with cor triatriatum who had anomalous dual drainage of right pulmonary veins into inferior vena cava/left atrium and anomalous connection of persistent left superior vena cava with a common pulmonary venous chamber. The patient underwent an operation with redirection of anomalous pulmonary venous drainage into left atrium and ligation of persistent left superior vena cava.

Cor Triatriatum↗

Ischemic spinal cord injury after aortocoronary bypass operation. A case report.

Although spinal ischemia is a very well recognized complication after operation on the thoraco-abdominal and abdominal aorta, it is very rare following coronary artery bypass surgery. A case of a 56-year-old man, who had juxtarenal aortic occlusion and became paraplegic after internal mammary artery grafting for ischemic heart disease is reported. The complete paraplegia was thought to be due to interruption of critical collateral blood supply to the spinal cord.

Humans↗

Surgical treatment of cardiac echinococcosis: report of eight cases.

Cardiac involvement of hydatid disease is uncommon, and establishing a diagnosis is difficult because the presenting symptoms are variable. Between 1985 and 1997, eight patients ranging in age from 8 to 56 years underwent surgical excision of cardiac hydatid cysts, located in the interventricular septum in two, the right atrium in one, and the intrapericardium in five. There was one hospital death due to septic shock, but the other seven patients recovered uneventfully.

Adolescent↗

Infantile lobar emphysema and tracheal bronchus in a patient with congenital heart disease.

A 7-month-old girl was admitted with severe respiratory distress. Chest roentgenogram showed hyperinflation of the right middle lobe and mediastinal shift. Bronchogram showed tracheal lobe displaced superiorly by the hyperinflated right middle lobe. Echocardiography showed left-to-right shunt at the ventricular level. The patient responded well after surgical correction of cardiac defect. Four years after the operation, computed tomography examinations showed no evidence of emphysema.

Bronchi↗

An intrapericardial teratoma with endocrine function.

Intrapericardial teratoma was diagnosed in a nine-year-old male infant with a three-month history of labored breathing and cough. The tumor was completely resected and found to be a mature teratoma, containing pancreatic tissue and producing insulin. A few glucagon and somatostatin containing cells were also present in the periphery of the islets. Postoperative course was uneventful. This is to our knowledge, the first report of an intrapericardial teratoma with such endocrine activity.

Cough↗

Congenital subclavian aortic steal syndrome: hypoplastic aortic arch with severe coarctation of the aorta of unusual location.

An unusual case of subclavian-aortic steal syndrome in a pediatric patient with hypoplastic aortic arch with coarctation of the aorta of unusual location is described. Aortography showed hypoplasia of the arcus aorta and severe coarctation proximal to the left subclavian artery associated with an aneurysm formation on the isthmus and descending aorta. The enlargement of the arcus aorta was accomplished by prosthetic patch aortoplasty extending from the ascending to descending aorta via median sternotomy using cardiopulmonary bypass and moderate hypothermia. Postoperatively, the patient is doing well with equalized blood pressure.

Aorta, Thoracic↗

A complication of pectus excavatum operation: endomyocardial steel strut.

An 18-year-old patient who had correction of pectus excavatum deformity in our department 4 years earlier was admitted because of stabbing chest pain. He had not attended to postoperative controls and had not come for extraction of the steel strut, although he had been contacted. He was diagnosed to have a broken steel strut, and the strut was noted to be embedded in the myocardium. This unreported complication of pectus excavatum operation forced us to review sternal support techniques.

Adolescent↗

Giant congenital coronary artery fistula to left superior vena cava and right atrium with compression of left pulmonary vein simulating cor triatriatum--diagnostic value of magnetic resonance imaging.

A 3-year-old girl with a continuous murmur on auscultation was found to have left coronary artery to right atrial fistula simulating cor triatriatum sinister on echocardiography. Coronary angiography of the patient was also insufficient to clarify the exact pathologic anatomy. Magnetic resonance imaging showed that the main drainage of the aneurysmal coronary artery was to the left superior vena cava, resulting in a diffuse arteriovenous fistula in the lower lobe of the left lung by compressing its pulmonary vein.

Child, Preschool↗

Unusual complication of femoro-popliteal saphenous vein bypass--aneurysm formation.

An aneurysm as an unusual complication of saphenous vein bypass for femoro-popliteal occlusive disease is reported. The aneurysm developed 1 year following the bypass procedure. A diagnosis of Behçet's disease based on microscopic immunological examination and the clinical picture was suspected following successful aneurysmectomy.

Anastomosis, Surgical↗

Experimental evaluation of three biomaterials for replacement of the pulmonary artery branches.

24 adult dogs were randomly divided into 4 groups and submitted to angioplastic replacement of a 2- to 3-cm segment of the right or left pulmonary artery by three kinds of autogenous biomaterials; azygous vein, jugular vein and pericardium, and by a synthetic arterial prosthesis in a control group. In vivo evaluation was carried out by catheterization with a balloon catheter allowing successive intraluminal occlusion of the pulmonary branches, and by cineangiopneumography. There was a good correlation between evaluation techniques. Final evaluation after a follow-up of 5-20 months was based on postmortem measurement of the anastomosis diameter and histologic examination. In each group, the results were classified into four grades, numbered 0-3, and compared statistically. The results show that in this experimental model: (a) none of the autogenous tissues (selected for their potential ability to grow) proved better than the control Dacron arterial prosthesis, and (b) of the three biomaterials, the azygous vein was superior to the jugular vein and pericardium.

Animals↗

[Pulmonary stenosis with intact ventricular septum. Surgical experience in 200 cases, excluding the neonatal period].

Experience over 10 years, studying two groups of patients (group I: 79 cases aged between 2 months and 2 years, group II: 151 cases aged over 2 years) has shown that the operative prognosis of severe forms is now the same as in simple forms. Interest is now focused on the long term function of the right ventricle with regard to the surgical procedure. The main discussion in management is between isolated pulmonary commissurotomy, whatever the anatomical form, and operations such as we perform which associate ventricular resection with or without an infundibular patch in severe cases. The possible causes of late ventricular dysfunction are discussed, especially the muscular resection, the operative myocardial protection and the preoperative myocardial sclerosis. The good results observed in this series as opposed to the doubt as to the cause and variability of late ventricular dysfunction do not justify a change in our management at present.

Adolescent↗

Congenital coronary arteriovenous fistula in a ten-year-old boy with angina pectoris.

Congenital arteriovenous fistula (CAVF) is a rare cardiac lesion. Angina pectoris is uncommon in younger patients with CAVF. Fistula-related symptoms, complications of this anomaly and surgical complications have a strong correlation with the age of the patient. A ten-year-old male patient with angina pectoris in whom the diagnosis of CAVF was established, and who, following surgical ligation recovered, is presented.

Angina Pectoris↗

Cardiac extension of Wilms' tumor.

Two children who were brought to the Istanbul Children's Hospital with congestive heart failure caused by extension of Wilms' tumor to the right atrium are presented. In both cases a large mass was noted in the right atrium by two-dimensional echocardiography. The tumors were successfully removed at open heart surgery, and chemotherapy and radiotherapy were started postoperatively. The patients are both alive and symptom-free; one, three and a half years and the other two years postoperatively.

Child↗

Ruptured abdominal aortic aneurysm with fistula into the right iliac vein.

Arteriovenous fistula between major abdominal vessels is an unusual complication of ruptured abdominal aortic aneurysm. It most frequently occurs between the aorta and the inferior vena cava, however, it is rare when occurring between the aorta and iliac veins. A case of an arteriovenous fistula (AVF), secondary to erosion of an arteriosclerotic abdominal aortic aneurysm into both the retroperitoneum and the iliac vein is presented. The literature is reviewed and the symptoms and the treatment are discussed.

Aorta, Abdominal↗