Biomedical subjects

S Ozkutlu

Publications and source records attributed to S Ozkutlu.

79 records · Page 5Linked to original sources

PubMedDate not supplied

Total correction for tetralogy of Fallot after Brock-type operation.

We present a case of tetralogy of Fallot who had previously undergone a graded Brock-type operation. The post-operative development of pulmonary arteries and pulmonary trunk after the Brock operation were very suitable for total correction, which was then performed successfully. In contrast to shunt, in Brock-type operations enlargement of the outflow tract induces symmetrical growth of hypoplastic pulmonary arteries without the risk of acquired pulmonary obstruction or peripheral stenosis at the site of anastomosis. After palliative operations, the repair can be deferred until the pulmonary arteries are of a suitable size.

Adolescent↗

PubMedDate not supplied

Absent pulmonary valve syndrome with agenesis of the left pulmonary artery.

Absent pulmonary valve syndrome is represented by rudimentary nodules without identifiable leaflets, and it is commonly associated with a ventricular septal defect and tetralogy of Fallot. Unilateral absence of a pulmonary artery is also a rare congenital anomaly. The following is a case report of a one-day-old newborn with cyanosis. The physical examination revealed a to-and-fro murmur and no expansion of the left hemithorax. Echocardiography revealed tetralogy of Fallot, absent pulmonary valve, and enlarged main and right pulmonary arteries. The catheterization and angiography confirmed the diagnosis and absence of the left pulmonary artery.

Cyanosis↗

PubMedDate not supplied

Effects of secondary hyperparathyroidism on cardiac function in pediatric patients on hemodialysis.

Cardiovascular complications are an important cause of morbidity and mortality in chronic hemodialysis patients. In order to examine the effect of parathyroid hormone (PTH) and vitamin D on left ventricular functions, 11 patients between the ages of 13 and 18 years on regular hemodialysis were investigated using M-mode echocardiography and systolic time intervals. The ratio of the pre-ejection period to the left ventricular ejection time was found to be 0.38 +/- 0.02 (range (0.25 +/- )>50) and was elevated above normal in five of the 11 patients examined. Four of these patients has hypertension and one had severe anemia. The left ventricular ejection fraction was 55 +/- 2.54% and fractional fiber shortening was 31.55 +/- 2.26%, both of which were within normal limits for age. Although the velocity of circumferential fiber shortening was within normal limits in the majority of cases, the mean value was 1.437 +/- 0.11 circ/s, which is above normal for this age period. PTH levels were between one and 4.70 ng/ml. All of the hemodialysis patients had been receiving 1 alpha hydroxy-cholecalciferol and had normal calcium levels. Although they had high PTH levels, most of these patients displayed normal myocardial contractility. No significant correlation was obtained between increment in PTH levels and myocardial function indices. These results imply that PTH is not the only factor affecting myocardial functions. Since all of these patients have received vitamin D therapy for long periods, we suggest that vitamin D may have prevented the deleterious effect of PTH on myocardial function.

Adolescent↗

PubMedDate not supplied

"Acquired" subvalvular aortic stenosis after repair of several congenital cardiac defects.

Discrete subvalvular aortic stenosis is a progressive lesion. In this report we presented nine patients who had no significant left ventricular-aortic obstruction at initial cardiac catheterization or echocardiographic examination, but later developed significant subvalvular aortic stenosis. Associated lesions included ventricular septal defect in three, patent ductus arteriosus in two, aorticopulmonary window in one, tetralogy of Fallot in one, supramitral membrane in one, and ventricular septal defect and patent ductus arteriosus in one case. Nine patients were diagnosed with subvalvular aortic stenosis 18 months to eight years after surgical correction. Eight of the patients required surgery for subvalvular obstruction. In conclusion, discrete subaortic stenosis is a rare, late complication of the surgical repair of several congenital heart defects. It is a progressive lesion after surgery; therefore these patients require careful follow-up.

Aortic Stenosis, Subvalvular↗

PubMedDate not supplied

Blade atrial septostomy: experience with 18 patients.

Blade atrial septostomy was performed in 18 patients, including 14 with transposition of the great arteries, three with tricuspid atresia and one with severe mitral stenosis and ventricular septal defect. The patients' ages ranged from 25 to 210 days (mean: 108 +/- 64 days), and weights ranged from 3.0 to 6.0 kg. Following blade septostomy, partial arterial pressure of oxygen (PaO2) increased from an average of 22 +/- 3.3 mmHg to 38.9 +/- 7.6 mmHg (p < 0.001), and prompt clinical improvement was observed in the majority of patients. Significantly decreased atrial pressures (from 8.16 +/- 6.1 to 3.93 +/- 2.2 mmHg, p < 0.01) and significantly enlarged inter-atrial openings (from 1.6 +/- 0.9 to 7.5 +/- 1.8 mm, p < 0.001) were achieved with successful blade atrial septostomy. Blade atrial septostomy is an effective and life-saving procedure in patients who require nonrestrictive inter-atrial communication.

Echocardiography↗

PubMedDate not supplied

Leprechaunism in two Turkish patients.

We report two cases of Leprechaunism with the classical features. The first case had hyperglycemia and severe hyperinsulinemia. The postmortem examination of the second child revealed enlargement of both ovaries, islet cell hyperplasia in the pancreas, and cholestasis and paucity of bile ducts in the liver. Cystic changes were noted in the ovaries, and the kidneys contained a few small cortical cysts. Both patients died at early ages.

Abnormalities, Multiple↗

PubMedDate not supplied

Echocardiographic assessment of left and right ventricular diastolic functions in children with dilated cardiomyopathy.

We evaluated left and right ventricular diastolic functions by pulsed Doppler echocardiography in 16 children with dilated cardiomyopathy and in 20 healthy age-matched control subjects. The cardiomyopathy group demonstrated an abnormal relaxation pattern of the left ventricle. In the cardiomyopathy group compared to normal subjects, peak early filling velocities (43.3 +/- 11 cm/s versus 60.4 +/- 11 cms/s, p < 0.01), the corresponding velocity-time integrals (3.3 +/- 1.4 cm versus 4.6 +/- 1.2 cm, p < 0.01) and the ratio of peak early filling velocity to late filling velocity (1.22 +/- 0.47 versus 1.49 +/- 0.23, p < 0.05) were significantly lower whereas isovolumic relaxation time was significantly longer (58.9 +/- 19.8 ms versus 49.7 +/- 8.9 ms, p < 0.05). In addition, right ventricular diastolic filling was also impaired in children with dilated cardiomyopathy. Peak early filling velocities (41 +/- 7.9 cm/s versus 47.5 +/- 8.8 cm/s, p < 0.05) and the corresponding velocity time integrals (3.0 +/- 1.0 cm versus 3.87 +/- 1.1 cm, p < 0.05) were significantly decreased, while isovolumic relaxation time was significantly increased (60.6 +/- 16.3 ms versus 52.2 +/- 12.8 ms, p < 0.05) in the cardiomyopathy group. The study suggests that abnormalities of both right and left ventricular diastolic function may occur, and should be searched for, in pediatric patients with dilated cardiomyopathy.

Adolescent↗