Browsing by Author "Bostan, Özlem Mehtap"

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A rare and fatal cause of hypertrophic cardiomyopathy: Danon disease
(Cambridge Univ Press, 2023-01-05) Türkmen, Hasan; TÜRKMEN, HASAN; Uysal, Fahrettin; UYSAL, FAHRETTİN; Bostan, Özlem Mehtap; BOSTAN, ÖZLEM MEHTAP; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; 0000-0001-7707-2174
Danon disease is a rare and fatal disease caused by a mutation in the lysosome-associated membrane protein 2 gene. Impaired intracellular autophagy causes lysosomal vacuoles to accumulate mainly in myocardial and skeletal muscle cells, leading to hypertrophic cardiomyopathy, skeletal myopathy, and varying degrees of intellectual disability. Two distinct childhood presentations of Danon disease are described in this report.
A rare anomaly: Recurrent congenital aorto-azygos fistula after two procedure of transcatheter occlusion
(Springer, 2015-10-01) Uysal, Fahrettin; Bostan, Özlem Mehtap; Çil, Ergün; UYSAL, FAHRETTİN; BOSTAN, ÖZLEM MEHTAP; ÇİL, ERGÜN; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Kardiyoloji Anabilim Dalı; 0000-0001-7707-2174; 0000-0003-3516-0082; AAH-3865-2021; AAH-4421-2021; AAG-9324-2021; AAG-8558-2021
Akut romatizmal ateş olgularının klinik özellikleri ve romatizmal kalp hastalığının uzun süreli izlem sonuçlarının değerlendirilmesi
(Uludağ Üniversitesi, 2011) Öztürk, Rıfat Can; Bostan, Özlem Mehtap; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.
Çalışmanın amacı, ülkemizde hala önemli bir sağlık problemi olmaya devam eden akut romatizmal ateş'in (ARA) Bursa ili ve çevresinde, epidemiyolojik, klinik ve laboratuvar özelliklerini incelemek, yıllara göre görülme sıklığını saptamak ve karditli olgularda meydana gelen kapak hastalıklarının uzun süreli izlemde prognozunu değerlendirmektir.Bu çalışmada, Uludağ Üniversitesi Tıp Fakültesi Çocuk Kardiyoloji Bilim Dalı'nda, Ocak 2000 ile Şubat 2011 tarihleri arasında, ARA tanısı alan 151 olgunun bilgileri retrospektif olarak incelendi. Başvuru tarihi, geliş şikayetleri, majör, minör ve destekleyici bulgular, laboratuar bulguları, ekokardiyografik bulgular ve izlemde kapak tutulumundaki değişiklikler değerlendirildi. Kardit saptanan olguların ilk ekokardiyografik incelemeleri ve sırasıyla inflamasyon düzeldikten sonra ve izlemdeki son ekokardiyografik incelemeleri kapak yetersizlikleri açısından incelendi.Olguların ilk başvuru yaşları 9,6 ± 2,42 (4-15) yaş olarak saptandı. Kız erkek oranı 1,2/1 olarak bulundu. Olguların 69'u (%45,7) 9 yaş ve altında, 82'si (%54,3) 10 yaş veya üzerinde idi. En sık başvuru şikayetlerinin ateş yüksekliği (%62,9) ve eklem yakınmaları (%36,6) olduğu tespit edildi. ARA'nın majör Jones kriterlerine göre dağılımı incelendiğinde, %76,8'inde kardit en sık görülen bulguydu. Birlikte görülme oranı en fazla (%30,4) artrit ve karditte tespit edildi. Majör kriterlerin cinsiyete ve yaş gruplarına göre dağılımında fark yoktu.İlk ekokardiyografik incelemede, en sık kapak tutulumu birlikte mitral ve aort yetersizliği (MY, AY) olarak saptandı (%59,8). Tek başına değerlendirildiğinde mitral kapağın (%36,2) en sık tutulan kapak olduğu görüldü. İnflamasyon düzeldikten sonra yapılan kontrol ekokardiyografik incelemede başlangıçta saptanan MY'lerin %15'inde, AY'lerin ise %20,4'ünde tamamen düzelme görüldü. Takip süresince yapılan son ekokardiyografik değerlendirmede, toplam düzelme oranı MY için %37,5 ve AY için %50 olarak saptanırken, olguların %39,5'inde kapak lezyonunda değişme olmadığı saptandı. Subklinik kardit (sessiz kardit) olguların %17,2'inde mevcuttu. Altı (%5,4) olguda cerrahi girişim yapıldığı tespit edildi.Sonuç olarak, Bursa ili ve çevresinden başvuran hastalarda yapılan ve 10 yıllık bir süreyi kapsayan bu çalışmada, son yıllarda olgu sayısında bir miktar azalma olsa da, ARA'nın bölgemiz için bir sağlık sorunu olmaya devam ettiği görüldü.
Arterial tortuosity syndrome: 40 new families and literature review
(Nature Publishing Group, 2018-01-11) Bostan, Özlem Mehtap; Temel, Şehime Gülsün; Uysal, Fahrettin; Uludağ Üniversitesi/Tıp Fakültesi/Pediatrik Kardiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Histoloji ve Embriyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Genetik Anabilim Dalı.; 0000-0001-7707-2174; 0000-0002-9802-0880; AAG-8558-2021; AAG-8385-2021; AAH-4421-2021; 8676936500; 6507885442; 24469008200
Purpose: We delineate the clinical spectrum and describe the histology in arterial tortuosity syndrome (ATS), a rare connective tissue disorder characterized by tortuosity of the large and medium-sized arteries, caused by mutations in SLC2A10. Methods: We retrospectively characterized 40 novel ATS families (50 patients) and reviewed the 52 previously reported patients. We performed histology and electron microscopy (EM) on skin and vascular biopsies and evaluated TGF-beta signaling with immunohistochemistry for pSMAD2 and CTGF. Results: Stenoses, tortuosity, and aneurysm formation are widespread occurrences. Severe but rare vascular complications include early and aggressive aortic root aneurysms, neonatal intracranial bleeding, ischemic stroke, and gastric perforation. Thus far, no reports unequivocally document vascular dissections or ruptures. Of note, diaphragmatic hernia and infant respiratory distress syndrome (IRDS) are frequently observed. Skin and vascular biopsies show fragmented elastic fibers (EF) and increased collagen deposition. EM of skin EF shows a fragmented elastin core and a peripheral mantle of microfibrils of random directionality. Skin and end-stage diseased vascular tissue do not indicate increased TGF-beta signaling. Conclusion: Our findings warrant attention for IRDS and diaphragmatic hernia, close monitoring of the aortic root early in life, and extensive vascular imaging afterwards. EM on skin biopsies shows disease-specific abnormalities.
Atypical presentation of moyamoya disease with pulmonary hypertension: A case report
(Kare Pupl, 2018-05) Kızılkaya, Mete Han; Uysal, Fahrettin; Gürbüz, Emre; Taşkapılıoğlu, Mevlüt Özgür; Bostan, Özlem Mehtap; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Kardiyoloji Anabilim Dalı.; 0000-0001-6332-5302; 0000-0001-5472-9065; 0000-0001-7707-2174; ABB-8161-2020; HPC-7315-2023; AAG-8558-2021; AAH-4421-2021; AAW-5254-2020; 57201153209; 24469008200; 57202016783; 25936798300; 8676936500
Bilateral multiple pulmonary arteriovenous fistulas and duplicated renal collecting system in a child with Noonan's syndrome
(Cambridge Univ Press, 2006-10-20) Semizel, Evren; Bostan, Özlem Mehtap; Saǧlam, Halil; Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; 0000-0003-0710-5422; AAG-8558-2021; C-7392-2019; 12646191300; 8676936500; 35612700100
Noonan's syndrome involves the association of multiple congenital abnormalities, with a variety of cardiac defects. We describe here the association of Noonan's syndrome with multiple pulmonary arteriovenous fistulas and bilateral duplicated renal collecting systems. To the best of our knowledge, this is the first reported case of an association of the Noonan phenotype with pulmonary arteriovenous fistulas.
Bursa Büyükşehir Belediyesi sınırları içinde 0-48 aylık çocuklarda malnutrisyon prevalansı ve bunu etkileyen faktörler
(Uludağ Üniversitesi, 1994) Bostan, Özlem Mehtap; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.
Bu araştırma, Bursa Büyükşehir Belediyesi sınırları içinde 0-48 aylık çocuklarda malnutrisyon prevalansını ve etkileyen faktörleri saptamak amacıyla yapılmıştır. Araştırmaya katılan çocuklarda %15.4 oranında mal nutrisyon saptanmıştır. Bunların %12 si hafif derecede, %2.7 si orta derecede, %0.7 si ağır derecede malnutrisyonlu olarak bulunmuştur. Kız çocuklarda erkek çocuklara oranla daha fazla malnutrisyon saptanmıştır. Doğum sırası ve ailede yaşayan kişi sayısı arttıkça malnutrisyon görülme oranının arttığı, anne sütü alımı, hastalanma oranı ve ailenin ekonomik düzeyiyle malnutrisyon görülme sıklığının yakın şekilde etkilendiği tespit edilmiştir.
Bursa ilinde 6-18 yaş arası yarışmalı spor yapan lisanslı sporcularda elektrokardiyografik bulguların değerlendirilmesi
(Bursa Uludağ Üniversitesi, 2022) Öz, İrfan; Bostan, Özlem Mehtap; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.
AMAÇ: Spora katılım öncesi değerlendirme (SKÖD) spor ilişkili morbidite ve mortalitenin önlenmesinde en önemli araçlardan biridir. Bu çalışmada; SKÖD’de anamnez ve fizik muayene ile birlikte EKG’nin, semptomu olmayan kalp ve ritim hastalıklarının saptanmasında etkisinin ve öneminin değerlendirilmesi amaçlanmıştır. GEREÇ VE YÖNTEM: Çalışmaya alınacak sporcu sayısının belirlenmesi amacıyla Bursa Gençlik ve Spor İl Müdürlüğü’ne başvurularak aktif lisanslı sporcu sayısının 14,266 olduğu saptandı. Güç analizi yapılarak çalışmaya en az 261 sporcunun dahil edilmesi planlandı. COVİD-19 pandemisi nedeniyle aktif sporcu sayısının azalması sonucu 245 sporcu çalışmaya dahil edilebildi. Sporculardan SKÖD açısından anamnez alındı, fizik muayene yapıldı ve EKG’leri çekildi. EKG verileri 2017’de uluslararası konsensüs tarafından belirlenen kriterler baz alınarak değerlendirildi. BULGULAR: Sporcuların %87,8’ine (n=215) SKÖD yapıldığı, %12,2’sinin (n=30) ise SKÖD ve EKG çekimi yapılmadan lisans aldığı saptandı. SKÖD yapılan hastaların %39,5’ine (n=85) EKG çekimi yapılırken %60,5’ine (n=130) EKG çekimi yapılmadığı öğrenildi. Sonuç olarak çalışmaya alınan tüm sporcuların %34,7’sine (n=85) SKÖD ve EKG ile değerlendirme yapıldığı tespit edildi. Sporcu EKG’lerinin %97,1’i (n=238) normal, %1,2’si (n=3) borderline ve iii %1,6’sı (n=4) patolojik olarak değerlendirildi. SKÖD yapılan ve EKG çekilen sporcuların, SKÖD yapılan fakat EKG çekilmeyen ve SKÖD yapılmayan sporcularla yapılan karşılaştırmalı analizinde anlamlı bir farklılık saptanmadı. SONUÇ: Rutin kullanımı tartışmalı olmasına rağmen, SKÖD’de EKG çekilmesi semptomatik olmayan kalp ve ritim hastalıklarının saptanmasında önemli, kolay uygulanabilir ve etkili bir tetkiktir. Bu çalışma sonucunda SKÖD’de EKG’nin rutin tarama programına dahil edilmesi önerilmektedir.
Cardiac involvement in costello syndrome: Evaluation of six cases
(Galenos Yayıncılık, 2013-08-01) Uysal, Fahrettin; Bostan, Özlem Mehtap; Semizel, Evren; Akaltun, Filiz; Üner, Gülcan; Çil, Ergün; UYSAL, FAHRETTİN; BOSTAN, ÖZLEM MEHTAP; Akaltun, Filiz; Üner, Gülcan; ÇİL, ERGÜN; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Kardiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı Anabilim Dalı.; 0000-0001-7707-2174; 0000-0003-3516-0082; CCJ-6951-2022; AAG-8558-2021; AAH-4421-2021; AAG-9324-2021; GHF-4123-2022
Introduction: Costello syndrome is probably an autosomal dominant inherited disorder that is characterized by postnatal growth retardation, developmental delay, coarse facies, loose skin, nonprogressive cardiomyopathy and friendly behavior. The aim of this study was to evaluate a variety of clinical findings and cardiac involvement of six patients diagnosed as Costello syndrome.Materials and Methods: Six cases that had a typical features of Costello syndrome admitted to pediatric cardiology department due to cardiac murmur between 2002-2013 years were evaluated. Their complaints, clinical findings, treatments and clinical courses were examined.Results: Three of the patients were male and the mean age of patients was 34 +/- 12 months (7 months to 11 years). All of the cases had coarse faces, deep palmar and plantar creases, hypertelorism, epicanthal folds, depressed nasal bridges and cardiac murmur at auscultation. Congenital heart disease was found in all patients. Five patients had pulmonary stenosis and balloon pulmonary valvuloplasty was performed in 3 of these patients. Atrial septal defect was detected in 3 patients and 1 of the patient had hypertrophic cardiomyopathy. Mental retardation was found in 2 patients.Conclusions: Costello syndrome must be keep in mind in all patients with psychomotor retardation, coarse faces, sparse hairs, deep palmar and plantar creases, phenotypical features resembling a storage disease especially in association with pulmonary stenosis and hypertrophic cardiomyopathy.
Carvedilol therapy in pediatric patients with dilated cardiomyopathy
(Türk Pediatri Dergisi, 2009) Askari, Hülya; Semizel, Evren; Bostan, Özlem Mehtap; Çil, Ergün; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; AAG-9324-2021; AAH-3865-2021; 26537185400; 12646191300; 8676936500; 35587943300
Carvedilol reduces mortality and hospitalization in adults with congestive heart failure. Limited information is available about its use in children. The objective of this study was to determine the dosing, efficacy and side effects of carvedilol for the management of dilated cardiomyopathy in children. Sixteen children with idiopathic dilated cardiomyopathy, aged 7 months to 138 months and with an ejection fraction less than 40%, were treated with carvedilol. The average initial dose was 0.1 mg/kg/day and it was uptitrated to 0.4 mg/kg/day. After six months on carvedilol, there were improvements in clinical scoring system from an average of 2.94 to 2.50 (p<0.05), in mean fractional shortening from 17.2 +/- 6.1% to 22.7 +/- 5.1% (p<0.05), and in ejection fraction from 35.2 6.8% to 43.1 +/- 11.2% (p<0.05). No side effect was observed during the study period. Two patients died due to serious infection. Carvedilol in addition to standard therapy for dilated cardiomyopathy in children improves cardiac function and symptoms. It is well tolerated, with minimal adverse effects, but close monitoring is necessary.
Coarctation of persistent 5th aortic arch: First report of catheter based intervention
(Texas Heart Inst, 2014-08) Uysal, Fahrettin; Bostan, Özlem Mehtap; Çil, Ergün; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Kardiyolojisi Anabilim Dalı.; 0000-0003-3516-0082; AAG-9324-2021; AAH-4421-2021; AAG-8558-2021; 24469008200; 8676936500; 35587943300
Persistent 5th aortic arch, originally called double-lumen aortic arch, is a rarely reported cardiac developmental anomaly that results in systemic-to-systemic or systemic-to-pulmonary shunting. When this malformation occurs, other intracardiac defects are almost always present. We report the case of a 7-month-old girl who presented with a heart murmur; she was found to have an interrupted 4th aortic arch and coarctation of a persistent 5th aortic arch, with no other defects. To our knowledge, this is the 3rd report of a pediatric patient with this condition in isolation, and the first report of its diagnosis and treatment by means of cardiac catheterization and balloon angioplasty.
Çocukluk çağındaki göğüs ağrılarının etyolojik nedenlere göre değerlendirilmesi
(Uludağ Üniversitesi, 2014) Doğan, Fatma Oflu; Bostan, Özlem Mehtap; Uludağ Üniversitesi/Tıp Fakültesi/Aile Hekimliği Anabilim Dalı.
Göğüs ağrısı çocukluk ve genç erişkin döneminde oldukça sık görülen bir yakınmadır. Erişkinlerdeki göğüs ağrısının kardiyovasküler hastalıklarla ve ani ölümle ilişkisi bilindiğinden çocuklardaki ağrıya aileler ve sağlık personeli en üst düzeyde önem vermektedir. Uludağ Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları genel çocuk polikliniğine 01.06.2012-31.12.2012 tarihleri arasında 6-17 yaş arası göğüs ağrısı ile başvuran olgular retrospektif olarak incelemeye alındı. Bilinen bir kalp hastalığı olup, birlikte göğüs ağrısı olan hastalar çalışmaya dahil edilmedi. Göğüs ağrısı yakınması ile başvuran olguların %24,6’sında organik veya psikojenik neden tespit edilmeyerek idiopatik kaynaklı kabul edilmiştir. Göğüs ağrısına neden olan organik etkenler araştırıldığında ilk sırayı %24,6 oranı ile gastrointestinal kökenli göğüs ağrısının aldığı bunu %22,8 ile kasiskelet kökenli ve %1,8 ile kardiyak ve solunum sistemi kökenli ağrıların izlediği görülmüştür. Psikojenik kökenli ağrılar ise %24,6 oranda tespit edilmiştir. Ağrının devam süresi, lokalizasyonu, sıklık derecesi ve göğüs ağrısı ortaya çıkışı ile başvuru arasında geçen süre ile ilişkisi bakımından istatistiksel olarak anlamlı bir fark saptanmamıştır. Ailede kalp hastalığı olan bir kişinin bulunması durumunda göğüs ağrısı ile başvuran olgunun semptomları kendine adapte ettiği düşünülmektedir. Laboratuvar araştırmaları, anamnez ve klinik muayene ile konulan tanıları doğrulamak ve lezyonların ağırlığını saptamak açısından yararlı bulunmuştur. Olgularımıza genel olarak baktığımızda 6 aydan uzun süren tekrarlayıcı göğüs ağrısı bulunan olgularda ağrının psikojenik veya idiopatik olduğu düşünülmüştür. Özellikle bu gruptaki hasta ve ailelerinin önemli bir kalp hastalığı bulunmadığı konusunda ikna edilmeleri ile pek çok olguda göğüs ağrısının geçtiği gözlenmiştir.
Complete atrioventricular block as a complication of varicella infection in a child: Recovery with a single dose of intravenous immunoglobulin therapy
(Sage Publications, 2016-06-01) Uysal, Fahrettin; Bostan, Özlem Mehtap; Çetin, Benhur; Uysal, Berfin; Güney, Begüm; Çil, Ergün; UYSAL, FAHRETTİN; BOSTAN, ÖZLEM MEHTAP; Çetin, Benhur; Güney, Begüm; ÇİL, ERGÜN; Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0001-7707-2174; 0000-0002-8470-4907; 0000-0003-3516-0082; AAH-3865-2021; AAG-8558-2021; AAG-9324-2021; AAH-4421-2021; H-2691-2017
Congenital anomalies of coronary arteries in children: The evaluation of 22 patients
(Springer, 2013-11-28) Uysal, Fahrettin; Bostan, Özlem Mehtap; Semizel, Evren; Şenkaya, Işık; Aşut, Emre; Çil, Ergün; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Kardiyolojisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0003-3516-0082; 0000-0001-7707-2174; AAG-9324-2021; AAG-8558-2021; AAH-4421-2021; 24469008200; 8676936500; 12646191300; 56495079800; 56205836200; 35587943300
Although congenital coronary artery anomalies are seen in 0.6-1 % of adult patients undergoing coronary angiography, the data for the pediatric population are few. This study of 22 children with coronary artery anomalies evaluated them in terms of demographic and clinical features and analyzed their angiographic findings and surgical results. Databases in the Department of Pediatric Cardiology at the University of Uludag were searched for all the patients with a diagnosis of congenital coronary artery anomaly who underwent coronary angiography between 1993 and 2013. Patients with coexistent congenital heart disease were excluded from the study. The study noted 22 patients (0.9 %; 10 boys and 11 girls) with coronary artery anomalies. The mean age of these patients was 58.77 +/- A 52.04 months (range, 1 month-16 years). Coronary arteriovenous fistula (50 %) and anomalous left coronary artery from the pulmonary artery (ALCAPA) (36 %) were the most common anomalies. In addition, the study included one patient with diffuse coronary artery hypoplasia, one patient with muscular bridge, and one patient with left main coronary artery originating from the right aortic sinus valsalva. Of the 11 patients who had coronary atrioventricular fistula, 7 were asymptomatic, whereas 75 % of the patients with ALCAPA syndrome were admitted because of heart failure. Although 13 patients had an exact diagnosis by echocardiography, 50 % of the patients with ALCAPA syndrome had their diagnosis determined by catheter angiography performed because of severe mitral regurgitation or dilated cardiomyopathy. The mortality rate for all the patients was found to be 18.1 %. Eight patients with coronary arteriovenous fistula have been followed up without surgery to the present. In contrast, seven patients with ALCAPA syndrome have undergone surgery, and three have died. Two of these patients died during the postoperative period, and the remaining patient died suddenly during the preoperative period at home. Isolated congenital coronary artery anomalies are very rare in the pediatric population. Although most congenital coronary artery anomalies are clinically silent, they may be associated with severe symptoms in children. Recognition of potentially serious anomalies such as ALCAPA syndrome is mandatory so that early surgical treatment can be prescribed.
Congenital arteriovenous fistula between descending aorta and the left innominate vein
(Springer, 2019-07-01) Kandemirli, Sedat Giray; Kızılkaya, Mete Han; Erdemli, Başak Gürsel; Akça, Tuğberk; Bostan, Özlem Mehtap; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Kardiyoloji Anabilim Dalı.; 0000-0002-2747-974X; 0000-0001-6332-5302; 0000-0001-7707-2174; AEX-4557-2022; HPC-7315-2023; AAH-6568-2021; AAG-8558-2021; A-1409-2017; 22834938400; 57201153209; 57209833506; 8676936500; 57209823599
Thoracic aortocaval fistulae are rare entities where a direct shunt between thoracic arteries and systemic veins is seen. They can be traumatic or congenital in origin. Congenital thoracic aortocaval fistulae usually involve descending aorta and azygos, hemiazygos systems. Presenting symptoms range from continuous murmur to signs of congestive heart failure. In this case report, imaging findings of a 3-year-old girl referred for continuous murmur over the left sternal border are presented. Computed tomography angiography revealed multiple tortuous vessels along the descending aorta with a course toward the left brachiocephalic vein, and was suspicious for an aorta-venous fistula. Subsequent digital subtraction angiography for treatment planning showed a fistula originating at the level of the left 6th intercostal artery, with direct drainage into the left brachiocephalic vein without involvement of the azygos/hemiazygos system.
Determination of reference values for tricuspid annular plane systolic excursion in healthy Turkish children
(Aves, 2015-03-25) Uysal, Fahrettin; Bostan, Özlem Mehtap; Çil, Ergün; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Kardiyolojisi Anabilim Dalı.; 0000-0003-3516-0082; 0000-0001-7707-2174; AAH-4421-2021; AAH-3865-2021; AAG-9324-2021; AAG-8558-2021; 24469008200; 8676936500; 35587943300
Objective: Tricuspid annular plane systolic excursion (TAPSE) is an echocardiographic measurement used for evaluating right ventricular systolic function. While established reference values of TAPSE exist for the adult population, only a limited number of studies have attempted to evaluate reference values for the pediatric population. The aim of the present study was to determine the reference values for TAPSE in healthy children in Turkey. Methods: A total of 765 healthy children aged between 0 and 18 years, all of whom were referred to our clinic with cardiac murmurs, were evaluated prospectively. Patients with no cardiac pathologies or other disorders were excluded from the study. The measurement of TAPSE was obtained using a 2D-guided M-mode technique with echocardiography, and the relationship between age and surface area with TAPSE was investigated. The statistical analysis was carried out using the SPSS 20.0 software package (SPSS Inc., Chicago, IL, USA, 2012). Results: The mean TAPSE value was found to be 19.56 +/- 5.54 mm, and no significant difference was identified between male and female children. TAPSE values showed a positive correlation with increasing age and surface area. The mean TAPSE value was 9.09 +/- 1.36 mm in newborns and 25.91 +/- 3.60 mm in the 13-18 years age group. A negative correlation was seen between TAPSE and heart rate. Conclusion: In the present study, the reference values for TAPSE in healthy Turkish children were presented in percentile tables and the corresponding z-scores were determined. These reference values may be useful in daily practice for the evaluation of right ventricular systolic function in children.
Dilated cardiomyopathy in childhood: Prognostic features and outcome
(Taylor & Francis, 2006-04) Bostan, Özlem Mehtap; Çil, Ergün; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Kardiyolojisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri ve Pediatrik Kardiyoloji.; AAG-9324-2021; AAH-3865-2021; AAG-8558-2021; 8676936500; 35587943300
The natural history of dilated cardiomyopathy in children is difficult to predict due to the heterogeneous character of the disease. The outcome in infants and children is highly variable from complete recovery to death. In this study, 40 children diagnosed with dilated cardiomyopathy between 1995 and 2004 in our paediatric cardiology unit were reviewed with respect to clinical course and outcome, retrospectively. The medical history of these patients with dilated cardiomyopathy was reviewed to determine age, gender, family history, preceding viral illness, duration of symptoms before the diagnosis, symptoms and signs at presentation, treatment and outcome. The diagnosis was made on the basis of cardiomegaly and evidence of poor left ventricular function by echocardiography. Median age at diagnosis was 14 months, ranging from 2 months to 8 years. At presentation, 28 patients (70%) were under and twelve (30%) were above the age of two years. Twenty-eight (70%) patients had signs of congestive heart failure. Mean duration of follow-up was 40 +/- 24 months (ranging from 6 months to 9 years), 21 patients (52.5%) recovered, 17 patients (42.5%) had residual disease and two (5%) died. The cause of death in both patients was progressive cardiac failure. Sixteen of 28 patients (57%) who were below the age of two years and five of 12 patients (42%) who were above the age of two years at presentation recovered. The rate of recovery was significantly different between the two age groups (p < 0.05). Seventeen of 21 (81%) patients with a history of recent viral illness at presentation recovered. The mean duration of the disease among those who recovered was 11 +/- 8.3 months. Five of 19 (26%) patients without recent viral illness recovered. The mean duration of the disease in this group was 22 +/- 12 months. There was a significant difference between the two groups with respect to recovery and recovery time (p < 0.05). During the first 6 months after diagnosis, there was a significant difference between the patients who recovered and the patients who had residual disease with respect to improvement in the left ventricular FS (22 +/- 3.5%, 15.2 +/- 2.8%, respectively) (p < 0.05). In conclusion, in this study, the rate of recovery and survival is higher than in previous studies. A good outcome is related to age at presentation (<= two years old), a history of viral disease within three months of presentation and improvement in ventricular function during the first 6 months after diagnosis. Intractable heart failure has an adverse effect on the outcome.
Dual chamber cardiac pacing in children: Single chamber pacing dual chamber sensing cardiac pacemaker or dual chamber pacing and sensing cardiac pacemaker?
(Wiley, 2002-12) Çeliker, Alpay; Karagöz, Tevfik; Özer, Saadet; Özme, S.; Bostan, Özlem Mehtap; Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; AAG-8558-2021; 8676936500
Background : Dual chamber pacemakers (single chamber pacing dual chamber sensing cardiac pacemaker (VDD) and dual chamber pacing and sensing cardiac pacemaker (DDD)) are being used frequently in children and adolescents. The aim of this study was to verify the safety and performance of the VDD and DDD pacing systems, and to evaluate the differences between two pacing modes with regard to atrial sensing and tracking functions. Methods : In this study, we evaluated 14 patients with VDD pacing and 15 patients with DDD pacing between 1994 and 2000. In the patient group with VDD pacing, all had congenital or acquired atrioventricular ( AV) block. In the patient group with DDD pacing, 11 had congenital or acquired AV block, three had sinus node dysfunction with AV conduction disturbance and one had idiopathic hypertrophic subaortic stenosis. Twenty-eight devices were implanted in the subpectoral area using the transvenous route. After implantation the atrial tracking capabilities of the pacing systems were analyzed by telemetry, Holter monitoring, and treadmill exercise testing. Results : The mean age of patients in the VDD pacing group was younger. The percentage of congenital heart disease was higher in the DDD pacing group. There was no significant difference regarding fluoroscopy time during implantation and follow-up time between the two groups. During implantation, in the VDD pacing group the mean sensed atrial signal was 3.1+/-1.3 mV and this decreased to 1.37+/-0.68 mV (P<0.05) during follow-up. This pattern was also observed in DDD group (3&PLUSMN;2 mV vs 1.9&PLUSMN;1.5 mV, P<0.05). Although the P wave measurement at implantation did not differ between the two groups, it was significantly higher in the DDD pacing group at the last control. Three patients with VDD pacing were reprogrammed to VVI or single chamber pacing and sensing, rate adaptive cardiac pacemaker because of complete loss of AV synchrony. There was no atrial sensing problem in the DDD pacing group. During the follow-up, one patient with VDD pacing developed diaphragmatic stimulation and required lead revision. In one patient with DDD pacing, venous thrombosis occurred in the right subclavian vein and was treated with thrombolytic therapy. During treadmill exercise testing, in one patient with VDD and one patient with DDD pacing temporary failure of atrial sensing occurred. At 24 h Holter monitoring, intermittent loss of atrial sensing was documented in two patients with VDD pacing. Conclusions : Dual chamber pacing in children with DDD or VDD pacemakers is a suitable method for bradycardia treatment. Atrial sensing problems may occur in VDD pacemakers. Therefore, DDD pacing mode should be preferred whenever suitable for the patient to maintain the AV synchrony.
Early left ventricular diastolic dysfunction in premature infants born to preeclamptic mothers
(Walter De Gruyter, 2011-01) Çetinkaya, Merih; Bostan, Özlem Mehtap; Köksal, Nilgün; Semizel, Evren; Özkan, Hilal; Çakır, Seher; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; AAG-8558-2021; AAG-8393-2021; 23994946300; 8676936500; 7003323615; 12646191300; 16679325400; 7005414819
Aim: To evaluate the cardiac function in premature infants born to preeclamptic mothers and its clinical consequences. Methods: This was a prospective observational cohort study performed in a tertiary neonatal intensive care unit. Fifty-three premature infants born to preeclamptic mothers comprising the study group were evaluated and compared with 42 premature infants born to normotensive mothers (control group). Relationship between echocardiographic measures and neonatal morbidity were assessed as the main outcome measures. Results: Left ventricle end-diastolic dimension (LVEDD), peak flow velocities during early diastole (peak E wave), peak flow velocities during atrial contraction (peak A wave), and peak E/A ratio were significantly lower in the study group. Within the study group, these parameters were also significantly lower in infants with respiratory problems. LVEDD was significantly smaller in preeclamptic infants with intrauterine growth retardation (IUGR). Conclusion: Left ventricle diastolic dysfunction (LVDD) was detected in premature infants born to preeclamptic mothers in the first week after delivery. LVDD was associated with higher incidence of respiratory problems, transient tachypnea of the newborn, longer duration of oxygen requirement, and IUGR.
Echocardiographic diagnosis of total anomalous pulmonary venous connection of the infracardiac type
(Aves, 2007-03) Semizel, Evren; Bostan, Özlem Mehtap; Çil, Ergün; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0003-3516-0082; AAG-9324-2021; 12646191300; 8676936500; 35587943300