SUMMARY OBJECTIVE: This study aimed to compare the effectiveness of resection and extended end-to-end anastomosis between neonate and infant patients with coarctation. METHODS: This study was designed retrospectively and included 41 neonate (<30 days) and infant (30 days to 1 year) patients who were operated on using the resection and extended end-to-end anastomosis technique for aortic coarctation. Preoperative aortic annulus diameters and Z scores, all aortic arch diameters and Z scores, the presence of hypoplastic aortic segment, and the presence of prematurity were reviewed in both groups. Subsequently, we investigated whether these parameters were statistically related to the residual gradient in the operation area, whether there was a need for early re-intervention, and what was the incidence of mortality in the early postoperative period. In addition, the aortic arch Z scores of the patients at 6 months postoperatively were examined. RESULTS: While the mean age (p<0.001), body weight (p<0.001), and proximal arch Z score (p=0.029) were found to be significantly lower in the neonate group than in the infant group, the total length of the intensive care unit stay (p=0.013) and the total length of hospital stay (p=0.017) were found to be significantly higher. In addition, significant enlargement was detected in the proximal arch, distal arch, and isthmus segments in both patient groups. CONCLUSION: The resection and extended end-to-end anastomosis is an equally effective technique that can provide a marked decrease in gradient in the coarctation area and a significant enlargement of the aortic arch segments in the early period after coarctation repair in both neonate and infant patients. OBJECTIVE endtoend end METHODS 4 <30 30 (<3 (3 year segment groups Subsequently reintervention, reintervention re intervention, intervention re-intervention addition examined RESULTS p<0.001, p0001 p p<0.001 , 0 001 (p<0.001) p=0.029 p0029 029 (p=0.029 p=0.013 p0013 013 (p=0.013 p=0.017 p0017 017 (p=0.017 higher CONCLUSION <3 3 (< ( p000 p<0.00 00 (p<0.001 p=0.02 p002 02 (p=0.02 p=0.01 p001 01 (p=0.01 < p00 p<0.0 (p<0.00 p=0.0 (p=0.0 p0 p<0. (p<0.0 p=0. (p=0. p<0 (p<0. p=0 (p=0 p< (p<0 p= (p= (p< (p

ABSTRACT Introduction: Cyanotic congenital heart diseases constitute 40-45% of all congenital heart diseases. In patients who are not suitable for primary repair, modified BT (MBT) shunt and central shunt (CS) procedures are still frequently used. Methods: This study included 62 pediatric patients who underwent MBT shunt or CS via median sternotomy. Patients’ demographic, echocardiographic, operative, and postoperative data were collected retrospectively. The patients were classified as single ventricle and bi-ventricle according to their cardiac anatomy, and the presence of prematurity and heterotaxy was noted. Procedure details of the patients who underwent endovascular intervention prior to the surgery were investigated, and operation data were accessed from the surgery notes. Data regarding postoperative follow-ups were obtained and comparatively analyzed. Results: Of the total 62 patients, 32 (51.6%) were newborns and 16 (25.8%) had a body weight < 3 kg. MBT shunt was applied to 48 patients (77.4%), while CS was applied to 14 patients (22.6%). There was no significant difference between the two surgical procedures in terms of requirement for urgent shunt or cardiopulmonary bypass, additional simultaneous surgical intervention, need for high postoperative inotropes, and in-hospital mortality (P>0.05). The rate of congestive heart failure in patients with in-hospital mortality was determined as 66.7% and it was significantly higher than in patients without heart failure (P<0.001). Conclusion: MBT shunt and CS are still frequently used in cyanotic patients. The use of small-diameter shunts, particularly when centrally located, can prevent the onset of congestive heart failure and lower mortality. Introduction 4045% 4045 40 45% 45 40-45 repair (MBT (CS Methods 6 sternotomy Patients demographic echocardiographic operative retrospectively biventricle bi anatomy noted investigated notes followups follow ups analyzed Results 51.6% 516 51 (51.6% 1 25.8% 258 25 8 (25.8% kg 4 77.4%, 774 77.4% , 77 (77.4%) 22.6%. 226 22.6% . 22 (22.6%) bypass inotropes inhospital hospital P>0.05. P005 P P>0.05 0 05 (P>0.05) 667 66 7 66.7 P<0.001. P0001 P<0.001 001 (P<0.001) Conclusion smalldiameter small diameter shunts located 404 40-4 51.6 5 (51.6 25.8 2 (25.8 77.4 (77.4% 22.6 (22.6% P00 P>0.0 (P>0.05 66. P000 P<0.00 00 (P<0.001 40- 51. (51. 25. (25. 77. (77.4 22. (22.6 P0 P>0. (P>0.0 P<0.0 (P<0.00 (51 (25 (77. (22. P>0 (P>0. P<0. (P<0.0 (5 (2 (77 (22 P> (P>0 P<0 (P<0. ( (7 (P> P< (P<0 (P (P<

Abstract Introduction: In this study we try to observe the fate of the left internal thoracic artery grafts that were bypassed to left anterior descending artery with moderate stenosis identified with fractional flow reserve (FFR) technique. Doppler ultrasonography was chosen as a noninvasive screening method. Methods: A total of 30 patients who underwent coronary artery bypass grafting depending on results of the fractional flow reserve between January 2007 and January 2012, were subjected to transthoracic color Doppler ultrasonographic evaluation irrespective of the presence of symptoms, and the presence of a systolic-diastolic flow pattern was investigated using the supraclavicular approach. Results: The left internal thoracic artery graft was found to be functional in 63.3% of patients within a mean period of 35.1±19.7 months between coronary bypass and color Doppler ultrasonography. This period was found to be 29.4±19.6 months in the functional graft group, and 44.7±16.6 months in the dysfunctional graft group (P=0.046). Preoperative complaints of angina were reported to fall from 88.9% to 16.7% in the functional graft group, when compared to the postoperative period (P<0.001), but fell from 90.9% to 36.4% in the dysfunctional graft group (P=0.034). Conclusion: Functional left internal thoracic artery graft rates of the study population were found to be lower than the studies reported in the literature.