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Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Kawasaki Disease (KD) is a type of systemic vasculitis mediated by an abnormal immune response, similar to autoinflammatory disorders, due to increased release of proinflammatory cytokines. This cross-sectional study aims to evaluate the relationship between the frequency and severity of KD and the presence of Mediterranean Fever (MEFV) gene variants. Materials and Methods: Thirty-eight children diagnosed with KD were included in the study. Demographic and clinical data such as age at diagnosis, gender, and duration of fever prior to intravenous immunoglobulin (IVIG) treatment were recorded. Laboratory and echocardiographic data at the time of diagnosis were also retrospectively reviewed. MEFV gene analysis was performed for all patients. Results: The study comprised 38 patients, including 25 boys (65.8%) and 13 girls (34.2%), with a median age of 3.4 years (range 1.8-6.3 years). Coronary arterial lesions were observed in 11 patients (28.9%), and 13 patients (34.2%) were resistant to initial IVIG treatment. Twenty-two patients (57.9%) had at least one allele with MEFV variants. Of these, eight patients (36% of MEFV-positive patients) had at least one exon-10 variant, while 14 patients had only exon-2 variants. No statistically significant differences were found in clinical, demographic, or echocardiographic parameters between MEFV-positive and MEFV-negative patients. Conclusion: This study found that the presence of MEFV gene variants in KD patients is almost three times higher compared to the general Turkish population. This relationship warrants further clarification through nationwide studies, especially in countries where Familial Mediterranean Fever (FMF) is a significant concern. [ABSTRACT FROM AUTHOR]

Introduction: The major complication and the main reason of reoperation following surgery of total anomalous pulmonary venous return (TAPVR) repair, is the occurrence of pulmonary venous obstruction. The pathology of pulmonary venous obstruction followed by surgery of TAPVR is a fibrous intimal hyperplasia associated with some medial hypertrophy. The conventional surgical therapies have been complicated by a high rate of re-stenosis. We would like to share our experience with a patient who was followed up in our clinic and developed restenosis and severe aortic regurgitation after removal of pulmonary vein obstruction after TAPVR repair. Case: A 9-year-old male patient had TAPVR repair surgery at an external center when he was 23 days old. Due to the development of pulmonary vein stenosis after TAPVR repair, he operated again in our center when he was 4,5 months old. During the clinical follow-up of our patient, severe aortic regurgitation and severe pulmonary vein stenosis developed over time. In doppler echocardiographic imaging, the peak pressure gradient obstructed left PV was 70-80 mmHg and right PV was 30 mmHg. Pulmonary vein stenosis repair and aortic valve replacement (AVR) were performed in the same operation. After operation echocardiographic imaging, the peak pressure gradient left PV was 7-8 mmHg, right PV was 5-6 mmHg and mild regurgitation of mechanical aortic valve was detected. Discussion: The total anomalous pulmonary venous connection is a rare congenital heart disease. The development of pulmonary venous obstruction is one of the major risk factors for poor outcomes after surgical repair. [ABSTRACT FROM AUTHOR]

Objectives: In this study, a comparison of cardiac magnetic resonance imaging (MRI) and simultaneous transthoracic echocardiography data were obtained from patients with great artery transposition (TGA), who underwent arterial switch operation (ASO) surgery. In to discover the most effective and optimal viewing method during long-term follow-ups. Materials and Methods: This retrospective cohort included 20 TGA patients (16 male, 4 female), which had ASO surgery. Along with cardiac MRI and transthoracic echocardiography data were obtained from the images. The mean age was 93.00±29.82 months (60-144). Seventeen patients had TGA only. However, 3 patients with TGA included an existing ventricular septal defect. Results: We showed a meaningful correlation between echocardiographic variables (left ventricle dilatation of the left ventricle function of the aorta failure, myocardial performance index) and MRI parameters (ejection fraction of left ventricle dilatation of the left ventricle function of the aorta insufficiency). Conclusion: TGA patients require careful pre and post operative evaluation, anatomical and a functional use of cardiac indicators. For this purpose, both echocardiography and MRI are useful, safe, and trustworthy methods of diagnosis. Choosing the optimal imaging technique and lifetime reoccurring assessments of the left ventricle function is of vital importance in foreseeing complications, preventing morbidities, and creating a protocol. In clinical practice, the myocardium performance index provides values similar to that of the MRI about the left ventricle dilatation and left ventricle dysfunction. These results provide awareness about the use of specific parameters and the use of information based on quantitative data. [ABSTRACT FROM AUTHOR]

Abstract Background Patent ductus arteriosus is a common congenital cardiac condition. Its importance is mostly underestimated and accepted as an “easy” heart disease. Physiological consequences of pulmonary overflow may cause severe mortality in premature neonates. Accurate timing of surgical intervention is essential to decrease the mortality in very low birth weight premature infants. On-site surgery in the intensive care units (ICUs) results excellent surgical quality without jeopardizing the safety of the patients. Methods We have summarized the clinical and operative data of 26 premature neonates (1000 gr). Results There was no surgical mortality in both groups. Co-existing problems were observed in both groups, which did not affect surgical mortality and morbidity. Conclusions Surgery in the ICU is a safe method for premature neonates with physiologically significant PDA. This technique should be the method of choice in experienced centers.

Introduction: Ductus arteriosus aneurysm (DAA) is characterized by a localized saccular or tubular dilation of the ductus arteriosus. Although DAA may be identified in infants, children and adults, case reports suggest that the most common age of diagnosis is less than two months. Various theories have been proposed regarding the pathogenesis, such as delayed closure of the aortic end of the ductus arteriosus and congenital weakening of the ductal wall. We wanted to present a case of asymptomatic ductus arteriosus aneurysm, which is rarely detected in childhood. Case: An 8-year-old male patient had a murmur between both scapulae, and echocardiography showed descending aorta tortuosity and a gradient of 25 mmHg was obtained. CT angiography was performed with the suspicion of aortic coarctation. After the left subclavian artery exit, a lobulated diverticulum on the medial anterior wall of the aorta and narrowing in the main lumen were detected. His physical examination revelaed no difference in lower and upper extremity blood pressure. The lesion was visualized by catheter angiography and pressure records were taken. In the injection made into the ascending aorta, an appearance compatible with a ductal aneurysm was observed in the distal of the left subclavian artery. The diameter of the transverse aorta was 19.8 mm proximal to the left subclavian artery, and the diameter of the descending aorta adjacent to the lesion was 11.4 mm. The pressure was 125/92 mmHg proximal and 110/90 mmHg distal to the aneurysmatic region. The patient was asymptomatic and a clinical follow-up decision was taken at the Pediatric Cardiology-Cardiovascular Surgery Council. Discussion: Ductus arteriosus aneurysm may be observed in patients with connective tissue disorders such as Marfan, Ehlers-Danlos and Larsen syndromes. Previous reports suggest that congenital DAA encountered postnatally may be associated with a high rate of severe complications. Spontaneous rupture, erosion, thromboembolism, infection and compression of adjacent structures are some of the reported complications. In children, the aneurysm is usually asymptomatic and may not be recognized until complications like infection, thrombus, embolism and sometimes rupture, develop. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate sports injuries around the knee joint during long jump attempt. Methods: A total of 68 patients admitted to emergency service due to knee injury during long jump attempt were retrospectively investigated between January 2005 and January 2012. All cases were evaluated in terms of isolated or combined injuries of the knee and surrounding structures, long jump distance, injury side, demographic data and radiological findings. All injuries were classified into three groups according to the number of damaged anatomical structures. Study data were statistically evaluated using the Mann-Whitney U test, Pearson chi-square test, Fisher's exact test, and Fisher-Freeman-Halton exact test. Significance was evaluated at p<0.01 and p<0.05. Results: All patients were male, and the age range was 23.25±2.82 years. The incidence of the left-side injury was 63.2%. Effusion was the common radiological finding. The incidence of anterior cruciate ligament injuries was the highest (66.2%), followed by that of the medial meniscus (63.3%), medial collateral ligament (25%), lateral meniscus (22.1%), lateral collateral ligament (11.8%), extensor mechanism (10.3%), and posterior cruciate ligament injuries (4.4%). The incidence of anterior cruciate ligament and medial collateral ligament injuries of the right side was significantly higher than that of the left side (p=0.016; p=0.014). No significant association was found between the long jump distance and injuries (p=0.076). Conclusion: All structures of the knee joint, particularly the anterior cruciate ligament, medial meniscus, and medial collateral ligament, appeared to be at high risk of injury during long jump attempt. [ABSTRACT FROM AUTHOR]