Researcher:
Yıldırım, Işıl Şafak

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Doctor

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Işıl Şafak

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Yıldırım

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Yıldırım, Işıl Şafak
Yıldırım, Işıl

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2015 - 20193

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    Subcutaneous defibrillator implantation in pediatric patients
    (Turkish Soc Cardiology, 2016) Ertuğrul, İlker; Karagöz, Tevfik; Aykan, Hakan; Özer, Sema; Karagöz, Heves; Yılmaz, Mustafa; N/A; Yıldırım, Işıl Şafak; Doctor; N/A; Koç University Hospital; N/A
    Objective: Although sudden cardiac death is rare in children, an intracardiac defibrillator system is indicated in children with various types of cardiomyopathy, primary electrical diseases, and after surgical repair of congenital heart defects. The use of transvenous defibrillator lead systems is limited in pediatric patients because of a small body size and/or limited vascular access. Subcutaneous array leads combined with an abdominally placed generator can enable implantation. Method: This is a retrospective study of 13 patients who underwent subcutaneous defibrillator implantation between September 2010 and March 2015. The subcutaneous system was preferred because patients were not amenable to transvenous lead placement. Results: The median patient age was 4.1 years, and the median patient weight was 12.1 kg. Diagnoses of patients were long-QT syndrome in 6, aborted cardiac arrest with left ventricular non-compaction in 3, hypertrophic cardiomyopathy with sustained ventricular tachycardia in 3, and arrythmogenic right ventricular cardiomyopathy in 1. Revision of the subcutaneous lead was required in 5 patients 2-26 months after the implantation. Appropriate shocks were observed in three patients. Inappropriate shock and lead fractures were observed in one patient during the follow-up period. The failure of therapy was observed in one patient. There were no perioperative complications and no early or late deaths. Conclusion: Subcutaneous defibrillator systems are safe and effective in pediatric patients when the transvenous method is risky and contraindicated. Because the high growth rate in this population leads to lead failures, a close follow-up of this population is essential.
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    Clinical and electrophysiological evaluation of pediatric Wolff-Parkinson-White patients
    (Turkish Soc Cardiology, 2015) Ozer, Sema; Karagoz, Tevfik; Sahin, Murat; Ozkutlu, Suheyla; Alehan, Dursun; Celiker, Alpay; N/A; Yıldırım, Işıl Şafak; N/A; N/A; Koç University Hospital; N/A
    Objective: Wolff-Parkinson-White (WPW) syndrome presents with paroxysmal supraventricular tachycardia and is characterized by electro-cardiographic (ECG) findings of a short PR interval and a delta wave. The objective of this study was to evaluate the electrophysiological properties of children with WPW syndrome and to develop an algorithm for the management of these patients with limited access to electrophysiological study. Methods: A retrospective review of all pediatric patients who underwent electrophysiological evaluation for WPW syndrome was performed. Results: One hundred nine patients underwent electrophysiological evaluation at a single tertiary center between 1997 and 2011. The median age of the patients was 11 years (0.1-18). of the 109 patients, 82 presented with tachycardia (median age 11 (0.1-18) years), and 14 presented with syncope (median age 12 (6-16) years); 13 were asymptomatic (median age 10 (2-13) years). Induced AF degenerated to ventricular fibrillation (VF) in 2 patients. of the 2 patients with VF, 1 was asymptomatic and the other had syncope; the accessory pathway effective refractory period was <= 180 ms in both. An intracardiac electrophysiological study was performed in 92 patients, and ablation was not attempted for risk of atrioventricular block in 8 (8.6%). The success and recurrence rate of ablation were 90.5% and 23.8% respectively. Conclusion: The induction of VF in 2 of 109 patients in our study suggests that the prognosis of WPW in children is not as benign as once thought. All patients with a WPW pattern on the ECG should be assessed electrophysiologically and risk-stratified. Ablation of patients with risk factors can prevent sudden death in this population.
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    PublicationOpen Access
    Retrograde transcatheter closure of anterior mitral valve leaflet perforation
    (Medknow Publications, 2019) N/A; N/A; Şengün, Berke; Yıldırım, Işıl Şafak; Yıldız, Ömer; Çeliker, Alpay; Undergraduate Student; Other; School of Medicine
    Transcatheter closure of mitral valve leaflet perforation is a very rarely performed and a difficult procedure for repairing the defect. Herein, we are the first to report on both the safety and feasibility of percutaneous retrograde transcatheter closure of anterior mitral valve leaflet perforation with an AMPLATZER (TM) Duct Occluder II (6 mm x 6 mm; ADO II; Abbott Vascular, IL, USA) device in a 19-year-old patient with a severe mitral valve regurgitation following cardiac surgery.