Kartal Koşuyolu

Training and Research Hospital

Kartal Koşuyolu Training and Research Hospital was established in
1985, in particular to provide medical services for the treatment of heart
diseases .The first heart transplantation was performed in our hospital
in 1989.We provide advanced treatment modalities in Cardiology and
Cardiovascular Surgery with 465-bed capacity, including 3 intensive care
units with 80 beds in total. On average for a year, 1000 bypass surgeries
and 12000 coronary angiographies are succesfully performed in our
center with 198 doctors, 360 nurses and 117 employees. In 2013, 17
lung transplantions and 9 heart transplantions were carried out. Our
patient is still alive 17 years after a heart transplantation. Our hospital
has an excellency in following fields;

Pediatric
Cardiovascular
Surgery
Cardiology
Pediatric
Cardiology

Thoracic
Surgery Cardiovascular
Surgery
 DEPARTMENT OF
CARDIOVASCULAR
MITRAL VALVE SURGERY SURGERY
Surgical methods that are used for mitral valve disorders
can vary depending on etiology and its type. Regarding
the cases of mitral regurgation, our department’s main
goal is to be able to apply valve repair methods for the
treatment of disease. Our hospital have sufficient staff
and equipment in this regard. Surgeons at our hospital
are on the forefront of mitral valve repair surgery. We
also perform Mitraclip, a percutaneous method of repair
for the mitral valve, on the patients who have either high
risk or no chance to be treated with cardiac surgery.
In our Invasive Cardiology Department, we perform
AORTIC VALVE SURGERY
In addition to heart valve replacement surgery that
percutaneous mitral balloon valvotomy to treat the mitral
we convensionally apply to treat aortic stenosis or
valve stenosis. For the conditions which are not suitable
aortic regurgitation, our department is also capable
to be treated with this procedure, open-mitral valvotomy
of performing bioprosthesis, sutureless aortic valve
with open-heart surgery, or valve replacement surgery are
replacement, aortic root replacement and repair. Aortic
performed.
arch and descending aorta repair are also performed
to treat aortic aneurysm (enlargement of the aorta) and
aortic dissection (a tear of the aorta walls). Besides, with
hybrid surgical approach, abdominal endovascular aortic
repair (EVAR) and/or thoracic endovascular aortic repair
(TEVAR) and aort surgery are carried out.
ABDOMINAL AORT SURGERY
For the cases of abdominal aortic aneurysm and ruptures,
our department provides treatment with endovascular
stent grafting or open surgery grafting. To treat peripheral
vascular diseases, abdominal and distal bypass surgery
are performed.

CORONARY ARTERY BYPASS SURGERY
Coronary artery bypass grafting (CABG) surgery is a
procedure that uses arteries or veins from the body to
reroute blood around a blockage in the coronary arteries.
In our department, coronary bypass surgery is carried
out to treat the conditions which are caused by coronary
artery disease (except coronary stent indications). We also
carry out complete arterial revascularization particularly
for young patients. Beating heart bypass surgery is
another method which we perform frequently. Our
cardiothoracic surgery team is highly experienced in both
bypass techniques.
VENOUS SURGERY
In addition to vein striping operation which is carried
out to remove varicose veins, our department perform
endovenous laser therapy, foam sclerotherapy. We also
offer arteriovenous fistulas for kidney failure.
HEART TRANSPLANTATION
In our department, every week, we have a council meeting
for patients with heart failure. We form the lists of
patients who will be subjected to transplantation or heart
supporter systems. Heart transplantation and routine
follow-up for heart transplant patients are carried out by
our specialized team . Our physicians also aggressively
pursue non-transplant options, including the use of
medical- and device-based therapies, such as the newest
medications, resynchronization therapy. We also offer
permanent and temporary ventricular assist devices.
SERVICES OFFERED IN OUR
CARDIOLOGY DEPARTMENT

MITRACLIP
MitraClip is a procedure that is performed without open-
surgery by sewing two leaflets of mitral valve together
to treat the patients with mitral valve regurgitation. By
attaching a “clip” (the MitraClip device) to your valve,
the device allows the valves to close more completely,
and therefore helps to restore normal blood flow through
your heart. The patients whose valves are sturdy but not
big enough because of cardiac hypertrophy caused by
another reasons are subjected to mitraclip. This method
is not suitable for patients who have a leaking through the
TAVI (Transcatheter Aortic Valve Implantation)
is a process of replacing aort valve percutaneously valve because of calcification.
without open-heart surgery. Aortic valve has a vital role
in circulation, because it provides the flow of oxygen-rich
blood from heart to aort which transports the blood to all
the tissues and organs of the body. The problems on aortic
valve could cause aortic stenosis (an abnormal narrowing
of aortic valve) or aortic valve regurgitation (the condition
that valve doesn’t close properly and the blood leaks back
to heart’s pumping chamber). For the conditions which
causes severe functional disturbance, aortic valve must
be replaced. Because replacing the valve with open heart
surgery is so risky for older and exhausted people, TAVI
will be the best choice for them. Nowadays, TAVI provides
a solution to patients who suffer from aortic stenosis.

EVAR (Endovascular aneurysm repair)

EVAR provides the treatment of aortic diseases with or
without surgery. The diseases such as aortic aneurysm,
dissection, ulcer and hematoma could be lethal because
of bleeding. Until recently, these disorders have been
treated with open surgery, but now the surgery is applied
as an alternative way to EVAR. With EVAR, the stent graft
is inserted in aortic aneurysm (without removing any
tissue from the aorta). This procedure is very suitable
especially for those the surgery is very risky.
MITRAL BALLOON VALVULOPLASTY
A rheumatic heart disease during childhood can cause
mitral valve stenosis later in life. For patients whose valves
do not have moderate leakage and narrowed without
serious corruption, we perform balloon valvuloplasty to
widen the narrowed valves without open heart surgery.
This method gives more time to patients delaying the
surgery. In the years after balloon valvuloplasty, the
valve can get narrowed again and the surgery becomes
inevitable.

NON-CORONARY MAJOR VESSEL

INTERVENTIONS
The diseases known as arteriosclerosis might cause
disorders not only in heart vessels, but also in the other
vessels of body, resulting an interference with blood
supply to some organs including brain, kidneys, intestine,
arms and legs. We are able to treat the disease with stents
(tiny tube-shaped devices inserted into a vessel to keep it
open), without requiring open-surgery. Stent interventions
for carotid arteries, mesenteric arteries and peripheral
arteries are carried out in our hospital.

ELECTROPHYSIOLOGY STUDY and ABLATION

Arrhytmias (irregular heartbeat) may be caused by
different heart disorders. The ones which could not be
treated with drugs can be identified by cardiac mapping
and can be treated with delivering energy (heat or
freezing cold). After process, it can be necessary to
take medications if our doctors suggest. Some serious
arrhythmias which might cause the heart to stop beating
can be treated with this method.
TREATMENT OF CONGENIAL
HEART DISEASES
The circulatory system of unborn baby in a mother’s womb
works differently from that of born humans. All nutrients
and oxygen which is indispensible for the survival of fetus
are obtained from mother. To achieve this, the oxygenated
blood which comes from placenta must be carried to
fetus passing through the holes which will close after
birth. Sometimes these holes in the walls of heart do not
close after birth and causes a mixing of oxygenated and
deoxygenated blood. To treat this defect, there are some
procedures without requiring open-surgery. With these
methods, congenial heart defects including ASD, VSD,
PDA ,PFO. Also the stenosis in the great arteries of the
heart like pulmonary stenosis, and coarctation of the aorta
can be treated without open-heart surgery in our hospital.

Transcatheter Closure of Atrial Septal Defects

(ASD)
An opening in the wall between two atrias of the heart
called as ASD. This hole allows the flow of oxygen-rich
blood from the left atrium into the right atrium, instead
of flowing into the left ventricle as it should and causes
oxygen-rich blood to mix with deoxygenated blood in
right atrium. As a result, the volume of blood that will be Transcatheter Closure of Patent
pumped to lungs will increase causing higher amounts
Ductus Arteriosus (PDA)
The ductus arteriosus is a fetal blood vessel located
of blood flow than normal in the lungs. Small holes quite
between aorta which distributes oxygenated blood to all
commonly close on their own before the age of 4-5 years.
parts of the body and pulmonary artery which carries
If not, they can be treated with cardiac catheterization by
deoxygenated blood from the heart to the lungs. This
entering through the vessel of upper thigh. Large holes
vessel closes on its own within a few days after birth.
and the ones that did not close neither on their own nor
Sometimes the vessel does not close when the baby is
by catheterization can be closed with surgery. Intervention
born, allowing oxygen-rich blood from the aorta to mix
therapy is preferred for also children if they are suitable
with oxygen-poor blood from the pulmonary artery.This
for it.
defect is called patent ductus arteriosus (PDA). Most
PDA can be closed with cardiac catheterization without
requiring open-surgery. For larger PDAs, the surgery can
be needed. All recent devices for percutaneous treatment
of congenital heart defects in pediatric cardiology are
available in our hospital to treat the disease.
 DEPARTMENT OF
PEDIATRIC CARDIOLOGY

Transcatheter Closure of Ventricular Septal

Defect (VSD)
Ventricular Septal Defect is an opening in the wall between
the left and right ventricles of the heart. Via this hole,
oxygen-rich blood which leak from left ventricule travels to
right ventricule and then to lungs. In our clinic, the defects
can be treated with interventional procedures and cardiac
catheterization depending on the size of hole.
Treatment of Arrhythmias in the Laboratory of
Electrophysiology
The babies can be born with some heart rhythm problems
including tachycardia (an abnormally fast resting heart
rate), bradycardia (a slow heart rate), or irregular heart
rate. In our clinic, the treatment of rhythm disorders in older
children can be done with cardiac catheterization (either
radiofrequency catheter ablation or cryoablation
 DEPARTMENT OF
PEDIATRIC CARDIOVASCULAR SURGERY

Single Ventricle
In some congenial diseases such as tricuspid atresia,
atrioventricular septal defects (AVSD), hypoplastic left
ventricle syndrome (HLVS), the surgery does not fully
repair the defects. This conditions are treated with the
surgery which is performed gradually including the Glenn
and Fontan procedures. With these operations, the vessels
which carry deoxygenated blood to the heart directed to
pulmonary artery to make the blood reach lungs.

Hypoplastic left heart syndrome Tetralogy of Fallot

Hypoplastic left heart syndrome occurs when the left
side of the heart (left ventricle, aorta, aortic and mitral
valves) do not develop completely. In our clinic, the defect
is treated with Norwood operation or hybrid procedure
(Norwood procedure with Glenn operation). Our clinic
provides follow-up care for children who had succesful
surgical treatment.
Transposition Great Arteries
The disease occurs when two main arteries leaving
the heart –aorta and pulmonary artery are switched in
position. In our clinic, arterial switch (the Jatene procedure)
is succesfully performed for treatment of newborns.
Atrial switch –Senning or Mustard operations can also be
performed for severe cases.
Tetralogy of fallot is the most common form of congenital
heart diseases.Required treatment methods for complete
repair such as the closure of ventricular septal defect
(VSD), the treatment of pulmonary stenosis, and shunt
operations are performed in our clinic. We also provide the
second surgery for those who have their first operation in
other clinics. Our clinic is capable of performing operations
for treatment of all different types of congenital heart
defects. All surgeries are performed in well-equipped
operating rooms by a specialized doctor, accompanying
him a team of two associate professors, two experts
and pediatric surgeons. The follow-up care for patients
are done by professional anesthetists and intensive care
experts in critical care units which completely belong to
pediatric surgery department.

Denizer Caddesi Cevizli Kavşağı No: 2 Cevizli / Kartal İSTANBUL

Telefon: + 90 216 500 1 500 FAX: + 90 216 459 63 21
E-mail: iletisim@kosuyolu.gov.tr
www.kosuyolu.gov.tr