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ŞAYLAN ÇEVİK, BERNA

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ŞAYLAN ÇEVİK

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    PublicationOpen Access
    Constrictive pericarditis diagnosed following liver transplantation
    (MARMARA UNIV, FAC MEDICINE, 2021-10-31) ŞAYLAN ÇEVİK, BERNA; Cetiner, Nilufer; Cevik, Berna Saylan; Tutar, Engin; Erolu, Elif; Koray, A. K.; Akalin, Figen
    Constrictive pericarditis is frequently diagnosed during evaluation of the patients for hepatosplenomegaly and easily missed if not considered in differential diagnosis. Herein, we present a patient diagnosed with constrictive pericarditis during his investigation for impaired liver functions and right heart failure one year after liver transplantation. A thirteen-year-old boy presented with abdominal distention, dyspnea and fatigue. He had undergone liver transplantation due to liver failure in the previous year, and the symptoms had recurred in the last three months. Physical examination revealed normal heart sounds. Abdominal distention and ascites were present. Cardiothoracic index and pulmonary vascular markings were normal on chest X-ray. Echocardiography showed biatrial dilatation. Thickening of the pericardium with calcifications was demonstrated by thorax computerised tomography. High pulmonary wedge pressure and equalization of end-diastolic pressures were found during catheter-angiography. Pericardiectomy was performed, histopathology was compatible with chronic fibrinous pericarditis. The patient improved dramatically after surgery, the right heart failure findings resolved, and the liver graft functions turned to be normal. Constrictive pericarditis must be considered in differential diagnosis of hepatosplenomegaly, liver dysfunction and right heart failure since surgical treatment is possible and lifesaving.
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    PublicationOpen Access
    Paediatric and adult congenital cardiology education and training in Europe
    (2022-03-01) ŞAYLAN ÇEVİK, BERNA; McMahon C. J., Heying R., Budts W., Cavigelli-Brunner A., Shkolnikova M., Michel-Behnke I., Kozlik-Feldmann R., Wahlander H., DeWolf D., Difilippo S., et al.
    Background: Limited data exist on training of European paediatric and adult congenital cardiologists. Methods: A structured and approved questionnaire was circulated to national delegates of Association for European Paediatric and Congenital Cardiology in 33 European countries. Results: Delegates from 30 countries (91%) responded. Paediatric cardiology was not recognised as a distinct speciality by the respective ministry of Health in seven countries (23%). Twenty countries (67%) have formally accredited paediatric cardiology training programmes, seven (23%) have substantial informal (not accredited or certified) training, and three (10%) have very limited or no programme. Twenty-two countries have a curriculum. Twelve countries have a national training director. There was one paediatric cardiology centre per 2.66 million population (range 0.87-9.64 million), one cardiac surgical centre per 4.73 million population (range 1.63-10.72 million), and one training centre per 4.29 million population (range 1.63-10.72 million population). The median number of paediatric cardiology fellows per training programme was 4 (range 1-17), and duration of training was 3 years (range 2-5 years). An exit examination in paediatric cardiology was conducted in 16 countries (53%) and certification provided by 20 countries (67%). Paediatric cardiologist number is affected by gross domestic product (R-2 = 0.41). Conclusion: Training varies markedly across European countries. Although formal fellowship programmes exist in many countries, several countries have informal training or no training. Only a minority of countries provide both exit examination and certification. Harmonisation of training and standardisation of exit examination and certification could reduce variation in training thereby promoting high-quality care by European congenital cardiologists.