Groundbreaking surgery saves young girl born with horizontal heart
ISTANBUL
In what is being hailed as a landmark medical achievement, a five-year-old girl born with a rare heart anomaly has made a miraculous recovery following a pioneering operation performed for the first time in Türkiye, and only the second of its kind globally.
Fatma Nur Yolaldı, the daughter of Fadile and Mustafa Yolaldı from the capital Ankara was born with a horizontally positioned heart — an extremely rare congenital defect known as “Topsy-Turvy Syndrome.”
The condition caused her heart to lie sideways within her chest cavity, compressing critical blood vessels, and eventually leading to the complete failure of her left lung.
Diagnosed during a prenatal scan at four and a half months of gestation, Fatma Nur’s complex heart structure also included an aortopulmonary window — a rare defect involving a hole between the aorta and the pulmonary artery.
At just one month old, she underwent an initial operation to close the hole. However, by her first birthday, the abnormal position of her heart began triggering serious respiratory issues. Despite the placement of a stent to keep her airway open, tissue regrowth caused complete obstruction. Over the next four years, her condition worsened, and eventually, her left lung collapsed entirely.
The life-saving surgery came after many centers refused to operate due to the extreme risk. In a final attempt, her family reached out to Doctor Afksendiyos Kalangos, chair of Pediatric and Congenital Cardiovascular Surgery at Koç University Hospital, renowned for taking on complex cases. Alongside surgeon Yılmaz Zorman, Kalangos led a multidisciplinary team in an intricate procedure performed in March.
During the surgery, Fatma Nur’s body temperature was lowered to 20 degrees Celsius using a technique called deep hypothermia to protect her brain function. The main artery compressed by her misaligned heart was removed and replaced with an 11-centimeter donor graft, creating a new aortic arch. Her severely infected and non-functional left lung was also removed.
“Had we not operated, she would have died,” Kalangos stated. “We couldn’t reposition the heart, but we could relieve the pressure on her right lung. Creating a new path for the artery using donor tissue was the only chance of survival.”
Fatma Nur’s successful recovery marks her as only the second known patient in the world to survive such an operation. The procedure not only set a precedent in Turkish medical history but also opened a new chapter in global pediatric cardiovascular surgery.
“This may be the only time in our careers we encounter such a case,” Zorman said. “We used rarely applied techniques. The operation was high risk but essential. ”
Fatma Nur now looks forward to starting school, a simple joy she had never been well enough to experience, thanks to the successful operation.
