Turkish doctors perform one-of-a-kind heart operation on Moyamoya patient

Fatih Çekirge – SAMSUN

In a surgery that could enter global medical literature, the doctor behind its success recounts performing one of the rarest heart operations ever recorded — not in Istanbul or the capital Ankara, but in the northern city of Samsun. 

“I’ve been in heart surgery since I graduated in 2002,” Doctor Emrah Ereren of Samsun University Hospital stated to the daily Hürriyet, “but this was unlike anything I have ever done before.”

The patient, 52-year-old Murat Şanlıer, was diagnosed with Moyamoya, a rare condition first observed in Japan that affects blood vessels in the brain and leads to gradual narrowing of carotid arteries. The disease occurs in just three in one million people and can result in strokes and cerebral hemorrhages if left untreated.

“What made it so risky, ” Ereren explains, “was that in typical bypass surgery, we check the carotid arteries beforehand and sometimes we open one if needed. But here, both were shut. That meant any plaque dislodged during surgery could go straight to the brain. A stroke was a very real possibility.”

Despite the dangers, Şanlıer opted to stay in Samsun. “We explained the entire situation to Mr. Murat. He had the option to go to Istanbul or Ankara, but he insisted on having the procedure here. That trust meant a lot,” Ereren said.

Before proceeding, the team consulted extensively — even turning to AI for insight. “AI gave a very detailed explanation of why it was too risky,” Ereren recounted, “but in the end, we had to make the decision ourselves.”

On May 14, doctors performed a beating-heart triple bypass — a rare method where the heart continues beating throughout the procedure with pump assistance, avoiding the need to stop the heart.

“We had the heart-lung machine as a backup, but we managed to do it with the heart still working. That alone lowered some of the neurological risk.”

The five-hour surgery was followed by nine days of intensive care. The team is currently preparing a scientific paper to document the case for global publication. “To our knowledge, this is the third case worldwide and first in Türkiye.”

Ereren emphasized the importance of expanding regional heart centers. “Heart surgery is resource-intensive. Big cities can’t carry the whole burden,” he said. “Now more than ever, we need strong regional facilities. Not everyone can afford or access treatment in big cities. We have the talent and the capability right here.”