Mitral pozisyonda bloprotez uygulaması ve erken sonuçları
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Date
1990
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Uludağ Üniversitesi
Abstract
Son iki yıl içinde mitral kapak hastalığı bulunan 60 olguya Carpentier-Edwards tipi mitral biyoprotez replasmanı yapıldı. Olguların kadın erkek oranı 45/15 ve yaş ortalaması 30.6 yıl olarak saptandı. Kırkbir olguda mitral stenozu, on olguda mitral yetmezliği, dokuz olguda ise mitral stenozu ile birlikte mitral yetmezligi ardı. Kılpak lezyonlar tüm olgularda romatizmal kardit sonucu oluşmuştu. Onüç olguda sol atrial trombüs vardı. Olguların beşi daha önce kapalı mitral komissürotomi ameliyatı geçirmişti. Ameliyat öncesinde ortalama pulmoner arter basıncı (MPAP) 43 mm Hg, pulmoner arter wedge basıncı (PAUP) 27 mm Hg ve kardiak indeks (Cl) 2.6 Lidakim2 olarak saptandı. Ameliyat sonrasında bu değerler MPAP 30 mm Hg, PAUP 15 mm Hg ve CI 3.1 L/dak/m2 olarak belirlendi. Ameliyatta olgu kaybedilmedi. Ameliyat sonrası ilk ayda üç olgu miyokard yetersizliği nedeniyle kaybedildi. Olgular ortalama 10 ay ( 4-25 ay) süreyle izlendiler. Bir olguda sol hemiparezi, diğer bir olguda antikoagülan kullanımına bağlı subdural hematom oluştu.
In 60 consecutive cases with mitral valve disease we performed CarpentierEdwards mitral bioprosthesis replacement in the last two years. Femalelmale ratio was 45!15. The mean age of the cases was 30.6 years. Forty-one cases had mitral stenosis, ten had mitral regurgitation and nine had mitral regurgitation in addition to mitral stenosis. Valvular lesions were due to rheumatic carditis in all cases. Thirteen of the cases had left atrial thrombosis. In fıve cases c/osed mitral commissurotomy had been performed before. Mean pulmonary artery pressure (MPAP) was 43 mmHg. pulmonary artery wedge pressure (PAWP) was 27 mmHg and cardiac index (CI) was 2.6 min nı 2 preoperatively. Postoperatively those values were found as follows: MPAP 30 mm Hg. PA WP 15 mm Hg and CI 3.1 L/min/m2 All of the patients survived operation. Three of henı died in the postoperative first month due to intractable cardiac failure. The nıean follow up period was 10 months. Subdural hematoma has developed in one case due to anticoagulant therapy and left hemiparesis was found in another case.
In 60 consecutive cases with mitral valve disease we performed CarpentierEdwards mitral bioprosthesis replacement in the last two years. Femalelmale ratio was 45!15. The mean age of the cases was 30.6 years. Forty-one cases had mitral stenosis, ten had mitral regurgitation and nine had mitral regurgitation in addition to mitral stenosis. Valvular lesions were due to rheumatic carditis in all cases. Thirteen of the cases had left atrial thrombosis. In fıve cases c/osed mitral commissurotomy had been performed before. Mean pulmonary artery pressure (MPAP) was 43 mmHg. pulmonary artery wedge pressure (PAWP) was 27 mmHg and cardiac index (CI) was 2.6 min nı 2 preoperatively. Postoperatively those values were found as follows: MPAP 30 mm Hg. PA WP 15 mm Hg and CI 3.1 L/min/m2 All of the patients survived operation. Three of henı died in the postoperative first month due to intractable cardiac failure. The nıean follow up period was 10 months. Subdural hematoma has developed in one case due to anticoagulant therapy and left hemiparesis was found in another case.
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Keywords
Mitral pozisyon, Bloprotez uygulaması, Mitral position, Bloprosthetic application
Citation
Özkan, H. vd. (1990). ''Mitral pozisyonda bloprotez uygulaması ve erken sonuçları''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 17(1), 159-169.