Konjenital VSD’lerin cerrahi tedavisinde kullanılan otolog perikart yama ile sentetik yama materyallerin sonuçlarının karşılaştırılması
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Date
2010-01-22
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Uludağ Üniversitesi
Abstract
Çalışmada opere olan izole VSD olgularında perikart ve sentetik yama sonuçlarının karşılaştırılması amaçlanmıştır. Retrospektif çalışmada ameliyat olan 40 (%44.44) kadın, 50 (%55.56) erkek toplam 90 hasta dosyası incelendi. 32 hastada (%35.56) perikart yama, 58 hastada ( % 64.44) sentetik yama kullanılmıştı. Olguların 25’i (% 27.78) perimembranöz, 16’sı (%17.78) subarteriel 43’ü (% 47.78) inlet, ve 6’sı (% 6.67) musküler tipte idi. Hastaların 46’sı (% 51.11) 1 yaş altı, 37’si (%41.11) 1-10 yaş arası, 6’sı (%6.67) 10-20 yaş arasında, 1’i (%1.11) ise 20 yaşından büyüktü. Hastalar taburculuk öncesi ve kontrollerde EKO ile değerlendirilmişlerdi. Rezidü VSD saptanan 38 olgudan 14’ünde perikart, 24’ünde sentetik yama kullanılmış, bunlardan sekiz tanesi ortalama 1,8 yıl içinde spontan kapanmıştı. Atriyoventriküler blok gelişen 3 olguya (%3.33) kalıcı kalp pili takılmış, perioperatif 5 olgu (%5.56) kaybedilmişti. VSD’lerin kapatılmasında kullanılan perikart ile sentetik yamalar arasında işlev bakımından istatistiksel olarak fark bulunamadı. Kullanılabilir, masrafsız ve kolay bulunması peri- kardın avantajları arasında sayılabilir. Uzun dönem sonuçlara ihtiyaç vardır.
The aim of the study was to compare the results of pericardial and synthetic patches in isolated VSD cases that are operated. In the retrospective study, total of 90 patient files were examined, 40 of them being women (44.44%), and 50 being men (%55.56) who were operated. Pericardial patches were used for 32 patients (35.56%), and synthetic patches were used for 58 patients (64.44%). 25 of the cases (27.78%) were perimembranous, 16 of them (17.78%) were subarterial , 43 (47.78%) were inlet, and the last 6 (% 6.67) had a muscular type. 46 patients (51.11%) were under age 1, 37 of them (41.11%) were between ages 1-10, 6 patients (6.67%) were between ages 10-20, 1 of the patients (1.11%) was over age 20. Patients were evaluated by means of ECHO before the discharge and in the controls. Pericardial patches were used for 14 cases out of 38, for which residual VSD was determined, and synthetic patches were used for the other 24 cases, and eight of them closed spontaneously in approximately 1.8 years. Permanent pacemaker was placed in 3 cases (3.33%) in which atrioventricular blocks had developed, and perioperative 5 cases (5.56%) were lost. Statistically no significant difference was discovered between the pericardial and synthetic patches used for the confinement of VSD’s. Cost-effectiveness, availability and ease of utility may be included among the advantages of pericardial patches. Long-term results are needed.
The aim of the study was to compare the results of pericardial and synthetic patches in isolated VSD cases that are operated. In the retrospective study, total of 90 patient files were examined, 40 of them being women (44.44%), and 50 being men (%55.56) who were operated. Pericardial patches were used for 32 patients (35.56%), and synthetic patches were used for 58 patients (64.44%). 25 of the cases (27.78%) were perimembranous, 16 of them (17.78%) were subarterial , 43 (47.78%) were inlet, and the last 6 (% 6.67) had a muscular type. 46 patients (51.11%) were under age 1, 37 of them (41.11%) were between ages 1-10, 6 patients (6.67%) were between ages 10-20, 1 of the patients (1.11%) was over age 20. Patients were evaluated by means of ECHO before the discharge and in the controls. Pericardial patches were used for 14 cases out of 38, for which residual VSD was determined, and synthetic patches were used for the other 24 cases, and eight of them closed spontaneously in approximately 1.8 years. Permanent pacemaker was placed in 3 cases (3.33%) in which atrioventricular blocks had developed, and perioperative 5 cases (5.56%) were lost. Statistically no significant difference was discovered between the pericardial and synthetic patches used for the confinement of VSD’s. Cost-effectiveness, availability and ease of utility may be included among the advantages of pericardial patches. Long-term results are needed.
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Keywords
Konjenital, Ventriküler septal defekt, Cerrahi, Perikart, Ventricular septal defect, Congenital, Surgical, Pericardial
Citation
Helvaci, H. vd. (2009). ''Konjenital VSD’lerin cerrahi tedavisinde kullanılan otolog perikart yama ile sentetik yama materyallerin sonuçlarının karşılaştırılması''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 35(3), 123-126.