Parsiyel atrioventriküler kanal defektinde cerrahi onarım ilkeleri ve erken dönem sonuçlar
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Date
1995-11-29
Authors
Zeybek, Rahmi
Şiein, B. Hayrettin
Dengiz, Banu
Karahan, Nagehan
Şağban, Mansur
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Parsiyel atrioventriküler kanal defekti (PAVKD) nadir görülen bir kardiak anomali olup tüm atrial septal defekt olgularının yaklaşık % 5 'ini oluşturur. Bu olguların cerrahi tedavisinde izlenen prensipler halen bir taktım farklılıklar göstermektedir. Mitral kapak fonksiyon bozukluğunun onarımda gözetilen prensipler ve atrial septal defektin kapatılmasında ileti sisteminin korunmasına yönelik cerrahi yaklaşımlar halen tartışmalı konulardır. Bu çalışmada İzmir Atatürk Devlet Hastanesi Kalp ve Damar Cerrahisi Kliniğinde 1992 ve 1993 yıllarında opere edilen 8 PAVKD olgusu değerlendirilmiştir. Bu olgularda uygulanan cerrahi teknik, erken postoperatif dönemde izlenen komplikasyonlar ve 1 yıllık poliklinik izlem bulguları sunulmuştur. Tüm olgularda ostium primum defekti yama ile kapatıldı. ileti sisteminin korunması için sütürler yüzeysel olarak defekt dudağımın solunda, mitral annulus üzerinde bırakıldı. Tüm olgularda mitral kleft tek tek sütürlerle kapatıldı. İki olguda postoperatif erken dönemde geçici ritm ve ileti bozuklukları gelişti ve tamamen kayboldu. Hiçbir olguda hastane mortalitesi ve bir yıllık özlerinde mortaliteye rastlanmadı. Preoperatif dönemde çeşitli derecelerde mitral kapak yetmezliği gösteren 5 olgudan 4 'ünde postoperatif dönemde mitral yetmezlik tamamen ortadan kalktı, 1 olguda ise mitral yetmezliği operasyon öncesi orta derecede iken postoperatif dönemde hafif derece olarak sürdü.
Parfait atrioventricular canal defects (PAVCD) are unusual cardiac anomalies, representing about 5 percent of all atrial septal defects. There are still some controversies in some principal objectives in the surgical treatment of these patients. The principles in repair of mitral valve dysfunction and the surgical strategies to avoid heart block during patch closure of the atrial septal defect are still controversial issues. In this study, 8 PAVCD cases operated in İzmir Atatürk State Hospital Cardiovascular Surgery Clinic in 1992 and 1993 are included Operative techniques, early postoperative complications and one year follow-up results are presented Ostium primum defect was closed with patch in all cases. To avoid heart black, sutures were placed superficially to the lefi of the rim of the defect, directly in the annulus of the mitral valve. Mitral valve cleft was repaired with interrupted sutures in all patients. Transient arrhythmia and conduction disturbances developed in 2 patients in the early postoperative period and resolved completely. There was no mortality in hospital and one year follow-up period Four of 5 patients who had mitral insufficiency in arioıts degrees preoperatively improved completely. Mitral insufficiency decreased but persisted in one patient to a mild degree.
Parfait atrioventricular canal defects (PAVCD) are unusual cardiac anomalies, representing about 5 percent of all atrial septal defects. There are still some controversies in some principal objectives in the surgical treatment of these patients. The principles in repair of mitral valve dysfunction and the surgical strategies to avoid heart block during patch closure of the atrial septal defect are still controversial issues. In this study, 8 PAVCD cases operated in İzmir Atatürk State Hospital Cardiovascular Surgery Clinic in 1992 and 1993 are included Operative techniques, early postoperative complications and one year follow-up results are presented Ostium primum defect was closed with patch in all cases. To avoid heart black, sutures were placed superficially to the lefi of the rim of the defect, directly in the annulus of the mitral valve. Mitral valve cleft was repaired with interrupted sutures in all patients. Transient arrhythmia and conduction disturbances developed in 2 patients in the early postoperative period and resolved completely. There was no mortality in hospital and one year follow-up period Four of 5 patients who had mitral insufficiency in arioıts degrees preoperatively improved completely. Mitral insufficiency decreased but persisted in one patient to a mild degree.
Description
Keywords
Parsiyel atrioventriküler kanal defekti, Ostium primum, Partial atrioventricular canal defect
Citation
Zeybek, R. vd. (1995). ''Parsiyel atrioventriküler kanal defektinde cerrahi onarım ilkeleri ve erken dönem sonuçlar''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 22(1-2-3), 5-8.