Küçük aort kökünde mekanik kapak replasmanı sonrası hemodinamik bulguların ve sol ventrikül performansının değerlendirilmesi
Küçük Resim Yok
Tarih
1999
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Küçük aort kökü mevcut olan olgularda küçük ölçekli protez kapak takılması sonrasındaki hemodinamik performans ve uzun dönem sonuçları hakkında tartışmalar devam etmektedir. Bu çalışma küçük aortik anulusa sahip olgulara takılan 19 ve 21 numaralı mekanik protez kapakların klinik ve hemodinamik etkilerini araştırmak amacıyla planlanmıştır. Ocak 1997 ile Mart 1998 tarihleri arasında aort kapak replasmanı geçiren 36 olgu iki gruba ayrıldı. 19 ve 21 numaralı St. Jude marka mekanik kapak takılan olgular birinci grubu, 23 ve daha büyük numaralı St. Jude marka mekanik kapak takılan hastalar ikinci grubu oluşturdu. Olgular preoperatif ve postoperatif dönemde klinik ve ekokardiyografik olarak değerlendirildiler. Her iki grupta da hastanede veya takip döneminde mortalite olmadı. Erken ve geç dönem komplikasyonlar arasında iki grup arasında anlamlı bir fark yoktu. Transvalvüler gradiyentte iki grupta da preoperatif değerlere göre anlamlı azalma saptandı. Her iki grupta postoperatif dönemde ejeksiyon fraksiyonunda minimal bir artış oldu. Sol ventrikül end-diastolik ve end-sistolik çaptaki değişiklik iki grupta da anlamlı değildi. İnterventriküler septum ve sol ventrikül arka duvar kalınlığında her iki grupta da preoperatif değerlere göre anlamlı bir azalma gözlendi. Bu sonuç 19 ve 21 numaralı St. Jude mekanik kapakların minimal transvalvuler gradiyente ve iyi hemodinamik performansa sahip olduğunu göstermektedir. Uygun olgularda küçük ölçekli protezlerin kullanılması erken veya geç dönem mortaliteyi ya da kardiyak olayları olumsuz olarak etkilememektedir.
The results of long-term follow-up and hemodynamic performances after aortic valve replacement in the small aortic root are still controversial. This study was designed to assess the clinical and hemodynamic consequences of aortic valve replacement with 19 or 21 mm mechanical proshesis. Between January 1997 and March 1998 aortic valve replacement was performed in 36 patients whom divided in two groups. Group I consisted of 18 patients receiving either 19 or 21 mm St. Jude mechanical valves and group II consisted of 18 patients receiving either 23mm or larger sizes St. Jude mechanical valves. The clinical and echocardiographical studies were performed before the operation and postoperative period. There was no operative or late mortality in both groups. The morbidity was similar in two groups. There was a significant reduction of transvalvular gradient in group I and group II. Left ventricular ejection fraction was slightly increased in both groups. Left ventricular end-diastolic and end -systolic diameters were not significantly changed while interventricular septum and posterior wall thickness were regressed significantly in both group. These data show that 19 and 21 mm mechanical St. Jude valves exhibit equally favorable hemodynamic performance with minimal transvalvular gradient. The use of small aortic valve prosthese in selected cases does not adversely affect the incidence of early or late mortality or cardiac events.
The results of long-term follow-up and hemodynamic performances after aortic valve replacement in the small aortic root are still controversial. This study was designed to assess the clinical and hemodynamic consequences of aortic valve replacement with 19 or 21 mm mechanical proshesis. Between January 1997 and March 1998 aortic valve replacement was performed in 36 patients whom divided in two groups. Group I consisted of 18 patients receiving either 19 or 21 mm St. Jude mechanical valves and group II consisted of 18 patients receiving either 23mm or larger sizes St. Jude mechanical valves. The clinical and echocardiographical studies were performed before the operation and postoperative period. There was no operative or late mortality in both groups. The morbidity was similar in two groups. There was a significant reduction of transvalvular gradient in group I and group II. Left ventricular ejection fraction was slightly increased in both groups. Left ventricular end-diastolic and end -systolic diameters were not significantly changed while interventricular septum and posterior wall thickness were regressed significantly in both group. These data show that 19 and 21 mm mechanical St. Jude valves exhibit equally favorable hemodynamic performance with minimal transvalvular gradient. The use of small aortic valve prosthese in selected cases does not adversely affect the incidence of early or late mortality or cardiac events.
Açıklama
Anahtar Kelimeler
Kalp ve Kalp Damar Sistemi
Kaynak
Türk Göğüs Kalp Damar Cerrahisi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
7
Sayı
2
