Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass
Küçük Resim Yok
Tarih
2015
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada bidireksiyonel kavopulmoner anastomoz oluşturmak için atan kalpte kavoatriyal şant tekniğinin sonuçları sunuldu. Çalışmaplanı:Nisan 2003 - Kasım 2012 tarihleri arasında tek ventrikül kalp fizyolojisi olan 38 ardışık hastaya (18 erkek, 20 kız; ort. yaş 14.9±16.8 ay; dağılım 4 ay - 2.5 yıl) atan kalpte bidireksiyonel kavopulmoner anastomoz uygulandı. Ameliyat sırasında ortalama vücut ağırlığı 8.3±3.6 kg idi. Ameliyat öncesi ortalama oksijen satürasyonu ve pulmoner arter basıncı sırasıyla %70.7±9.4 ve 14.0±3.8 mmHg idi. Bul gu lar: Ameliyata bağlı mortalite görülmedi. Ortalama vena kava superior klemp zamanı ve klemp sırasında vena kava basıncı sırasıyla 24.3±4.7 dakika ve 26.9±5.5 mmHg idi. Ameliyat sonrası nörolojik komplikasyon veya ritim bozuklukları görülmedi. Ameliyat sonrası oksijen satürasyonu %85.9±5.9 idi. Ameliyat sonrası dört hasta kaybedildi. Ortalama yoğun bakım ünitesinde kalış süresi iki gün idi. Takip ekokardiyografisinde herhangi bir tıkanıklık olmaksızın, fonksiyonel bidireksiyonel kavopulmoner anastomoz izlendi. So nuç: Kavoatriyal şant desteği ile kardiyopulmoner baypas kullanılmadan bidireksiyonel kavopulmoner anastomozu uygulanabilir ve güvenli bir yöntemdir. Ayrıca, kardiyopulmoner baypasın olumsuz etkilerini de ortadan kaldırır.
Background: in this article, we present the results of an off- pump cavoatrial shunt technique to creat a cavopulmonary bidirectional anastomosis. Methods: Thirty-eight consecutive patients (18 boys, 20 girls; mean age 14.9±16.8 months; range 4 months to 2.5 years) with univentricular heart physiology underwent an off-pump cavopulmonary bidirectional anastomosis between April 2003 and November 2012. the mean weight during surgery was 8.3±3.6 kg. the mean preoperative oxygen saturation and pulmonary artery pressure were 70.7±9.4% and 14.0±3.8 mmHg, respectively. Results: There was no surgery-related mortality. the mean superior vena cava clamping time and the mean vena cava pressure during clamping were 24.3±4.7 minutes and 26.9±5.5 mmHg, respectively. There were no postoperative neurological complications or dysrhythmias. the mean postoperative saturation was 85.9±5.9%. There were four postoperative deaths. the mean length of intensive care unit stay was two days. Follow-up echocardiography showed functioning cavopulmonary bidirectional anastomosis without any obstruction. Conclusion: the cavopulmonary bidirectional anastomosis without cardiopulmonary bypass with the support of a cavoatrial shunt is a feasible and safe method. It also eliminates the adverse effects of cardiopulmonary bypass.
Background: in this article, we present the results of an off- pump cavoatrial shunt technique to creat a cavopulmonary bidirectional anastomosis. Methods: Thirty-eight consecutive patients (18 boys, 20 girls; mean age 14.9±16.8 months; range 4 months to 2.5 years) with univentricular heart physiology underwent an off-pump cavopulmonary bidirectional anastomosis between April 2003 and November 2012. the mean weight during surgery was 8.3±3.6 kg. the mean preoperative oxygen saturation and pulmonary artery pressure were 70.7±9.4% and 14.0±3.8 mmHg, respectively. Results: There was no surgery-related mortality. the mean superior vena cava clamping time and the mean vena cava pressure during clamping were 24.3±4.7 minutes and 26.9±5.5 mmHg, respectively. There were no postoperative neurological complications or dysrhythmias. the mean postoperative saturation was 85.9±5.9%. There were four postoperative deaths. the mean length of intensive care unit stay was two days. Follow-up echocardiography showed functioning cavopulmonary bidirectional anastomosis without any obstruction. Conclusion: the cavopulmonary bidirectional anastomosis without cardiopulmonary bypass with the support of a cavoatrial shunt is a feasible and safe method. It also eliminates the adverse effects of cardiopulmonary bypass.
Açıklama
Anahtar Kelimeler
Kalp ve Kalp Damar Sistemi, Cerrahi
Kaynak
Türk Göğüs Kalp Damar Cerrahisi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
23
Sayı
4
