Yenidoğan ve Bebeklik Döneminde Arkus Aorta Rekonstrüksiyonları

Giriş: Aortik ark hipoplazisinin çeşitliliği yenidoğan hastalarda geniş bir spektrumda görülebilir. Bu yazıda koarktasyon ve hipoplastik aortik ark tanılı hastalarda, aortik ark rekonstrüksiyonu tartışılacak, yenidoğan ve bebek hastalarda cerrahi kararlara ve hasta yönetimine odaklanılacaktır. Hastalar ve Yöntem: Aortik ark rekonstrüksiyonu yapılan 15 hasta retrospektif olarak incelendi. Beraberinde komplike doğumsal kalp hastalıkları bulunan bu hastalarda operasyon sonrası cerrahi sonuçları araştırıldı. Bulgular: Hastaların ortanca yaşı 74 gün (4-306 gün) ve ortalama ağırlığı 4192 ± 1253 gram idi. Aortik ark doğumsal hastalığının cerrahi tedavisi, 15 hastada antegrad serebral perfüzyon ile yapılmıştır. Bütün hastalarda aortik rekonstrüksiyon perikardiyal yama ile yapılmış ve yedi hastada koarkte segment tamamen rezeke edilmiştir. Hastaların yedisinde tek aşamalı onarım gerçekleştirilmiştir. Ortalama takip süresi 13.7 ± 9.3 aydı. Bir hastaya tekrar gelişen aort koarktasyonu nedeniyle ameliyat sonrası altıncı ayda balon anjiyoplasti uygulanmıştır. Takip sırasında bir erken ve bir geç mortalite saptanmıştır. Sonuç: Yenidoğan ve bebeklerde aortik ark rekonstrüksiyonları düşük mortalite ve morbidite oranlarıyla yapılabilmektedir.

Anahtar Kelimeler:

Arkus aorta hipoplazisi, cerrahi düzeltme

Arcus Aorta Reconstructions in Neonates and Early Infants

Introduction: Various instances of aortic arch hypoplasia (AAH) with a wide spectrum of severity have been observed in the neonatal patients. The purpose of this paper is to discuss the aortic arch reconstruction in the coarctation of the aorta and AAH while focusing on the surgical decisions and patient management for the neonatal and infant patients. Patients and Methods: We performed a retrospective review of 15 patients who underwent aortic arch reconstruction. Importantly, we investigated postoperative outcomes with associated complex congenital heart diseases. Results: The median age and mean weight of the patients were 74 days (range: 4-306 days) and 4192 ± 1253 gram, respectively. The surgical correction of aortic arch congenital abnormalities was performed under selective antegrade cerebral perfusion in all the 15 patients. All the reconstructions were performed with pericardial patch, and the coarcted segment of the aorta was completely resected in seven of the patients. One-stage repair was performed in the seven of the patients. The mean follow-up time was 13.7 ± 9.3 months. In one patient, transcatheter balloon angioplasty was performed for re-coarctation six months after operation. There was one early and one late mortality. Conclusion: Aortic arch reconstruction can be performed with a low mortality and morbidity in the newborn and infants.

Keywords:

Arch of the aorta, reconstructive surgical procedure aortic arch reconstruction, neonate,

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi