Orhan TEZCAN, ORKUT GÜÇLÜ, SÜLEYMAN YAZICI, Emre Demir BENLİ, Sinan DEMİRTAŞ, Celal YAVUZ, Ahmet ÇALIŞKAN, OĞUZ KARAHAN, Binali MAVİTAŞ

Kalp damar kliniğimizdeki 14 yıllık konjenital kalp hastalığı deneyimlerimiz

Amaç: Kliniğimizde konjenital kalp hastalığı tanısı ile tedavi edilen hastaların tanı ve tedavi sonuçlarını tartışmayı amaçladık. Yöntemler: Dicle Üniversitesi Kalp Damar Cerrahisi Anabilim Dalında, 2000-2014 tarihleri arasında konjenital kalp hastalığı tanıları ile tedavi edilen 78 hastaya ait kayıtlar retrospektif olarak incelendi. Hastalar 16 yaş ve altı (Grup I) ve 16 yaş üstü (Grup II) olmak üzere gruplandırıldı. Her iki grubun demografik özellikleri, sıklık sırasına göre görü- len patalojileri ve tedavi sonuçları karşılaştırıldı. Bulgular: Grup Ide 35 hasta, grup IIde 43 hasta vardı. Grup Ideki olguların 17si (%49) erkek, 18i (%51) kadın, yaş ortalaması 6,2 idi. Grup Ideki hastaların 17si atrial septal defekt (ASD) mevcuttu. Bu ASD lerin birine pulmoner darlık (PD), birine kleft mitrale, birine patent duktus arteriozus (PDA), birine de total pulmoner venöz dönüş anomalisi (TPVDA) eşlik ediyordu. Grup Ideki diğer hastaların 11i de PDA 7si ventriküler septal defekt (VSD) , 1i fallot tetralojisi (TOF), idi. Grup IIdeki olguların 9u (%21) erkek, 34ü (%79) kadın, yaş ortalaması 22,5 idi. Grup IIdeki hastaların ise 36inde ASD mevcuttu.Bu ASDlerin 2sinde PD, birinde kleft mitrale, birinde de PDA eşlik ediyordu. Grup IIdeki diğer hastaların 3ünde VSD, 2sinde TOF, 2sinde de PDA saptandı. Postoperatif erken dö- nemde 1 hasta kaybedildi. Sonuç: Birinci grupta en sık görülen patoloji ASD, ikinci grupta ise PDA idi. Birinci grupta çeşitli kompleks anomaliler görülürken ikinci grupta daha çok izole ASD gibi basit patolojiler tespit edildi.

14 years experience of congenital heart disease in our cardiovascular clinic

Objective: We aimed to discuss the treatment results of the patients with congenital cardiovascular diseases who were operated in our clinic Methods: Between 2000-2014, there were 78 patients with diagnosis of congenital heart disease, who were treated at Dicle University Cardiovascular Surgery Department, were retrospectively analyzed. Patients were separated into two groups as under the age of 16 (Group I) and older than 16 years (Group II). The demographic characteristics of both groups, frequency of observed pathology and treatment outcomes were compared. Results: There were 35 patients at group I, 43 patients at group II. 17 (49%) cases were male, 18 (51%) cases were female and the mean age was 6.18 at group I. Seventeen patients had atrial septal defect (ASD) in Group I. One pulmonary stenosis (PS), 1 cleft mitrale, 1 patent ductus arteriosus (PDA), and 1 total anomalous of pulmonary venous return (TAPVR) anomaly was accompanied to these ASD pathologies. Eleven patient had PDA, 7 had ventricular septal defect (VSD), 1 had Tetralogy of Fallot (TOF) in other patients group I. Nine of cases were male (21%) , 34 of cases (79%) were female, mean age was 22.47 at group II. Thirty six ASD was detected in Group II. Two of ASD were accompanied with pulmonary stenosis, one with cleft mitrale and 2 with PDA. Three VSD, 2 tetralogy of fallot (TOF), 2 PDA were detected in other patients in group II. One patient died at early postoperative period. Conclusion: In the group of children age, 48.5% of patients were male. The group of over 16 age , %79 of patient were male. At the group of children age, the common pathology was ASD however PDA is the common pathology at second group. While more complex anomalies were detected in the first group,at the second group rather non complex isolated anomalies as ASD were detected

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1. Çağatay G, Soydan İ. Klinik Kardiyoloji, İstanbul kitapevi.2013;22:355-356. 2. Hoffman JIE. İncidence of congenital heart disease: I. Postnatal incidence. Pediatr Cardiol 1995;16:103-113.
3. Rose V, Gold RJM, Lindsay G, et al. A possble increase inthe incidence of congenital heart defect among the offspring of affected parents. J Am Coll Cardiol 1985;6:376-382.
4. Paç M, Akçevin A,Aka A, et al. Kalp ve Damar Cerrahisi 2004;43:861-165.
5. Laks H, Marelli D, Drinkwater DC. Surgery for adults with congenital heart disease. In: Edmunds LH. Cardiac Surgery in the Adult 1st ed New York:McGraw-Hill. 1997:1365-66.
6. Gök H. Klinik Kardiyoloji,İstanbul kitapevi.2013;22:593.
7. Kirklin JW, Barratt-Boyes BG. Cardiac surgery New York. 1993:750-751.
8. Laver RM, Dushane JW, Edwards JE. Obstruction of left ventricular outlet in association with ventricular septal defect. Circulation.1960;22:110-117.
9. İsomatsu Y, İmai Y, Shinoka T, et al. The Journal of Thoracic and Cardiovascular Surgery.2001;122:527-528.
10. Arthur E Baue . Glenns thoracic and Cardiovascular Surgery 6th edition 1996:1115-1127.
11. Castaneda AR, Jonas RA, Mayer JE, et al. Cardiac surgery of the neonate and infant. J Thorac Cardiovasc Surg 1994:143-156.
12. Murphy JG, Gersh BJ, Mcgoon MD, et al. Long term outcome after surgical repair of isolated atrial septal defect. N Eng J Med 1990:1645.
13. Mitchell SC, Korones SB, Berendes HW. Congenital heart disease. Circulation; 1971;43:323-332.
14. De Cancq HE. Repair of patent ductus arteriosus. Am J Dis Child 1963;106:402.
15. Therrien J, Marelli AJ. Medical management of cyanotic congenital heart disease in adults. Contemporary Treatments in Cardiovascular Disease l997;2:227-240.
16. Jacobs JP, Burke RP,Quintessenza JA, et al. Congenital Heart Surgery Nomenclature and Database Project: atrioventricular canal defect. Ann Thorac Surg 2000; 69:36-43.
17. Walhout RJ, Lekkerkerker JC, Oron GH, et al. Comparison of polytetrafluoroethylene patch aortoplasty and end-to-end anastomosis for coarctation of the aorta. J Thorac Cardiovasc Surg 2003;126:521-528.
18. Mazzitelli D, Schreiber C, Guenther T, et al. Twenty-five years of experience with repair of tetralogy of Fallot in the first year of life [abstract]. Glasgow: European Association of Cardio-Thoracic Surgery; 1999.
19. Castaneda AR. Classical repair of tetralogy of fallot: timing, technique and result. Semin Thorac Cardiovasc Surg 1990;2:70-75.