Esra ERTÜRK TEKİN, Uğurcan SAYILI, Atakan ATALAY, Ayhan UYSAL, Yüksel BAŞTÜRK, Mehmet Şah TOPÇUOĞLU

Down Sendromlu Çocuklarda Komplet Atriyoventriküler Septal Defektin Cerrahi Onarımı Sonrası Erken Postoperatif Sonuçlar

Amaç: Bu çalışmanın amacı Down Sendromu olan ve Down Sendromlu olmayan komplet atriyoventriküler septal defekt (AVSD) onarımı yapılan çocukların erken postoperatif sonuçlarını değerlendirmektir. Gereç ve Yöntem: Bu prospektif çalışmaya komplet AVSD’ nin cerrahi onarımını takiben pediatrik yoğun bakım ünitesine yatırılan 20’si DS’ li olmak üzere toplam 30 çocuk dahil edildi. Bulgular: DS’ li çocuklar sayısal olarak daha erken ameliyat edilmişti. DS ve Down sendromlu olmayan (NDS) gruplar için sırasıyla medyan 16.5 ay (4-72) ve 23 ay (3-48) (p =0.640). Erken postoperatif mortalite yoktu. En sık görülen aritmi ektopik taşikardi idi ve iki grup arasında ektopik taşikardi oranı benzerdi (p =1). DS’ li çocuklarda, NDS grubu çocuklara göre pnömotoraks, plevral efüzyon ve enfeksiyon gibi kardiyak olmayan komplikasyon oranı toplamda anlamlı olarak daha yüksekti (p =0.032). DS' li çocuklarda mekanik ventilasyon ihtiyacı NDS grubuna gruba göre anlamlı düzeyde yüksekti ve bu süreler sırasıyla 6.8 saat ((2-37 saat) ve 1.9 saat (1-4 saat), p =0.013) şeklindeydi. Ancak, iki grup arasında yoğun bakım ve hastanede kalma süresi açısından istatistiksel olarak anlamlı fark yoktu (sırasıyla 9 gün (1-37 gün) ve 4.9 gün (0-13 gün), p =0.166). Sonuç: DS’ li çocuklarda, NDS grubu çocuklara göre erken postoperatif dönemde kardiyak olmayan komplikasyon oranı anlamlı derecede daha yüksekti.

Early Postoperative Outcomes After Surgical Repair of Complete Atrioventricular Septal Defects in Children with Down Syndrome

Objective: The aim of this study is to evaluate the early postoperative outcomes of children with and without Down syndrome (DS) who underwent complete atrioventricular septal defect repair surgically. Material and Method: In this prospective study, a total of 30 children, 20 of whom had Down syndrome, were admitted to the pediatric intensive care unit following surgical repair of complete atrioventricular septal defect. Results: Children with DS were operated numerically earlier. Median ages were: 16.5 months (4-72) and 23 months (3-48) for DS and Non- Down syndrome (NDS), respectively (p =0.640). There was no early postoperative mortality. The most common arrhythmia was ectopic tachycardia, and the prevalence of ectopic tachycardia was similar between the two groups (p =1). The total rate of non-cardiac complications such as pneumothorax, pleural effusion and infection was significantly higher in children with DS than in children without DS (p =0.032). There was a significantly longer duration of mechanical ventilation of 6.8 hours ((2-37 hours) in children with DS and 1.9 hours (1-4 hours) in the NDS group, respectively, p =0.013). However, there was no statistical difference between the two groups in terms of ICU and hospital stay (9 days (1-37 days) and 4.9 days (0-13 days), respectively, ( p =0.166). Conclusion: The rate of non-cardiac complications in the early postoperative period was significantly higher in children with DS compared to children without DS.

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