Arman BİLGİÇ, Gülden KAFALI, Alpay ÇELİKER

Balon anjiyoplasti yapılmış nativ koarktasyonlu çocuklarda izlem sonuçları ve komplikasyonlar

Amaç: Balon anjiyoplastinin (BA) yol açabileceği komplikasyonlar ve rekoarktasyon için risk taşıması nedeniyle infant ve çocuklardaki kullanımı tartışmalıdır. Nativ koarktasyonlu 31 olguyu işlemden 29±18 ay sonra kontrol anjiyografi ile değerlendirdik.Yöntemler: Olgular kontrol anjiyografi bulgularına göre başarılı izlem ve yeniden girişim grubuna ayrılarak, işlemöncesi ve sonrası veriler karşılaştırıldı. Koarkte segmentin elastik özelliklerinin, aortik segmentlerin hipoplazisininve patent duktus arteriozus (PDA) bulunmasının yeniden girişim için risk faktörü olup olmadıkları araştırıldı. Komplikasyonlar kaydedildi.Bulgular: Olguların BA yaşı 2.9±3.7 yıl idi. 29 olguda (%93.5) diskret tipte koarktasyon saptandı. Patent duktusarteriozus 5 olguda (%16) mevcuttu. Yirmidokuz olguda (%94) anjiyoplasti başarılı idi. Rezidüel gradiyentte artışsaptanan 2 başarısız olgu ile 9 başarılı olguda rekoarktasyon gelişmesi nedeniyle yeniden girişim (%35.5) gerekti.İşlem sonrası rekoarktasyon gelişmeyen 20 olgu ise (%64.5) başarılı izlem grubu olarak alındı. Başarılı izlem grubunun balon yarıçapı ile çevre ‘’stretch’’ yüzdesi anlamlı olarak daha yüksek bulundu (p

Follow-up results and complications of balloon angioplasty in children with native coarctation

Objective: Balloon angioplasty (BA) is controversial in infants and children with native coarctation because it has the potential risk of complications and recoarctation. We evaluated 31 children with native coarctation by controlangiography after 29±18 months. Methods: The patients were separated as successful follow-up and reintervention groups. All data before and after BA were compared in these groups. The possibility of whether elastic properties of the coarcted segment, hypoplasia of aortic segments and, the presence of a patent ductus arteriosus (PDA) are risk factors or not in the reintervention was investigated. Complications were recorded.Results: The patients’ average age at procedure were 2.9±3.7 years. Twenty nine patients (93.5%) had discrete coarctation and 5 patients (16%) had PDA. Balloon angioplasty was successful in 29 patients (94%). As a result of control angiography, 2 patients with increased residual gradient and 9 who developed recoarctation were the reintervention group (35.5%). Twenty patients (64.5%) were the successful follow-up group. Balloon half diameter and circumference stretch percent of the suc cessful group were signii cantly higher (p

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