Tayyar SARIOĞLU, Ahmet ARNAZ, Rıza TÜRKÖZ, Ayla OKTAY, Yusuf YALCİNBAS, Ayşe SARIOĞLU, Abdullah DOGAN, Arda SAYGILI

Ebstein Anomalisi; Cerrahi Yaklaşım ve Orta Dönem Sonuçları

Amaç: Bu çalışma ile Ebstein anomalili hastalarda yapılan cerrahi teknikler vesonrası takipleri geriye dönük takiplerininin değerlendirilmesi amaçlanmıştır.Yöntem: Çalışmaya Temmuz 2003 ile Şubat 2018 arasında Ebstein anomalisitanısı ile hastanemizde ameliyat edilen 13 hastanın tıbbi kayıtları geriye dönükolarak ilk geliş kliniği, cerrahi müdahale ve ameliyat sonrası verilere göregözden geçirildi.Bulgular: Onüç hastanın %46,2’si (n=6) kadın, %53,8’i (n=7) erkek idi. Olgularınyaşları ortalama 13,15±11,07 (2-31 yıl) yıldır. Ameliyat öncesi ekokardiyografideğerlendirmelerinde hastaların %92,3’ünde (n=12) ileri triküspit yetersizliğivardı. Bu hastaların 4’ünde triküspit kapak replasmanı, 5’inde triküspit kapakonarımı, 2’sinde Cone rekonstrüksiyonu, 2’sinde ise ileri derecede sağ ventrikülfonksiyon bozukluğu nedeni ile kapak tamiri ile birlikte kava-pulmoner şantameliyatları yapılmıştır. Hastalar ortalama 6,31±3,40 (1-14 yıl) süre ile takipedilmişlerdir. İlave anomaliler nedeni ile ek olarak % 53,8 (n=7) hastada atrialseptal defekt kapatılması, %7,7 (n=1) hastada mitral kapak replasmanıameliyatları yapılmıştır. Hastaların %23,1’inde atrial fibrilasyon/flutter vardı vebu üç hastaya ablasyon prosedürü uygulandı.Sonuç: Tüm Ebstein anomalili hastalarda opere olsun yada olmasın kalpyetmezliği, aritmiler, siyanoz ve diğer ilişkili bulguların belirtileri vesemptomları için uzun klinik izlemin gerekmektedir.

Ebstein's Anomaly; Surgical Approach and Mid-term Results

Objectives: In this study, it is aimed to evaluate the operations performed for Ebstein ’s anomaly retrospectively. Study design: Between July 2003 and February 2018, the medical records of 13 patients who were operated on with the diagnosis of Ebstein’s anomaly were reviewed retrospectively according to the clinical symptoms, surgical procedure, and postoperative follow-up. Results: Of the thirteen patients, 46.2% (n = 6) were female and 53.8% (n = 7) were male. The mean age of the cases is 13,15 ± 11,07 years (2-31 years). Preoperative echocardiographic evaluations revealed severe tricuspid regurgitation in 92.3% (n = 12) of the patients. In these patients, tricuspid valve replacement was performed in 4, tricuspid valve plasty in 5, Cone reconstruction in 2, and cava-pulmonary shunt with tricuspid valve plasty in 2 were performed. Patients were followed for an average of 6.31 ± 3.40 (1-14 years). Atrial septal defect closure in 53.8% (n = 7) patients and mitral valve replacement in 7.7% (n = 1) patients were performed due to additional anomalies. Atrial fibrillation/flutter was present in 23.1% of the patients and ablation procedure was applied to these three patients. Conclusion: Long-term clinical follow-up is required for the signs and symptoms of heart failure, arrhythmia, cyanosis and other related findings both in operated and non-operated patients with Ebstein’s anomaly.

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