Erişkin opere aort koarttasyonunda arteriyel kan basınç analizi

Amaç: Erişkinlerde aort koarktasyon cerrahisinin arteriyel kan basıncı üzerine etkisini belirlemek amaçlandı. Yöntem: Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Merkezinde 1962-1998 yılları arasında aort koarktasyonu nedeniyle öpere edilen 15-43 yaşlarındaki 93 erişkin hasta (61 erkek, 32 kadın) retrospektif olarak incelendi. Çalışmaya alınan hastaların 32'sine tüp greft interpozisyonu, 31'ine rezeksiyon-uç uca anastomoz, 24'üne patchplasti ve altısına şant operasyonu uygulandı. Hastaların preoperatif ve postoperatif (operasyon sonrası ortalama 9.011.2 gün) arteriyel kan basınçları karşılaştırıldı. Bulgular: Öpere edilen hastaların ortalama postoperatif sistolik (147.4±22.0 mm Hg) ve diastolik (82.0±10.8 mm Hg) kan basınçlarında preoperatif (Sistolik. 193.6±33.7 mm Hg, diyastolik: 99.8±17.9 mmHg) döneme göre anlamlı azalma görüldü. Hepsi hipertansif olan 93 hastanın 54'ünde operasyon sonrası kan basınç değerleri ABD VI. Birleşik Ulusal Komitesi'nin değerlerine göre normal sınırlarda idi. 15-19 yaş grubundaki 37 hastanın 28'i, 20-24 yaş grubundaki 23 hastanın 14'ü, 25-29 yaş grubundaki 16 hastanın 4'ü, 30-34 yaş grubundaki 11 hastanın 6'sı ve 35 yaş üstündeki 6 hastanın 2'sinin kan basınçları normal sınırlarda idi. Sonuç: Erişkinlerde aort koarktasyonu cerrahi tedavisiyle sistolik ve diastolik kan basınçlarında önemli düşüşler saptandı. Ancak yaş ilerledikçe cerrahiye rağmen kalıcı hipertansiyonda artış olduğu görüldü.

Blood pressure changes after adult aorta coarctation surgery

Objective: In this study, it was aimed to determine adult aorta coarctation surgery on arterial blood pressure. Methods: 93 adult patients (61 male, 32 female) aged 15-43 yrs who had operation between 1962 to 1998 for aortic coarctation in Siyami Ersek Cardiovascular Surgery Center were retrospectively evaluated. Tube graft interposition was done in 31 patients, resection and end to end anastomosis in 32 patients, patchplasty in 24 patients and by-pass procedure in 6 patients. The effect of surgery on the blood pressure was investigated. Results: The mean sistolic and diastolic blood pressure significantly reduced after operation (sistolic 193. 6±33.7 mmHg vs 147.4±22.0 mmHg, diastolic 99.8±17.9 mmHg vs 82.0±10.8 mmHg). From 93 patients (all with hypertension) 54 became normotensive after operation according to USA VIth National Committee Classification. Number of normotensive patients after operation was 28 (of 37) for 15-19 yrs group, 14 (of 23) for 20-24 age group, 4 (of 16) for 25-29 age group, 6 (of 11) for 30-34 age group and 2 (of 6) for over age group. Conclusion: The diastolic and systolic blood pressures reduce significantly in the adult patients operated for aortic coarctation. On the other hand, persistent hypertension seemed to increase in the older age groups in spite of the surgery.

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