İFLAS EDEN FONTAN DOLAŞIMI “GÜNCEL CERRAHİ VE MEDİKAL TEDAVİ SEÇENEKLERİ”

Tek ventrikül anatomisine sahip hastalarda uygulanan Fontan operasyonu sistemik venöz kanın pulmoner venöz dolaşımdan ayrılmasını sağlayarak bu hasta grubunun tedavisinde çığır açmıştır. Hastaya spesifik faktörlerin tanımlanması, uygulanan cerrahi tekniklerdeki modifikasyonlar ve ameliyat sonrası bakımdaki ilerlemeler sayesinde günümüzde Fontan operasyonu sonrası sağkalım oranı yükselmiştir. Fontan operasyonu sonrası erken veya geç dönemde Fontan dolaşımının iflası meydana gelebilir. İlerleyici ventriküler disfonksiyon, disritmi, ilerleyici hipoksemi, siyanoz, pulmoner vasküler rezistansta artma veya protein kaybettiren enteropati gelişebilen bu hasta grubu günümüzde daha fazla görülmektedir. Bu makalede Fontan dolaşımının iflasına yol açan nedenler ve bu durumlarda uygulanabilecek cerrahi veya medikal tedavi seçenekleri tartışılmaktadır.

Anahtar Kelimeler:

Fontan, Tek ventrikül, Protein-kaybettiren enteropati, İflas eden Fontan dolaşımı

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Fontan operation broke fresh ground in the treatment of patients with single ventricle anatomy by separating the systemic venous blood from pulmonary venous circulation. Survival rate following Fontan operation improved recently due to the discovery of patient specific factors, modifications in surgical techniques and improvement in postoperative patient care. Failure of Fontan circulation may happen in early or late follow-up period following Fontan operation. Progressive ventricular dysfunction, dysrhythmia, progressive hypoxemia, cyanosis, increase in pulmonary vascular resistance or protein-losing enteropathy may be observed in this patient group which is more frequently encountered at present. Conditions causing failure of Fontan circulation and the surgical or medical treatment options are discussed in this article.

Keywords:

Fontan, Single ventricle, Protein-losing enteropathy, Failing Fontan circulation,

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Başlangıç: 1916
Yayıncı: İstanbul Üniversitesi Yayınevi

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