TUĞRA GENÇPINAR, Çağatay BİLEN, Gökmen AKKAYA, SERDAR BAYRAK, HÜSEYİN HÜDAİ ÇATALYÜREK

İZOLE KARDİAK KİST HİDATİK HASTALIĞINA CERRAHİ YAKLAŞIM VE YÖNTEMLER

Giriş: Kardiyak Hidatik kist hastalığı Ecchinocccus Granulosus larvasının neden olduğu oldukça nadir görülen parazitik bir enfeksiyon hastalığıdır. Semptomlar kistin lokalizasyon bölgesine göre değişir. Kalp bölümlerine ve perikard içine rupture olabilir ve ani ölümle sonuçlanabilir. Kesin tedavi acil kalp ameliyatıdır. Bu retrospektif çalışmanın amacı, izole kardiyak kist hidatik hastalığına cerrahi yaklaşımların sonuçları ile değerlendirilmesidir. Gereç ve Yöntem: 2010-2015 yılları arasında tek merkezde kardiak kist hidatik tanısı alan ve opera edilen 6 erkek 3 kadın 9 hasta çalışmaya dahil edildi. Hastaların perioperative demografik verileri kayıt altına alındı. Hastaların taburculuk sonrası erken dönemde, birinci, üçüncü, altıncı ve on ikinci aylarda kontrol TTE ve sonrasında yıllık TTE takipleri ile uzun dönem yeniden cerrahi müdahale gerekliliği açısından izlendi. Bulgular: Hastalar operasyon sonrası ortalama 4,77±2,43 yıl takip edildi. Ortalama yaşları 38,88±19,7, olarak saptandı. İki hastaya torakotomi, 7 hastaya sternotomi uygulandı. Ortalama kardiopulmoner baypas süreleri 33,33±12,74 dakika ve ortalama aortic kross klemp süreleri 25,33±11,01 dakikaydı. Ortalama entübasyon ve yoğun bakım kalış süreleri 1,44±0,72, 3,44±1,74 gün olarak saptandı. Tüm hastalar postoperative kontrollerde NYHA class 1 olarak saptandı. Sonuç: Kardiyak kist hidatik nadir bir hastalık olsa da ülkemiz gibi endemic olduğu yerlerde atipik kardiyakyakınması olan hastalarda akılda tutulmalıdır. Potansiyel rupture ve buna bağlı gelişebilecek komplikasyonlar göz önüne alınarak cerrahi tedavi öncelikli olarak düşünülmelidir.

SURGICAL APPROACH AND MANAGEMENT TO ISOLATED CARDIAC CYST HYDATID DISEASE

Introduction:Cardiac Hydatic cyst disease is is a rare infestation of the larva of Ecchinocccus Granulosus. Symptoms depend on cysts localisation and site. Because of the risk of rupture into cardiac chambers and pericardium may result in sudden death. The mainstay of the treatment is urgent surgery. The purpose of this retrospective study is to evaluate the outcomes of surgical approaches to isolated cardiac hydatid cyst disease. Material and Method: Between 2010 and 2015, 9 male, 6 male, 3 female, who were diagnosed cardiac hydatid cyst and operated in a single center, were included in the study. Patient's perioperative demographic data were recorded. Patients were followed-up in the early post-discharge period in the first, third, sixth and twelfth months in terms of control TTE and subsequent annual TTE follow-ups in terms of long term re-surgical intervention. Results: The mean follow-up period was 4.77 ± 2.43 years. Their mean age was 38,88 ± 19,7. Two patients underwent thoracotomy and seven patients underwent sternotomy. Mean cardiopulmonary bypass times were 33.33 ± 12.74 minutes and mean aortic cross-clamp times were 25.33 ± 11.01 minutes. Mean intubation and intensive care unit stay were 1.44 ± 0.72, 3.44 ± 1.74 days. All patients were NYHA class 1 postoperative controls. Conclusion: Although cardiac hydatid disease is a rare disease, it should be remembered in patients with atypical cardiac complaints where they are endemic like our country. Considering potential rupture and associated complications, surgical treatment should be considered as a priority.

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