Sedat TAŞ, Ümmü TAŞ

Mitral Aparatların Korunması Yöntemi ile Yapılan Mitral Kapak Replasmanı Sonrasında Transtorasik Ekokardiyografide Görülen Kafa Karıştırıcı Hareketli Kitle

Ciddi mitral yetmezlik anlamlı morbidite ve mortalite ile ilişkilidir. Semptomatik ciddi mitral yetmezliği olan hastalara mitral kapak onarımı ya da mitral kapak replasmanı önerilir. Mitral kapak replasmanı sırasında sub valvular aparatın korunması postoperatif iyi sonuçlara sahiptir. Biz burada mitral aparat korunarak yapılan mitral kapak cerrahisi sonrası ekokardiyografi ile tespit ettiğimiz mitral aparat kalıntıları olan bir vaka taktim ettik. Vakamız 44 yaşında idi. Romatizmal, semptomatik ciddi mitral yetmezliği olan hastaya subvalvüler aparat korunarak mitral kapak replasmanı yapıldı. Post-operatif 3. günde yaptığımız ekokardiyografide sol ventrikül içinde hareketli bir kitleye rastladık. Laboratuvar paramet releri, kan kültürü ve seri ekokardiyografi yardımı ile kitle sebebini aydınlattık ve vaka olarak takdim ettik. Bu vakada mitral kapak replasmanı yapılmış hastalarda, postoperatif ekokardiyografik değerlendirmenin ve hastayı bir bütün olarak değerlendirmenin önemini vurgulamak istedik. Ardışık ekokardiyografik değerlendir me bu kapsamlı değerlendirmenin en önemli öğelerinden biridir.

A Confounding Mobile Mass Observed in Transthoracic Echocardiography After Mitral Valve Replacement Performed by the Preservation of the Native Mitral Apparatus

Severe mitral regurgitation is associated with significant morbidity and mortality. Mitral valve repair or mitral valve replacement is recommended for symptomatic patients. Preservation of the subvalvular apparatus has the merits of postoperative outcomes during mitral valve replacement for mitral regurgitation. We report a case of a remnant mitral subvalvular apparatus detected by echocardiography after chordal preserving mitral valve replacement. It was performed as mitral valve replacement with posterior leaflet chordal preservation in a 44-year-old male patient due to rheumatic, symptomatic severe mitral regurgitation. On the third post operative day, routine postoperative trans-thoracic echocardiography showed an unknown mobile mysterious formation in the left ventricle. We clarified the mysterious mass with the help of laboratory, blood culture and serial echocardiographic assessment and presented this case. We emphasize the importance of post-operative echocardiographic evaluation and a complete evaluation of the patients who have undergone mitral valve replacement. Serial echocardiographic evaluation is the main part of this assessment.

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