Tulay DEMİRCAN, Onur IŞIK, Muhammet AKYÜZ, Dilek ONCEL, Ali Rahmi BAKİLER

Fallot Tetralojili Olguların Preoperatif Deg erlendirilmesinde BT Anjiyografinin O nemi; Tek Merkez Deneyimi

Çalışmamızda Fallot tetralojili olgularda koroner ve pulmoner arter anomalileri ve eşlik eden ekstrakardiyak malformasyonların değerlendirilmesinde Bilgisayarlı Tomografi (BT) anjiyografinin tanısal önemi araştırıldı. Ayrıca operasyon öncesi çekilen BT anjiyografinin cerrahi açıdan faydalarını değerlendirmeyi amaçladık. Ocak 2016- Ocak 2018 tarihleri arasında Fallot tetralojisi (pulmoner kapak yokluklu ve pulmoner atrezili dahil) tanısı konulan olguların dosyaları geriye dönük olarak incelendi. Bilgisayarlı Tomografi anjiyografi çekilmemiş olanlar ve dosyasında eksik veri bulunanlar çalışmaya dahil edilmedi. Hastaların yaşı, cinsiyeti, operasyon yaşı, ekokardiyografi, BT anjiyografi ve operasyon sonuçları değerlendirildi. Toplam 32 hasta çalışmaya alındı. Ortalama yaşları 18±17 (1-84) ay idi. 32 hastanın 6’sında pulmoner kapak atrezili ve 1 olguda pulmoner kapak yokluklu Fallot tetralojisi vardı. BT anjiyografi ile saptadığımız ekstrakardiyak malformasyonlar 6 olguda aortopulmoner kolleteral arter, 2 olguda retroaortik seyirli inominate ven,1 olguda aberran sağ subklavian arter ve 1olguda koroner arter anomalisi idi. Fallot tetralojili hastalarda pulmoner arterlerin konfluensi, çapları ve aortopulmoner kolleteral arter gibi vasküler yapıları göstermede BT anjiyografi önemlidir. Bu inceleme cerrahi seçimi ve yaklaşım açısından belirgin fayda sağlamaktadır.

Importance of CT Angiography in Preoperative Evaluation of Patients With Tetralogy of Fallot; Single Center Experience

The aim of this study is to investigate the diagnostic significance of Computerized Tomography (CT) angiography in the evaluation of coronary and pulmonary artery anomalies and accompanying extracardiac structures in pediatric patients with tetralogy of Fallot. We also aimed to evaluate the surgical benefits of CT angiography performed before operation. The data of patients with operated tetralogy of Fallot and variants were retrospectively reviewed between January 2016- January 2018. Patients without CT angiography examination and cases with missing data were not included in the study. The age, gender, age at diagnosis, echocardiography and CT angiography and operation procedure were evaluated. A total of 32 patients were included in the study. The mean age of the patients was 18±17 (1-84) months. Of the patients, 6 had Tetralogy of Fallot with pulmonary atresia and 1 had tetralogy of Fallot without pulmonary valve. The extracardiac malformations detected by CT anjiography were aortopulmonary collateral artery in 6 patients, retroaortic innominate ven in 2 patients, aberrant right subclavian artery in 1 patient and coronary artery anomaly in 1 patient. CT angiography is important in patients with tetralogy of Fallot showing concomitant pulmonary artery confluence, diameter and aortopulmonary collateral artery. This examination provides significant benefits in terms of surgical choice and approach.

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