Ulaş KUMBASAR, Hatice Hale TEMEL, Onur SAYDAM, HASAN TOLGA ÇELİK, MURAT GÜVENER, RIZA DOĞAN, Metin DEMİRCİ, İlhan PAŞAOĞLU

The role of mean platelet volume as a predictor of postoperative shunt occlusion in children who underwent modified blalock-taussig shunt surgery

Purpose:Backgrounds:The modified Blalock-Taussig shunt (mBTS) is a palliative procedure which is often performed to maintain additional pulmonary blood flow. Postoperative shunt patency is critical in order to provide adequate systemic oxygenation. Mean platelet volume (MPV) correlates with platelet function and there is a possible correlation between an increase in MPV and the risk of thrombosis. Aim:The aim of this study was to determine the role of MPV as a potential risk factor in postoperative early shunt occlusion in children underwent mBTS surgery. Materials and methods:This study was carried out with 1117 women. Body Mass Index was calculated by the formula: body weight/height (kg/m²), body composition was assessed by bioelectrical impedance analysis; waist circumference was measured and waist/height ratio was calculated. For determining the physical activity status of individuals, individual physical activity records were investigated. In addition, the variables associated with obesity were assessed in relation to BMI. Results:In the majority of cases the operation was performed via thoracotomy (89.7%). The shunt was constructed between the subclavian artery and pulmonary artery in 187 cases. In the remaining 8 patients the shunt was connected to the innominate artery. Twenty-three patients (11.8%) experienced early shunt occlusion. Preoperative MPV levels were 8.2 (6.2-14.0) in no occlusion group and 8.3 (6.9-10.7) in occlusion group. Neither MPV nor other variables showed a statistically significant association with early shunt occlusion Conclusion:Despite some other studies demonstrating an association between high MPV levels and thrombosis, we could not find any statistically significant association between MPV and early shunt occlusion.

ModifiyeBlalock-Taussig Şant Operasyonu Geçiren Çocuklarda Erken Şant Oklüzyonu Öngörmede Ortalama Trombosit Hacminin Rolü

Amaç:Modifiye Blalock-Taussig (mBTS) şantı pulmoner kan akımını arttırmak amacı ile yapılan palyatif bir prosedürdür.Yeterli sistemik oksijenasyonu sağlayabilmek için şant açıklığının kritik önemi vardır. Ortalama trombosit hacmi (OTH),trombosit fonksiyonu ile ilişkilidir. Bu ilişki aynı zamanda artmış OTH ve tromboz riski arasında da olduğu düşünülmektedir. Çalışmamızın amacı mBTS operasyonu geçiren çocuklarda OTH’nin potansiyel bir risk faktörü olarak erken şant oklüzyonundaki rolünü belirlemektedir. Gereç ve yöntem:Çalışma Planı:Retrospektif kesitsel çalışma. Bu vaka kontrol çalışması Ocak 2006 ve Mart 2013 tarihleri arasında tıbbi kayıtlardan derlenmiştir. Toplamda 195 hasta çalışmaya dahil edilmiştir. Fonksiyonel tek ventrikül, Konoventriküler septum malalignment’i olan veya olmayan pulmoner atrezi ve pulmoner stenoz tanısı olan çocuklar dahil edilmiştir. Bulgular:Operasyonların büyük çoğunluğu torakotomi ile yapılmıştır (%89,7). 187 hastada şant subklavyen arter ve pulmoner arter arasında oluşturulmuştur. Kalan 8 hastada ise şant innominate arter ve pulmoner arter arasında oluşturulmuştur.23 hastada (%11,8) erken şant oklüzyonu izlenmiştir. Preoperatif OTH oklüzyon olmayan grupta 8.2 (6.2-14.0) iken oklüzyon izlenen grupta bu değer 8.3 (6.9-10.7) olarak izlenmiştir.OTH ve diğer değişkenler erken şant oklüzyonu izlenen ve izlenmeyen gruplar arasında istatiksel olarak anlamlı fark göstermemiştir. Sonuç:OTH ve trombozis arasındaki ilişkiyi gösteren yayınlardan farklı olarak çalışmamızda OTH ve erken şant oklüzyonu arasında istatiksel olarak anlamlı bir ilişki bulunamamıştır.

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