Fallot Tetralojisi Tanısı İle Takip Edilen Hastaların Kısa ve Orta Dönem Sonuçlarının Değerlendirilmesi

Amaç: Fallot tetralojisi tanısı alan çocuklarda, belirli bulguların varlığında, düzeltme ameliyatları yapılmaktadır. Bu çalışmada Fallot tetralojisi tanılı hastalarımızda uygulanan cerrahi tedaviler ile olguların kısa ve orta dönem sonuçlarını geriye dönük olarak değerlendirmeyi amaçladık. Materyal-Metot: Çalışmaya Ağustos 2017-Haziran 2020 tarihleri arasında hastanemizin pediatrik kardiyoloji bölümünce izlenen Fallot tetralojisi tanılı hastalar dahil edildi. Olgulara uygulanan cerrahi işlemler ile ameliyat öncesi ve sonrası izlemlerdeki veriler, hasta dosyaları incelenerek kaydedildi Bulgular: Çalışmaya alınan 27 hastadan 16’sı erkek, 11’i kız idi. McGoon oranı, Nakata indeksi ve pulmoner arter z-skoru, ameliyat edilme şartlarını karşılayan 19 hastaya cerrahi uygulanmıştı. Tek operasyon geçiren hasta sayısı 13 iken, iki operasyon geçiren hasta sayısı 6 idi. İlk operasyonda 14 hastaya (ortanca yaş: 10 ay) tam düzeltme operasyonu uygulanmıştı. İlk ameliyattan sonra izlem süreleri 1-143 ay arasında değişmekteydi. Tam düzeltme ameliyatından sonra 2 hastaya (91 aylık ve 148 aylık iken) ağır pulmoner yetmezlik gelişmesi ve sağ ventrikül yetmezliğiyle sonuçlanması sebebiyle pulmoner kapak replasmanı yapılmıştı. Hastaların hiçbirinde ciddi aritmi gelişmediği kaydedildi. Sonuç: Çalışmamızın bulguları, bir yaş altı Fallot tetralojisi tanılı çocuklarda, McGoon oranı, Nakata indeksi ve pulmoner arter z-skoru değerlendirilerek tam düzeltme ameliyatı yapılmasının olumlu sonuçlar ile ilişkili olduğunu düşündürmektedir. Daha geniş serili çalışmalarla Fallot tetralojisinde ameliyat sonuçları daha da yüz güldürücü olacaktır.

Evaluation Of Short and Long-Term Outcomes Of Children With Tetralogy Of Fallot

Objective: In children with tetralogy of Fallot (TOF),correction surgery may be performed in the presence ofcertain findings. We aimed to evaluate the surgical proceduresand short- and intermediate-term outcomes of our patientswith TOF retrospectively.Material-Method: This study included patients with thediagnosis of TOF who were followed-up in the pediatriccardiology unit of our hospital between August 2017 andJune 2020. Surgical procedures performed and data at preandpostoperative follow-up were noted from the patients’records.Results: Among the 27 cases with the diagnosis of TOF, 16were male and 11 were female. Nineteen patients who fulfilledthe required levels of McGoon ratio, Nakata index andpulmonary artery z-score underwent at least one operation.Among them, 13 were operated once, whereas 6 were operatedtwice. In 14 patients, complete repair was undertaken at thefirst surgery (median age: 10 months). Postoperative followupduration ranged between 1 and 143 months. In 2 patients,pulmonary valve replacement was carried out after completerepair (at the ages of 91 months and 148 months). None of thepatients developed severe arrhythmia.Conclusion: The results of this study suggest that in infantswith TOF, complete repair by assessing the McGoon ratio,Nakata index and pulmonary artery z-score may be associatedwith favourable short- and intermediate-term outcomes.

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