Hüseyin OKUTAN, Nurettin ÜNAL, Eyüp HAZAN, Baran UĞURLU, Ünal AÇIKEL, Öztekin OTO

Aort kapak replasmanı sonrası sol ventrikül kitle değişikliklerinin küçük çaplı St. Jude Medical ve Karbomedics protezlerinde karşılaştırılması

Amaç: Bu çalışmanın amacı, 19 ve 21 mm küçük çaplı St. Jude ve CarboMedics marka bileaflet mekanik kapakların aort kapak replasmanı sonrasında hemodinamik performansının karşılaştırılmasıdır. Materyal ve Metod: Hastalar Grup 1 (19 mm Carbomedics), Grup 2 (21 mm Carbomedics), Grup 3 (19 mm St. Jude) ve Grup 4 (21 mm St. Jude) olmak üzere dört gruba ayrıldı. Ameliyat öncesi, ameliyat sonrası 1. ay, 6. ay ve 12. ayda ekokardiyografik ölçümlerle sol ventrikül kütlesi (SVK) ve sol ventrikül kütle indeksi (SVKİ) hesaplandı. Bulgular: Grup 1 ve 3'de SVK ve SVKİ'deki ameliyat sonrası azalma istatistiksel olarak anlamlı bulunmadı (p > 0.05). Grup 2 ve 4'de SVK ve SVKİ'deki ameliyat sonrası azalma da, istatistiksel olarak anlamlı bulunmadı (p > 0.05). Tartışma: Sonuç olarak bizim bu çalışma ile ilgili yorumumuz; klinik ve grafik olarak SVK ve SVKİ değişiklikler Grup 2 ve Grup 4' de (St. Jude marka bileafet mekanik kapaklarda) daha iyi olduğu yönündedir. Klinik ve grafik olarak daha iyi sonuçlar elde ettiğimiz 19 ve 21 mm küçük çaplı St. Jude marka kapaklarda sonuçların tamamının istatistiksel olarak anlamlı çıkmamasının nedenin, düşük hasta sayısı olduğu düşüncesindeyiz.

Comparison of St. Jude Medical and Carbomedics prostheses on change in left ventricular mass following small size aortic valve replacement

Background: The purpose of this study was to evaluate the hemodynamic performance of St. Jude and CarboMedics aortic valve prosthesis in patients with small 19-mm and 21-mm diameter aortic annulus. Methods: >Postoperative hemodynamics were assessed in four groups. A (19 mm CarboMedics) valve was used in eighteen patients Group 1, a 21 mm CarboMedics valve was used in twelve patients Group 2, a (19 mm St. Jude) valve was used in seventeen patients Group 3, and a (21 mm- St. Jude) valve was used in fifteen patients Group 4. Preoperative, postoperative 1. month, 6. month and 12. month echocardiography was performed and left ventricular mass and left ventricular mass index were measured. Results: Postoperative left ventricular mass and left ventricular mass index were decreased in Group 1 and Group 3. Results were not statisticaly significantly (p > 0.05). Postoperative left ventricular mass and left ventricular mass index were decreased in Group 2 and Group 4. Results was not statisticaly significantly (p > 0.05). Conclusion: Group 2 and 4 provides a better hemodynamics and clinical performance than Group 1 and 3. It is concluded that, compared with 19 and 21 mm CarboMedics valves, the 19 and 21 mm St. Jude valves showed a significantly better hemodynamics and clinical performance. We believe that, the results were not statisticaliy significanty because of the small number of patients included in this study.

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