Anıl ÖZEN, Ümit KERVAN, Mustafa PAÇ, Ahmet SARITAŞ, Ayşenur PAÇ, Sİnan Sabit KOCABEYOĞLU, Ertekin Utku ÜNAL, Emre KUBAT

Bebeklik dönemi sonrası yapılan aort koarktasyonunun cerrahi tamiri sonrası uzun dönem sonuçları

Amaç: Bu çalışmada bebeklik döneminden sonra aort koarktasyonu cerrahi olarak tamir edilen hastalarda uzun dönem sonuçlar değerlendirildi. Çalışma planı: Ocak 1999 - Ağustos 2016 tarihleri arasında aort koarktasyonunun cerrahi tamiri yapılan ve poliklinik takibinde olan toplam 49 hasta (28 erkek, 21 kadın; ort. yaş 22.9±11.3 yıl; dağılım 3-56 yıl) bu çalışmaya alındı. Tamir işlemleri yama anjiyoplasti (%51), greft interpozisyonu (%40.8), basit ve genişletilmiş uç uça anastomoz (%6.12) ve subklavyen plastidir (%2). Bulgular: Ortalama takip süresi 78.1±33.5 ay (dağılım 2 -144 ay) idi. Hastaların 22’sinde (%44.9) rekoarktasyon, 19’unda (%38.7) hipertansiyon, üçünde (%6.1) çıkan aort anevrizması, beşinde (%10.2) aort kapak darlığı, beşinde (%10.2) aort yetmezliği ve ikisinde (%4.08) koroner arter hastalığı saptandı. İlk olarak yama anjiyoplasti yapılan hastalar ve interpozisyon greftleme yapılan hastalar arasında rekoarktasyon oranları açısından anlamlı bir fark yoktu (p=0.787). İlk ameliyat sırasında cerrahi rekoarktasyon olan ve olmayan hastalar arasında ortalama yaş açısından istatistiksel olarak anlamlı bir fark yoktu (p=0.696). Ancak ameliyat sonrası hipertansiyon gelişen hastaların, gelişmeyenlere kıyasla, ortalama yaşı anlamlı düzeyde yüksekti (p=0.006). Hiçbir hastada hastane mortalitesi ve serebrovasküler olay izlenmedi. Sonuç: Aort koarktasyonunun başarılı tamirinin ardından dahi, başka kalp hastalıkları gelişebilir. Bu nedenle, bu tür kalp hastalıklarının erken tanı ve tedavisi önem arz eder.

Long-term outcomes after surgical repair of the coarctation of aorta beyond infancy period

Background: This study aims to evaluate the long-term results of the patients in whom coarctation of the aorta was surgically repaired beyond the infancy period.Methods: Between January 1999 and August 2016, a total of 49 patients (28 males, 21 females; mean age 22.9±11.3 years; range 3 to 56 years) who underwent surgical repair of coarctation of the aorta and followed in the outpatient clinic were included in this study. The repair procedures included patch angioplasty (51%), interposition grafting (40.8%), simple and extended end -to-end anastomosis (6.12%), and subclavian plasty (2%).Results: The mean follow-up was 78.1±33.5 months (range 2 to 144 months). Of the patients, 22 (44.9%) had recoarctation, 19 (38.7%) had hypertension, three (6.1%) had an aneurysm of the ascending aorta, five (10.2%) had aortic valve stenosis, five (10.2%) had aortic insufficiency, and two (4.08%) had coronary artery disease. There was no significant difference (p=0.787) in the recoarctation rates between the patients who initially underwent patch angioplasty and the patients who initially underwent interposition grafting. The mean age in the initial surgery was not statistically significantly different (p=0.696) between the patients with and without recoarctation. However, the mean age was significantly higher (p=0.006) in the patients with postoperative hypertension than those who did not. None of the patients had in-hospital mortality or cerebrovascular accident.Conclusion: Even following a successful repair of coarctation of the aorta, further cardiac diseases may develop. Therefore, early diagnosis and treatment of such cardiac pathologies are of utmost importance.

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