Hazım Alper GÜRSU, Birgül VARAN, İlkay ERDOĞAN, Kürşat TOKEL, Murat ÖZKAN

Senning ameliyatı uygulanmış büyük arterlerin transpozisyonu olan hastaların orta dönem izlem sonuçları

Amaç: Bu çalışmada, Senning ameliyatı uygulanmış olan büyükarter transpozisyonlu hastaların orta dönem izlem sonuçlarıdeğerlendirildi.Çalışma planı: Büyük arter transpozisyonu tanısı konulmuşve kliniğimizde atriyal switch ameliyatı yapılmış 95 çocukhastanın (63 erkek, 22 kız; ort. yaş 15.2±23.9 ay; dağılım1 ay - 12.5 yıl) dosyaları retrospektif olarak incelendi.İzlemlerinde fizik inceleme, elektrokardiyografi ve ekokardiyografiuygulandı. Ek olarak, 25 hastaya ambulatuar elektrokardiyografimonitörizasyonu yapıldı.Bulgular: Atriyal switch ameliyatı yapılan 95 hastanın10'u ameliyat sonrası dönemde kaybedildi. Ortalama izlemsüresi 33.4±43.7 ay (1-16 yıl, ort. 18 ay) idi. İzlemde hastaların%25.8'inde aritmi, %21.2'sinde pulmoner venöz tüneldarlığı, %19'unda sağ ventrikül sistolik disfonksiyonu,%18.9'unda ağır triküspit kapak yetmezliği ve %15.3'ündetünel kaçağı saptandı. Hastaların %11.7'sine ikinci bir ameliyat,%8.2'sine pulmoner venöz tünel darlığı nedeniyle tekrarameliyat yapıldı.Sonuç: Senning ameliyatının kısa ve orta dönem sonuçları tatminedici değildir. Hastaların olası sağ ventrikül disfonksiyonu,aritmi, sistemik kapak yetmezliği ve tünel darlığına karşı takipedilmesi gerekmektedir.

Mid-term results of patients with transposition of great arteries who underwent Senning procedure

Background: This study aims to evaluate mid-term follow-up results for patients with transposition of great arteries to whom Senning procedure was performed. Methods: Files of 95 child patients (63 boys, 22 girls; mean age 15.2±23.9 months; range 1 month to 12.5 years), who were diagnosed with transposition of great arteries and underwent atrial switch operation in our institute, were retrospectively evaluated. In the follow-ups; physical examination, electrocardiography, and echocardiography were performed. In addition, ambulatory electrocardiography monitorization was conducted on 25 patients. Results: Out of 95 patients who were performed atrial switch operation, 10 died in the postoperative period. The mean follow-up period was 33.4±43.7 months (1-16 years; mean 18 months). During the follow-ups, arrhythmia was detected in 25.8% of the patients, stenosis of pulmonary venous baffle was detected in 21.2%, systolic dysfunction of the right ventricle was detected in 19%, severe tricuspid valve insufficiency was detected in 18.9%, and baffle leak was detected in 15.3%. Of the patients, 11.7% were operated a second time, and 8.2% were reoperated due to stenosis of pulmonary venous baffle. Conclusion: Short and mid-term results of Senning procedure are not satisfactory. Patients should be monitored for possible right ventricle dysfunction, arrhythmia, systemic valve insufficiency, and stenosis of the tunnel.

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