Muhammet AKYÜZ, Ertürk LEVENT, Yüksel ATAY, Soysal TURHAN, Ruhi ÖZYÜREK, Onur IŞIK, Emin Alp ALAYUNT, Mehmet Fatih AYIK

Short- and mid-term results of resection of discrete subaortic stenosis in children

Bu çalışmada, diskret subaortik darlık olan hastalarda kısa ve orta dönem cerrahi sonuçlarımız sunuldu.Çalışma planı: Eylül 2000 - Ocak 2012 tarihleri arasında kliniğimizde diskret subaortik darlık nedeniyle cerrahi tedavi uygulanan toplam 72 hasta (43 erkek, 29 kadın; ort. yaş 4.6±4.5 yıl; dağılım, 6 ay - 11 yıl) retrospektif olarak incelendi. Tüm hastalara transaortik stenotik yapı eksizyonuna ek olarak sınırlı miyektomi uygulandı. İşlem sonrası sol ventrikül çıkım yolu gradyanı ve aort kapak yetmezliği ekokardiyografi ile değerlendirildi.Bul gu lar: Ortalama takip süresi 4.9±2.7 yıl idi. Ameliyat sonrası erken ve geç dönemde mortalite gözlenmedi. Bir pediatrik hastada kalıcı kalp pili takılmasını gerektiren kalp bloku gelişti. Sol ventrikül çıkım yolu ortalama sistolik gradyanı ameliyat öncesi 48.4±13.7 mmHg'den (dağılım 32-70 mmHg), ameliyat sonrası dönemde 8.6±5.6 mmHg'ye (dağılım 4-15 mmHg) geriledi. Takip sırasında iki hastada (%2.7) tekrarlayan darlık nedeniyle tekrar ameliyat gerekti.So nuç: Çalışma bulgularımız, membranektomiye ek olarak sınırlı miyektominin mortalite ve morbiditeyi artırmadan iyi orta dönem sonuçları olduğunu göstermektedir

Çocuklarda diskret subaortik darlık rezeksiyonunun kısa ve orta dönem sonuçları

In this study, we report our short- and mid-term surgical results in patients with discrete subaortic stenosis.Methods: A total of 72 patients (43 males, 29 females; mean age 4.6±4.5 years; range, 6 months to 11 years) who were surgically treated for discrete subaortic stenosis in our clinic between September 2000 and January 2012 were retrospectively analyzed. Limited myectomy in addition to the transaortic excision of the stenotic structure was performed in all patients. Left ventricular outflow tract gradient and aortic valve regurgitation were evaluated by echocardiography following the procedure.Results: The mean follow-up was 4.9±2.7 (range, 1 to 10) years. No mortality occurred during the early and late postoperative period. Heart block which necessitated the placement of a permanent pacemaker developed in one pediatric patient. The mean preoperative left ventricle systolic gradient which was measured as 48.4±13.7 mmHg (range, 32 to 70 mmHg), diminished to 8.6±5.6 mmHg (range, 4 to 15 mmHg) in the postoperative period. Reoperation was necessary due to recurrent stenosis in two patients (2.7%) during follow-up.Conclusion: Our study results show that limited myectomy in addition to membranectomy results in good mid-term results without increasing morbidity and mortality

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