Ersin EREK, Selim AYDIN, Ibrahim Halil DEMİR, Bahar TEMUR, Dilek SUZAN, Barış KIRAT, Ender ÖDEMİŞ, Okan YILDIZ

Sığır jugüler ven kondüiti ile yapılan trunkus arteriyozus tamiri sonuçları

Amaç: Bu çalışmada Rastelli tipi trunkus arteriyozus olan hastalarda trunkus arteriyozus tamirinin sonuçları değerlendirildi. Çalışma planı: Ocak 2011 - Mart 2017 tarihleri arasında 13 hastaya (7 erkek, 6 kadın; medyan yaş 37 gün; dağılım, 16-60 gün) Contegra kondüiti kullanılarak trunkus arteriyozus tamiri yapıldı. Ameliyat öncesi tanı sekiz hastada trunkus arteriyozus tip 1 (Edwards-Collett), üç hastada tip 2, bir hastada tip 3 ve bir hastada tip 4 idi. Ameliyat için kullanılan Contegra kondüitleri 14 mm (n=5), 12 mm (n=7) ve 16 mm (n=1) idi. Bulgular: İki hastada (%15.4) erken ölüm görüldü. Medyan yoğun bakım ve hastanede kalış süreleri sırasıyla 10 (dağılım 6-14) ve 20 (dağılım 14-41) gün idi. Medyan takip süresi 36 (dağılım, 2-66) ay idi. Dört hastada (%31) takip sırasında kondüit boyutları ciddi şekilde artış gösterdi ve iki hastada 23 mm’ye, bir hastada 20 mm’ye ve diğer hastada 18 mm'ye ulaştı. Üç hastada orta derecede distal kondüit darlığı vardı. Dört hastada orta derecede pulmoner yetmezlik ve bir hastada ciddi pulmoner yetmezlik vardı. İki hastada orta derecede trunkal kapak yetmezliği ve bir hastada orta derecede rezidüel ventriküler septal defekt vardı. Hastaların hiçbirinde tekrar ameliyat gereksinimi olmadı. Sonuç: Contegra kondüiti bebeklerde trunkus arteriyozus tamiri için iyi bir alternatiftir; ancak, distal kondüit darlığı ve kondüit dilatasyonu gelişebileceği için yakın izlem gereklidir.

Outcomes of truncus arteriosus repair with bovine jugular vein conduit

Background: In this study, we aimed to evaluate the outcomes of truncus arteriosus repair in patients undergoing Rastelli type truncus arteriosus.Methods: A total of 13 patients (7 males, 6 females; median age 37 days; range, 16 to 60 days) underwent repair of truncus arteriosus using Contegra conduits between January 2011 and March 2017. Preoperative diagnosis was truncus arteriosus type 1 (Edwards-Collett) in eight, type 2 in three, type 3 in one, and type 4 in one patient. Contegra conduits used for operations were 14 mm (n=5), 12 mm (n=7), and 16 mm (n=1).Results: Early death was seen in two patients (15.4%). The median intensive care and hospital stays were 10 (range, 6 to 14) and 20 (range, 14 to 41) days, respectively. The median follow-up was 36 (range, 2 to 66) months. In four patients (31%), the conduit sizes severely increased during follow-up and reached 23 mm in two patients and 20 mm in one patient, and 18 mm in the other patient. Three patients had moderate distal conduit stenosis. Moderate pulmonary insufficiency was detected in four patients and severe pulmonary insufficiency in one patient. Two patients had moderate truncal valve insufficiency and one patient had moderate residual ventricular septal defect. None of the patients needed reoperation.Conclusion: Contegra conduit is a good alternative for repair of truncus arteriosus in infants; however close follow-up is necessary, as distal conduit stenosis and conduit dilatation may develop.

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