Ersin EREK, Sertaç HAYDİN, İsa ÖZYILMAZ, Neslihan KIPLAPINAR, Pelin AYYILDIZ, Yakup ERGÜL, Alper GÜZELTAŞ, Erkut ÖZTÜRK, Ender ÖDEMİŞ, İbrahim Cansaran TANIDIR

Surgery-related complications and their management in total anomalous pulmonary venous return during intensive care unit stay

Amaç: Bu çalışmada total anormal pulmoner venöz dönüşlü(TAPVD) hastalarda yoğun bakım döneminde gelişenkomplikasyonlar ve bunlara etki eden ameliyat öncesi ve sonrasıfaktörler değerlendirildi.Çalışmaplanı: Çalışmaya Ocak 2010 - Mayıs 2013 tarihleriarasında kliniğimizde ameliyat edilen 31 TAPVD hastası (21erkek, 10 kız; ort. yaş 36 gün; dağılım 2 gün-6 ay) dahiledildi. Kompleks kardiyak anomalisi ve tek ventrikül fizyolojisiolan hastalar çalışma dışı bırakıldı. Hastaların demografiközellikleri, ekokardiyografik, anjiyografik ve bilgisayarlıtomografi anjiyografik ve varsa kalp kateterizasyonu bulgularıdeğerlendirildi. Ameliyatların süresi ve zamanı, ameliyat sonrasıyoğun bakım ünitesinde gözlenen değişiklikler ve pulmonerhipertansif kriz, aritmi, sepsis ve düşük kardiyak debi gibikomplikasyonlar ayrıntılı olarak incelendi.Bul gu lar: Total anormal pulmoner venöz dönüşlü hastaların%58i suprakardiyak, %19u infrakardiyak, %13ü kardiyakve %10u karışık tipteydi. On hastada (%32) pulmoner venöztıkanıklık vardı. Sekiz hastada (%25) pulmoner hipertansif krizgelişirken altı hastada (%19) düşük kardiyak debi saptandı. Onbir hastada (%35) ritim sorunları gözlendi. Pulmoner venöztıkanıklık infrakardiyak drenaj TAPVDli, düşük kilolu veküçük yaştaki hastalarda daha yaygındı (p

To tal anormal pulmo nerv enö z dö nüşte yoğun bakım ünite sinde kalış süresince c errahiyle ilişkili ko mplikasyo nlarv e bunların yö netimi

Background: This study aims to evaluate complications thatappear in patients with total anomalous pulmonary venous return(TAPVR) during intensive care period and preoperative andpostoperative factors that affect them.Methods: The study included 31 TAPVR patients (21 males,10 females; mean age 36 days; range 2 days to 6 months) operatedin our clinic between January 2010 and May 2013. Patientswith complex cardiac anomaly and single ventricle physiologywere excluded. Patients demographical characteristics,echocardiographic, angiographic and computed tomographyangiographic, and any cardiac catheterization findings wereevaluated. Duration and timing of operations, postoperativechanges and complications such as pulmonary hypertensivecrisis, arrhythmia, septicemia, and low cardiac output observedin intensive care unit were reviewed in detail.Results: Of patients with TAPVR, 58% were supracardiac, 19%were infracardiac, 13% were cardiac, and 10% were mixed type.Pulmonary venous obstruction was present in 10 patients (32%).While pulmonary hypertension crisis developed in eight patients(25%), low cardiac output was detected in six patients (19%).Rhythm problems were observed in 11 patients (35%). Pulmonaryvenous obstruction was more common in patients with infracardiacdrainage TAPVR, low weight and small age (p

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