Hüsnü Fırat ALTIN, Numan Ali AYDEMİR, Ali Rıza KARACI

The effects of leaving additional pulmonary blood flow in combination with bidirectional cavopulmonary anastomosis on early outcomes

Amaç: Bu çalışmada tek ventrikül fizyolojisi nedeniyle bidireksiyonel kavopulmoner anastomoz yapılan hastalarda ilave pulmoner kan akımının erken dönem sonuçlara etkileri değerlendirildi.Çalışma planı: Ocak 2004 - Temmuz 2010 tarihleri arasında bidireksiyonel kavopulmoner anastomoz yapılan 121 hasta (62 erkek ve 59 kız; ort. yaş 45.2±41.1 ay; medyan yaş 31 ay; dağılım 4-252 ay) retrospektif olarak incelendi. Hastalar, bidireksiyonel kavopulmoner anastomoz ile birlikte ilave pulmoner kan akımı olan (grup 1) ve olmayan (grup 2) olarak iki gruba ayrıldı. Gruplar arasında demografik farklılık yoktu.Bul gu lar: Mortalite grup 1'de üç hastada (%3.4) görülürken, grup 2'de yoktu (%0) (p=0.55). Ameliyat sonrası ortalama oksijen satürasyonu değeri grup 1'de 87.1±5.8, grup 2'de 83.4±6.1 idi (p=0.01). Yoğun bakımda ortalama yatış süresi grup 1'de 3±5.4 gün (medyan 2.0 gün), grup 2'de 3.3±2.2 gün (medyan 3.0 gün) idi (p=0.02). Hastanede ortalama yatış süresi gruplar arasında istatistiksel olarak anlamlı bir farklılıkla grup 1'de 9.2±7.3 gün (medyan 7.0 gün), grup 2'de 11.6±7.8 gün (medyan 8.0 gün) idi (p=0.03).So nuç: Ameliyat sonrası erken dönemde ilave pulmoner kan akımı olan hastalarda oksijen satürasyon değerleri daha yüksek, yoğun bakımda ve hastanede kalış süreleri daha kısadır. Pulmoner arter basıncının

Bidireksiyonel kavopulmoner anastomoz sırasında ilave pulmoner kan akımının bırakılmasının erken dönem sonuçlara etkisi

Background: This study aims to assess the effects of additional pulmonary blood flow on the early outcomes of patients who underwent bidirectional cavopulmonary anastomosis due to single ventricle physiology.Methods: A total of 121 patients (62 males, 59 females; mean age 45.2±41.1 months; median age 31 months; range 4-252 months) who underwent bidirectional cavopulmonary anastomosis between January 2004 and July 2010 were retrospectively analyzed. Patients were divided into two groups as having (group 1) or not having (group 2) additional pulmonary blood flow accompanied by bidirectional cavopulmonary anastomosis. There was no demographic difference between the groups.Results: While mortality was seen in three patients (3.4%) in group 1, there was none (0%) in group 2 (p=0.55). Mean postoperative oxygen saturation value was 87.1±5.8 in group 1 and 83.4±6.1 in group 2 (p=0.01). Mean duration of intensive care stay was 3±5.4 days (median 2.0 days) in group 1 and 3.3±2.2 days (median 3.0 days) in group 2 (p=0.02). Mean duration of hospital stay was 9.2±7.3 days (median 7.0 days) in group 1 and 11.6±7.8 days (median 8.0 days) in group 2, with a statistically significant difference between the groups (p=0.03).Conclusion: Oxygen saturation values are higher and durations of intensive care and hospital stay are shorter in patients with additional pulmonary blood flow in early postoperative period. Maintenance of antegrade pulmonary blood flow in patients with pulmonary arterial pressure at

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