Erkut ÖZTÜRK, Alper GÜZELTAŞ, İbrahim Cansaran TANIDIR, Mustafa Orhan BULUT, Hacer KAMALI, İlker Kemal YÜCEL, Türkan SARITAŞ, Abdullah ERDEM, Ahmet ÇELEBİ

Yenidoğan ve infant döneminde sağ ventrikül çıkım yoluna stent yerleştirilmesi: Çok merkezli, retrospektif çalışma

Amaç: Bu çalışmada yenidoğan ve infant döneminde palyasyon amaçlı sağ ventrikül çıkım yoluna stent uygulanan olguların değerlendirilmesi amaçlandı. Çalışma planı: Ocak 2013 ve Ocak 2018 tarihleri arasında, üç merkezde, sağ ventrikül çıkım yoluna transkateter yoldan stent yerleştirilen toplam 38 hasta (20 erkek, 18 kadın; medyan yaş 51 gün; dağılım 3 gün-9 ay) retrospektif olarak incelendi. Hastaların demografik özellikleri, kardiyak patolojileri, anjiyografi işlem ve klinik izlem verileri kaydedildi. Bulgular: Tanılar Fallot tetralojisi (n=27), çift çıkışlı sağ ventrikül (n=8), kompleks doğumsal kalp hastalığı (n=2) ve Ebstein anomalisi (n=1) idi. Stent yerleştirme sırasında medyan ağırlık 3.5 (dağılım, 2-10) kg idi. Beş olguda genetik anormallikler mevcuttu. İşlem öncesi medyan oksijen satürasyonu %63 (dağılım, %44-80) ve medyan işlem süresi 60 (dağılım, 25-120) dk. idi. Akut işlem başarısı %87 idi. Takip döneminde stent daralması nedeniyle yedi hastaya tekrar girişim uygulandı. Takip döneminde, yedi olgu kaybedildi. Hastaların 26’sına mortalite olmaksızın tam düzeltme ameliyatı yapıldı. Yirmi iki hastada transanüler yama kullanılırken, iki hastada kapak koruyucu tam düzeltme ve iki hastada çift yönlü Glenn operasyonu gerçekleştirildi. Sonuç: Çalışma sonuçlarımıza göre, sağ ventrikül çıkım yoluna stent yerleştirilmesi, özellikle morbidite nedeni ile tam düzeltme ameliyatı yapılamayan olgularda akla gelmesi gereken bir palyasyon çeşididir.

Right ventricular outflow tract stenting during neonatal and infancy periods: A multi-center, retrospective study

Background: The aim of this study was to evaluate the outcomesof right ventricular outflow tract stenting for palliation during thenewborn and infancy periods.Methods: Between January 2013 and January 2018, a total of38 patients (20 males, 18 females; median age 51 days;range, 3 days to 9 months) who underwent transcatheter rightventricular outflow tract stenting in three centers were retrospectivelyanalyzed. Demographic characteristics, cardiac pathologies,angiographic procedural, and clinical follow-up data of the patientswere recorded.Results: The diagnoses of the cases were tetralogy of Fallot (n=27),double outlet right ventricle (n=8), complex congenital heart disease(n=2), and Ebstein’s anomaly (n=1). The median weight at the timeof stent implantation was 3.5 (range, 2 to 10) kg. Five cases hadgenetic abnormalities. The median pre-procedural oxygen saturationwas 63% (range, 44 to 80%), and the median procedural time was60 (range, 25 to 120) min. Acute procedural success ratio was87%. Reintervention was needed in seven of patients due to stentnarrowing during follow-up. During follow-up period, seven casesdied. Total correction surgery was performed in 26 patients withoutany mortality. While a transannular patch was used in 22 patients,valve protective surgery was implemented in two patients, and thebidirectional Glenn procedure was performed in two patients.Conclusion: Based on our study results, right ventricular outflowtract stenting is a form of palliation which should be consideredparticularly in cases in whom total correction surgery is unable to beperformed due to morbidity

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