Buğra HARMANDAR, Ali Rıza KARACİ, Reyhan DEDEOĞLU, Ahmet ŞAŞMAZEL, Hasan ERDEM, Dicle CENGİZ, İbrahim YEKELER, Ahmet ÇELEBİ, Numan Ali AYDEMİR

Yenidoğan ve infantlarda dolaşım aresti uygulamadan aortik arkus ve intrakardiyak tamiri

Amaç: Bu yazıda yenidoğan ve infantlarda aortik arkus ve intrakardiyak tamir ile birlikte, selektif antegrad serebral perfüzyon ile yapılan cerrahi deneyimimiz bildirildi.Çalışmaplanı:Mart 2007 - Nisan 2012 tarihleri arasında arkus aort ve intrakardiyak tamiri uygulanan 27 ardışık hastanın (18 erkek, 9 kız; ort. yaş 9.9+1.7 gün, dağılım 1-26 gün) tıbbi verileri retrospektif olarak incelendi. Ameliyat sırası risk faktörleri ve ameliyat sonrası 30 günlük mortalite arasındaki ilişki incelendi.Bul gu lar: Hastaların ortalama vücut ağırlığı 3.2±0.9 kg idi. On iki hastada majör kardiyak defekt vardı ve bunlar trunkus arteriozus (Vaan Pragh tip 4) (n=2), büyük arterlerin transpozisyonu (n=5), çift çıkışlı sağ ventrikülde Taussing Bing anomalisi (n=2) ve aortopulmoner pencere defekti (n=3) idi. Böbrek yetmezliği ve diyaliz ile mortalite arasında istatistiksel olarak anlamlı bir ilişki bulundu [Ki kare, sırasıyla 27 (p=0.000) ve 20.66 (p=0.000)].So nuç: Yenidoğanlarda ve infantlarda, intrakardiyak cerrahi tamir ile eş zamanlı arkus aort tamiri, tek aşamalı selektif antegrad serebral perfüzyon ile yapılabilir.

Aortic arch and intracardiac repair without circulatory arrest in neonates and infants

Background: In this article, we aimed to report our surgical experiences with selective antegrade cerebral perfusion combined with the aortic arch and intracardiac surgery in neonates and infants. Methods: Medical data of 27 consecutive patients (18 boys, 9 girls; mean age 9.9+1.7 days; range 1 to 26 days) who undergoing aortic arch and intracardiac repair between March 2007 and April 2012 were retrospectively analyzed. The link between perioperative risk factors and 30-day mortality following surgery were investigated. Results: The mean body weight of patients were 3.2±0.9 kg. Major associated cardiac defects were present in 12 and included truncus arteriosus (Vaan Pragh type 4) (n=2), transposition of the great arteries (n=5), double outlet right ventricle with Taussing Bing anomaly (n=2), and aortopulmonary window defect (n=3). Renal insufficiency and dialysis were statistically significantly associated with mortality [Chi square 27 (p=0.000) and 20.66 (p=0.000), respectively]. Conclusion: Aortic arch repair with simultaneous intracardiac surgical repair can be done with selective antegrade cerebral perfusion at a single stage in neonates and infants.

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