Amaç: Tam düzeltme ameliyatı yapılmış Fallot tetralojili hastalarımızın klinik durumlarının değerlendirilmesi, ritim bozukluklarının araştırılması, ekokardiyografi ile ventrikül fonksiyonlarının ve aort kökü dilatasyonunun değerlendirilmesidir.
Gereç ve Yöntemler: İstanbul Üniversitesi, İstanbul Tıp Fakültesi Çocuk Kardiyoloji bölümünde izlenen, düzeltme operasyonu uygulanmış Fallot tetralojili 50 çocuk çalışmaya dahil edildi. Düzeltilmiş Fallot tetralojili olgular aort kökü dilate olanlar ve dilate olmayanlar diye iki guruba ayrıldı. Her iki gurup arasında cinsiyet, tam düzeltme operasyonu yaşı, aort yetersizliği, triküspit yetersizliği, pulmoner yetersizlik, palyatif tedavi ve transanüler yama kullanımı açısından farklar değerlendirildi. Pulmoner kapak yetmezliği, tam düzeltme ameliyatı sırasında uygulanan transanüler yama yapılanlar ve yapılmayanlar olarak karşılaştırıldı.
Düzeltilmiş Fallot tetralojili olguların ekokardiyografik olarak ölçülen aort kökü ve asendan aort çapları yaş, cinsiyet ve vücut yüzey alanlarına göre normal dağılımları ile değerlendirildi.
Bulgular: Çalışmaya 24 Ocak-15 Mayıs 2014 tarihleri arasında 50 olgu alındı. Çalışmaya katılan olguların yaşları 2-21 yıl arasında değişmekte olup, ortalama 9.9 ±4.5 yıldır. Çalışmaya katılanların %52’si (n=26) erkek, %48’i (n=24) kızdır. Olguların total düzeltme yaşları 6 (0.5 yıl) ile 190 (15.8 yıl) ay arasında değişmekte olup, ortalama 28.3 ± 28.3 (2.3 ± 2.3 yıl) aydır. Postoperatif süreleri 1.3-17.8 yıl arasında değişmekte olup, ortalama 8.0 ± 4.1 yıldır. Olguların %28’ine (n=14) palyatif tedavi uygulanmıştır. Olguların aort kök ölçümleri 18.0 ile 42.5 mm arasında değişmekte olup, ortalama 27.9 ±5.3 mm’dir. Olguların %12’sinin (n=6) aort kökü dilatasyonu yok iken, %88’inin (n=44) aort kökü dilatasyonu vardır. Olguların tamamında (%100) sağ ventrikül dilatasyonu ve asendan aort dilatasyonu vardır.
Transanüler yama uygulananlarda, orta ve ağır pulmoner yetmezlik daha az saptandı (p: 0.02).
Sonuç: Olguların %88’inde (n: 44) aort kökü dilatasyonu saptandı. Yıllık aort kökü çapı ölçümlerinin verilmesi, Fallot tetralojili hastalarda ilerleyici aort kökü dilatasyonunun tedavisinde daha etkili bir stratejisinin planlanmasına yardımcı olacaktır.
Objective: This study aims to evaluate clinic situations, investigate arrhythmias, and assess ventricle function by echocardiography and aortic root dilation of patients with Tetralogy of Fallot who had undergone total correction surgery.
Material and Methods: 50 children with Tetralogy of Fallot and who had undergone a total correction operation in I.U. Faculty of Medicine Pediatric Cardiology Department were included to study. Corrected Tetralogy of Fallot cases were divided into two main groups as “aortic root dilated group” and “aortic root not-dilated group”. Groups were evaluated as to their gender, age of correction surgery, presence of aortic failure, tricuspid failure, pulmonary failure, aorta pulmonary shunt treatment and usage of transannular patch. Pulmonary valve failure was compared as those with and without transannular patches applied during the total correction surgery. Echocardiographically measured aortic root and ascending aorta diameters were assessed according to age, gender, and body surface area of the corrected Fallot Tetralogy cases.
Results: 50 subjects were involved to study in date between 24th Jan. 2014 and 15th May 2014. Age of the cases in study varied between 2 and 21 years and average age was 9.9 ± 4.5 years. 52% (n=26) of them are male and 48% are female (n=24). Total correction age was varied between 6 months (0.5 years) and 190 months (15.8 years) and average age was 28.3±28.3 months (2.3 ±2.3 years). Their postoperative periods were varied between 1.3 and 17.8 years and average period was 8.0±4.1 years. 28% (n=14) of the cases were received palliative treatment. Aortic root size was varied between 18 and 42.5 and average size was measured as 27.9±5.3 mm. Aortic root dilation ratio of the cases was 88% (n=44) while 12% of cases (n=6) had no aort root dilatation. All patients had right ventricle and ascending aorta dilation. Moderate and severe pulmonary failure was found less in those who underwent transannular patch.
Conclusion: Aortic root dilation was detected in 88% (n=44) of the cases. Providing annual aortic root diameter measurements will help to plan a more effective strategy for the treatment of progressive aortic root dilatation in patients with Fallot tetralogy.
Primary Language | Turkish |
---|---|
Subjects | Internal Diseases |
Journal Section | ORIGINAL ARTICLES |
Authors | |
Publication Date | July 16, 2021 |
Submission Date | February 26, 2020 |
Published in Issue | Year 2021 Volume: 15 Issue: 4 |
The publication language of Turkish Journal of Pediatric Disease is English.
Manuscripts submitted to the Turkish Journal of Pediatric Disease will go through a double-blind peer-review process. Each submission will be reviewed by at least two external, independent peer reviewers who are experts in the field, in order to ensure an unbiased evaluation process. The editorial board will invite an external and independent editor to manage the evaluation processes of manuscripts submitted by editors or by the editorial board members of the journal. The Editor in Chief is the final authority in the decision-making process for all submissions. Articles accepted for publication in the Turkish Journal of Pediatrics are put in the order of publication, with at least 10 original articles in each issue, taking into account the acceptance dates. If the articles sent to the reviewers for evaluation are assessed as a senior for publication by the reviewers, the section editor and the editor considering all aspects (originality, high scientific quality and citation potential), it receives publication priority in addition to the articles assigned for the next issue.
The aim of the Turkish Journal of Pediatrics is to publish high-quality original research articles that will contribute to the international literature in the field of general pediatric health and diseases and its sub-branches. It also publishes editorial opinions, letters to the editor, reviews, case reports, book reviews, comments on previously published articles, meeting and conference proceedings, announcements, and biography. In addition to the field of child health and diseases, the journal also includes articles prepared in fields such as surgery, dentistry, public health, nutrition and dietetics, social services, human genetics, basic sciences, psychology, psychiatry, educational sciences, sociology and nursing, provided that they are related to this field. can be published.