Aorta Kapağı Lezyonlarında Kullanılan Magovern Suni Valvlerinin Diğerleri ile Mukayesesi ve Uzun Süreli Takip Neticeleri

Year 1969, Volume: 22 Issue: 4, 757 - 770, 31.12.1969

Yüksel Bozer

Abstract

Bu çalışmada, bu güne kadar tarafımdan aorta kapağı değiştirilmiş ve çoğunlukla Magovern-Cromie kapağı kullanılan 31 vakanın diğer suni kapaklarla mukayesesi ve uzun süreli takip sonuçları incelenmiştir. Bu 81 hastanın birine Kay-Shiley, üçüne Starr-Edwards, beşine Hufnagel ve 22'sine de Magovern-Cromie suni aort kapağı takılmıştır. Vakaların yaş ortalaması 23 olup, 26 erkeğe karşılık 5 kadın hasta bulunmaktadır. Takip süresi azami 3.5 yıl ve ortalama 15 aydır. Ortalama yaşam süresi 16 aydır. Erken mortalite oranı %9.21 olmasına rağmen, genellikle ameliyattan sonra 6 ayı dolduranlarda yaşam oranı %82 ve hiçbir komplikasyon olmadan 6. aya erişenlerde ise 6 aydan sonra yaşam oranı %94'tür. Hastaların taburcu edildikten sonra uzun süreli takipte, herhangi bir sebeple ölüm oranı %4.16'dır. Bu oranlar, diğer yazarlarınkilerle karşılaştırıldığında oldukça tatminkâr olduğu görülmektedir.

Hastalarda, antikoagülasyon uygulanmış olsun veya olmasın, 6. aydan sonra emboli olayı meydana gelmemiştir. Hiçbir kapakta harabiyet veya buna bağlı hemolitik anemi görülmemiştir. Magovern kapağında postoperatif kapak etrafından kaçak, diğer yazarların aksine sadece tek bir vakada gözlemlenmiştir. Sütür yetersizliği ise hiç olmamıştır. Bu nedenle, özellikle çift kapak lezyonlarında, pompa süresini kısaltmak amacıyla Magovern kapağını, sadece aort lezyonlarında ise sessiz çalışması ve fizyolojik yapısı nedeniyle Hufnagel kapağını tercih etmekteyiz. Tromboemboli oranı %0.21, enfeksiyon ve endokardit oranı ise %12'dir.

Keywords

aort valv değişimi, Magovern-Cromie Valve, Thromboembolic Events

Comparison of Magovern Artificial Valves Used in Aortic Valve Lesions with Others and Long-Term Follow-Up Results

Abstract

In this study, the comparison of Magovern-Cromie valves used in 31 cases of aortic valve replacement with other prosthetic valves, and the long-term follow-up results are examined. Among these 81 patients, one had a Kay-Shiley valve, three had Starr-Edwards, five had Hufnagel, and 22 had Magovern-Cromie aortic prosthetic valves. The mean age of the cases was 23, with 26 male and 5 female patients. The maximum follow-up period was 3.5 years, and the average follow-up duration was 15 months. The average survival time was 16 months. The early mortality rate was 9.21%, however, the survival rate for patients who survived the first 6 months after surgery was 82%, and for those who reached the 6th month without complications, the survival rate after 6 months was 94%. The death rate during long-term follow-up after discharge, regardless of cause, was 4.16%. These rates are very satisfactory when compared to those reported by other authors.

In patients, whether anticoagulated or not, no embolic events occurred after the 6th month. No prosthetic valve damage or hemolytic anemia was observed. In the case of the Magovern valve, postoperative leakage around the valve was observed in only one patient, contrary to other authors. There was no suture insufficiency. For this reason, especially in cases of double valve lesions, we prefer the Magovern valve to shorten pump time, while in isolated aortic lesions, we prefer the Hufnagel valve due to its silent operation and physiological structure. The rate of thromboembolic events was 0.21%, and the rate of infection and endocarditis was 12%.

Keywords

Aortic Valve Replacement, Magovern-Cromie Valve, Thromboembolic Events

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