Sol Ventrikül Kitle İndeksinin Dikişsiz Biyoprotez Kapak ile Aort Kapak Replasmanı Sonrası Erken Dönem Sonuçlara Etkisi; İki On Yılın Karşılaştırılması

Abstract

Giriş: Çalışmanın amacı artmış sol ventrikül kitle indeksinin, aort darlığı nedeniyle dikişsiz biyoprotez kapak ile aort kapak replasmanı sonrası erken dönem sonuçlara etkisinin araştırılmasıdır.

 

Hastalar ve Yöntem: Aort darlığı nedeniyle dikişsiz biyoprotez kapak ile aort kapak replasmanı uygulanan 60 yüksek riskli hastanın operasyon sonrası erken dönem sonuçları retrospektif olarak analiz edilmiştir. Hastalar sol ventrikül kitle indeks değerlerine göre iki gruba ayrılmıştır. Sol ventrikül kitle indeksi Devereux formula ile hesaplanıp, vücut yüzey alanı ile indekslenmiştir. Erkek hastalar için > 134 g/m2 , kadın hastalar için > 100 g/m2 yüksek olarak tanımlanmıştır. Cerrahi sonrası erken dönem sonuçlar iki hasta grubunda karşılaştırmalı olarak değerlendirilmiştir.

 

Bulgular: Operasyon öncesi hasta özellikleri gruplar arasında benzer bulunmuştur. Erken mortalite %8.3’tür. Operasyon sonrası erken dönem mortalite ve morbidite açısından gruplar arasında anlamlı fark tespit edilmemiştir. Sol ventrikül kitle indeksi birinci grupta 114.7 ± 13.7 g/m2 ’den 109 ± 32.2 g/m2 ’ye (p= 0.60), yüksek kitle indeksi olan ikinci grup hastalarında 192.5 ± 31.9 g/m2 bazal değerinden 117.9 ± 25.2 g/m2 ’ye gerilemiştir (p< 0.001).

 

Sonuç: İzole aort darlığında operasyon öncesi artmış sol ventrikül kitle indeksinin, dikişsiz biyoprotez kapak ile aort kapak replasmanı sonrası erken dönem morbidite ve mortalite üzerine olumsuz etkisi tespit edilmemiştir. Ciddi sol ventrikül hipertrofisi olan yüksek riskli bu hasta grubunda altı aylık takipte sol ventrikül kitle indeksinde anlamlı azalma görülmesi cesaret verici olmakla birlikte uzun dönem takip gerektirmektedir

Keywords

• Aort kapak stenozu,sol ventrikül hipertrofisi,kalp kapak protezleri

Impact of Left Ventricular Mass Index on Early Outcomes After Aortic Valve Replacement with Sutureless Bioprosthetic Valve: A Comparison of Two Decades

Abstract

Introduction: The objective of the present study was to elucidate whether high left ventricular mass index (LVMI) affects early outcomes after sutureless bioprosthetic aortic valve replacement (AVR) in aortic stenosis (AS).

 

Patients and Methods: Postoperative early outcomes of 60 high-risk patients with aortic valve stenosis after replacement with sutureless bioprosthetic valve were retrospectively analyzed. Patients were grouped into two depending on LVMI. Left ventricular (LV) mass was calculated using the Devereux formula and indexed to the body surface area. High LVMI was defined as LVMI > 134 g/m2 for males and LVMI > 100 g/m2 for females. Early outcomes of surgery were compared between the normal and high LVMI patient groups.

 

Results: Preoperative patient characteristics were similar between the groups. Early mortality was 8.3%. There was no statistically significant difference between the groups with respect to postoperative early complication rates and mortality. LVMI decreased from 114.7 ± 13.7 g/m2 at baseline to 109 ± 32.2 g/m2 at follow-up in group I (p= 0.60) and from 192.5 ± 31.9 g/m2 at baseline to 117.9 ± 25.2 g/m2 in group II (p< 0.001).

 

Conclusion: The impact of high LVMI on morbidity and mortality after AVR with sutureless bioprosthetic valve was not deleterious in patients with isolated AS. Significant reduction in LVMI at 6 months is encouraging for these high-risk patients with severe LV hypertrophy; however, long-term follow-up is required.

Keywords

• Aortic stenosis,left ventricular hypertrophy,heart valve prosthesis

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