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

Year 2019, Volume: 22 Issue: 2, 112 - 119, 15.08.2019

Arzu Antal Burçin Çayhan Karademir Mehmet Dedemoğlu Ekin Can Çelik Mehmet Altuğ Tuncer

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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