Fallot Tetralojisi Tanısı ile Takip Edilen Hastaların Kısa ve Orta Dönem Sonuçlarının Değerlendirilmesi. Evaluation of Short- and Intermediate-Term Outcomes of Children with Tetralogy of Fallot

Year 2020, Volume: 11 Issue: 3, 353 - 357, 21.09.2020

Mahmut Keskin

Abstract

Amaç: Fallot tetralojisi tanısı alan çocuklarda, belirli bulguların varlığında, düzeltme ameliyatları yapılmaktadır. Bu çalışmada Fallot tetralojisi tanılı hastalarımızda uygulanan cerrahi tedaviler ile olguların kısa ve orta dönem sonuçlarını geriye dönük olarak değerlendirmeyi amaçladık.
Materyal-Metot: Çalışmaya Ağustos 2017- Haziran 2020 tarihleri arasında hastanemizin pediatrik kardiyoloji bölümünce izlenen Fallot tetralojisi tanılı hastalar dahil edildi. Olgulara uygulanan cerrahi işlemler ile ameliyat öncesi ve sonrası izlemlerdeki veriler, hasta dosyaları incelenerek kaydedildi
Bulgular: Çalışmaya alınan 27 hastadan 16’sı erkek, 11’i kız idi. McGoon oranı, Nakata indeksi ve pulmoner arter z-skoru, ameliyat edilme şartlarını karşılayan 19 hastaya cerrahi uygulanmıştı. Tek operasyon geçiren hasta sayısı 13 iken, iki operasyon geçiren hasta sayısı 6 idi. İlk operasyonda 14 hastaya (ortanca yaş: 10 ay) tam düzeltme operasyonu uygulanmıştı. İlk ameliyattan sonra izlem süreleri 1-143 ay arasında değişmekteydi. Tam düzeltme ameliyatından sonra 2 hastaya (91 aylık ve 148 aylık iken) pulmoner kapak replasmanı yapılmıştı. Hastaların hiçbirinde ciddi aritmi gelişmediği kaydedildi.
Sonuç: Çalışmamızın bulguları, bir yaş altı Fallot tetralojisi tanılı çocuklarda, McGoon oranı, Nakata indeksi ve pulmoner arter z-skoru değerlendirilerek tam düzeltme ameliyatı yapılmasının olumlu sonuçlar ile ilişkili olduğunu düşündürmektedir.


ABSTRACT

Objective: In children with tetralogy of Fallot (TOF), correction surgery may be performed in the presence of certain findings. We aimed to evaluate the surgical procedures and short- and intermediate-term outcomes of our patients with TOF retrospectively.
Material-Method: This study included patients with the diagnosis of TOF who were followed-up in the pediatric cardiology unit of our hospital between August 2017 and June 2020. Surgical procedures performed and data at pre- and postoperative follow-up were noted from the patients’ records.
Results: Among the 27 cases with the diagnosis of TOF, 16 were male and 11 were female. Nineteen patients who fulfilled the required levels of McGoon ratio, Nakata index and pulmonary artery z-score underwent at least one operation. Among them, 13 were operated once, whereas 6 were operated twice. In 14 patients, complete repair was undertaken at the first surgery (median age: 10 months). Postoperative follow-up duration ranged between 1 and 143 months. In 2 patients, pulmonary valve replacement was carried out after complete repair (at the ages of 91 months and 148 months). None of the patients developed severe arrhythmia.
Conclusions: The results of this study suggest that in infants with TOF, complete repair by assessing the McGoon ratio, Nakata index and pulmonary artery z-score may be associated with favourable short- and intermediate-term outcomes.

Keywords

Fallot tetralojisi,, İzlem,, Cerrahi, Sonuç., Tetralogy of Fallot, Follow-up, Outcome., Surgery

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