TY - JOUR T1 - Perkütan Balon Mitral Valvuloplasti Sırasında Transözofajiyal Ekokardiyografi Kılavuzluğunun İşlem Başarısı ve Komplikasyonlar Üzerine Etkisi TT - The Effect of Guidance of Transesophageal Echocardiography During Percutaneous Balloon Mitral Valvuloplasty on Procedural Success and Complications AU - Dural, Muhammet AU - Isgandarov, Kamal AU - Mert, Gurbet Özge AU - Ata, Necmi AU - Mert, Kadir Uğur PY - 2018 DA - September DO - 10.20515/otd.398350 JF - Osmangazi Tıp Dergisi PB - Eskişehir Osmangazi Üniversitesi WT - DergiPark SN - 1305-4953 SP - 1 EP - 7 VL - 40 IS - 3 LA - tr AB - Semptomatik mitraldarlığı (MD) hastaları perkütan yolla tedavi edilebilmektedir. Bu hastalardaperkütan mitral balon valvulaplasti (PMBV) ile MD ve semptomlarıgiderilebilmektedir. Bu çalışmamızda ciddi MD hastalarında PMBV işlemisırasında transözofajiyal ekokardiyografi (TEE) kılavuzluğunun işlem başarısıve komplikasyonlar üzerine etkisini araştırmak istedik. Çalışmaya ciddi MD ilebaşvuran ve PMBV yapılması planlanan 45 hasta alındı. PMBV işlemi 23 hastayaTEE kılavuzluğunda (TEE(+)), 22 hastaya ise TEE kılavuzluğu olmadan (TEE(-))gerçekleştirildi. Çalışmada her iki grubun transseptal ponksiyon (TSP) süresi,septum geçiş başarısı, kapak geçiş başarısı değerlendirildi. PMBV ile tedaviedilen tüm hastalara 24. saat ve 12. haftada transtorasik ekokardiyografi iledeğerlendirildi. Çalışmaya alınan hastaların TEE(+) grubunda yaş ortalaması47,9±11,4, TEE(-) grubunda ise 48,5±15 (p=0,88) idi. TEE(-) grubundakiolguların ortalama boyu 163,1±7,5 cm, TEE(+) grubunda ise 161,7±5,4 cm (p=0,47)olarak gözlendi. TEE(-) grubunda Wilkins skoru 8,5(7,0-10,0), TEE(+) grubundaise 9,0(7,0-11,0) (p=0,111) olarak gözlendi. TSP süresi TEE(-) grubunda veTEE(+) grubunda sırasıyla 25,24±5,1 dk. ve 21,86±3,8 dk (p=0,02) olarak tespitedildi. TEE(-) grubunda kapak geçiş başarısı %100 iken, TEE(+) grubunda %85,8olarak bulundu. TEE(+) grubunda mitral kapak geçişi daha başarısızdı ancakistatistiksel anlamlı fark yoktu (p=0,072). Komplikasyonlar her iki gruptabenzerdi. PBMV esnasında kullanılan TEE’nin TSP’den doğan komplikasyonlar, TSPbaşarısı, kapak geçiş başarısı, işlem başarısı, işlem komplikasyonları üzerineise herhangi bir etkisinin olmamasına rağmen TSP süresini kısalttığıgösterildi. Hastalarda işlem süresini kısaltmak, radyasyon maruziyetini en azaindirmek için PBMV işlemi sırasında TEE kılavuzluğu konvansiyonel yöntemeeklenebilir. KW - Ciddi mitral darlığı KW - perkütan mitral balon valvuloplasti KW - transeptal ponksiyon N2 - Patients with mitral stenosis (MS) can be treated with percutaneousmethods. In this patient population, MS and symptoms can be relieved bypercutaneous mitral balloon valvuloplasty (PMBV). In our study we aimed to investigate theeffect of guidance of transesophageal echocardiography (TEE) during PMBV onprocedural success and complications in patients with MS. Fourty-five patientswho were planning to undergo PMBV because of severe MS were included to thestudy. Procedure of PBMV performed in 23 patients with TEE guidance (TEE(+))and in 22 patients without TEE guidance (TEE(-)). Transseptal puncture (TSP)duration, transseptal transition success and transmitral transition successevaluated for each group. All patients treated with PMBV were evaluated withtransthorasic echocardiography after 24. h and 12 weeks. The mean age in the TEE(+)group of the study was 47,9±11,4 and48,5±15 (p=0,88) in TEE(-) group. The mean height was 163,1±7,5 cm inTEE(-) group and 161,7±5,4 cm (p=0,47) in TEE(+) group. It was demonstratedthat Wilkins score was 8.5 (7.0-10.0) in the TEE (-) group and 9.0 (7.0-11.0)in TEE (+) group (p = 0.111). TSP duration in the TEE (-) group and TEE (+)group were 25,24 ± 5,1 min. and 21.86 ± 3.8 min (p = 0.02), respectively. Inthe TEE (-) group, transmitral transition success was 100%, while in the TEE(+) group it was 85.8%. 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