VENTRİKÜLER SEPTAL DEFEKT TANISI, BOYUT VE TİPLERİ, KOMPLİKASYONLARI VE SPONTAN KAPANMA ORANLARI COVİD-19 PANDEMİSİNDEN ETKİLENDİ Mİ?

Öz

Amaç Polikliniğimize yönlendirilen hastalardan ventriküler septal defekt tespit edilenlerin sayısı, ventriküler septal defekt yeri ve boyutu, yol açtığı komplikasyonlar, medikal, cerrahi ya da spontan kapanma olasılığı incelenmiş, Covid-19 pandemisi koşullarında, rutin poliklinik muayene sayılarında ve VSD tanısı koyma oranında bir farklılık olup olmadığı, pandemi öncesi verilerimiz ile kıyaslanmıştır. Gereç ve Yöntem 2018-2022 yılları arasında hekime, göğüs ağrısı, çarpıntı, çabuk yorulma, nefes almada zorlanma, bayılma gibi semptomlar veya kalp dışı herhangi bir şikayet ile başvuru sırasında rutin muayenede üfürüm duyulması nedeniyle yapılan transtorasik ekokardiyografi sonuçları değerlendirilmiştir. Bulgular Pandemi öncesi 2018-2020 yılları arasındaki ekokardiyografi yapılan 16362 hastanın 91’inde (grup 1), pandemi dönemi olan 2020-2022 yılları arasında ekokardiyografi yapılan 14248 hastanın 202’sinde (grup 2), ventriküler septal defekt görülmüş olup, pandemi döneminde ventriküler septal defektli hasta oranının daha fazla olması yönünde anlamlıdır (p <0.001). Ventriküler septal defektlerin izleminde çeşitli komplikasyonlar gelişebilmektedir. Total olarak tüm komplikasyonlara sayı olarak bakıldığında pandemi öncesi dönemde komplikasyon oranı istatistiksel olarak anlamlı derecede daha fazladır (p=0.003). Ancak gelişen komplikasyonlar ayrı ayrı değerlendirildiğinde sadece ventriküler septal anevrizma gelişimi açısından pandemi öncesi grupta (grup 1) daha fazla oranda olması yönünde anlamlı fark saptandı (p=0.002). Diğer komplikasyonlar açısından anlamlı fark saptanmamıştır. Sonuç Hasta sayılarının benzer olması bize pediatrik kardiyoloji poliklinik başvuru sayılarında, pandemi koşullarında dahi ciddi bir azalma olmadığını kanıtlamıştır. Ancak ventriküler septal defekt tanı alma sıklığının pandemi döneminde daha fazla oranda olması, bu dönemde hastaneye gerçekten pediatrik kardiyoloji muayenesi gerektiren hastaların başvurmasından kaynaklanabilir.

Anahtar Kelimeler

• COVID-19 pandemisi ve VSD
• Komplikasyonlar
• Spontan kapanma
• Ventriküler septal defekt (VSD)

ARE VENTRICULAR SEPTAL DEFECT DIAGNOSES IN PEDIATRIC AGE GROUP AFFECTED BY THE COVID-19 PANDEMIC?

Öz

Objective Within the patients who were referred to our outpatient clinic, the number of those detected with a ventricular septal defect location and size of the defect, the complications it caused, the possibility of medical, surgical or spontaneous closure were examined and it has been compared with our pre-pandemic data whether there is a difference in the number of routine outpatient clinic examinations and the rate of diagnosis of ventricular septal defect under the conditions of the Covid-19 pandemic. Material and Method The results of transthoracic echocardiography made between the years 2018-2022 were evaluated which were performed due to hearing a cardiac murmur during routine examination of patients with symptoms such as chest pain, palpitations, fatigue, difficulty breathing, fainting, or any non-cardiac complaint. Results Ventricular septal defect was observed in 91 of 16362 patients (group 1) who underwent echocardiography between 2018 and 2020 before the pandemic, and in 202 of 14248 patients (group 2) who underwent echocardiography between 2020 and 2022, during the pandemic period. It is significant in that the patient rate is higher (p <0.001). Various complications may develop during the follow-up of ventricular septal defects. Considering the total number of complications, they were statistically significantly higher in the prepandemic period (p=0.003). However, when the developing complications were evaluated separately, a significant difference was detected only in terms of ventricular septal aneurysm development, with a higher rate in the pre-pandemic group (p=0.002). No significant difference was found in terms of other complications. Conclusion The similar number of patients has proven to us that there is no serious decrease in the number of pediatric cardiology outpatient clinic admissions, even under pandemic conditions. However, the higher frequency of diagnosis of ventricular septal defect during the pandemic period may be due to the fact that patients who actually require pediatric cardiology examination applied to the hospital during this period.

Anahtar Kelimeler

• Complications
• COVID-19 pandemic and VSD Spontaneous closure
• Ventricular septal defect (VSD)

Kaynakça

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