Turkiye Klinikleri Cardiovascular Sciences

.: ORIGINAL RESEARCH
Biodegradable Ring ve De Vega Annuloplasti ile Triküspit Yetmezlik Tamir Sonuçlarımız
Management of Tricuspid Regurgitation with Biodegradable Ring and De Vega Annuloplasty
Halil BAŞELa, Abdulsamed HAZARb, Cengiz MORDENİZc, Ayşenur DOSTBİLd, Evren Müge TAŞDEMİRe, Dolunay ODABAŞIe, Hakan ÇOMAKLIe, Şahin KAPANe, Melike KARADAĞ KUTLUe
aKalp Damar Cerrahisi AD, Yüzüncü Yıl Üniversitesi Tıp Fakültesi, bKalp Damar Cerrahisi AD, cAnesteziyoloji ve Reanimasyon AD, Harran Üniversitesi Tıp Fakültesi, Şanlıurfa dAnesteziyoloji ve Reanimasyon Kliniği, eKalp Damar Cerrahisi Kliniği, Van Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Van
Turkiye Klinikleri J Cardiovasc Sci. 2009;21(3):376-81
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, diğer kalp rahatsızlıkları ile birlikte olan triküspit yetmezliklerinde De Vega annuloplasti ile yeni bir malzeme olan biodegradable ringin karşılaştırılmasını yapmaktır. Gereç ve Yöntemler: Ocak 2004-Ocak 2008 tarihleri arasında mitral kapak hastalığı yanı sıra triküspit tamiri yapılan toplam 120 hasta çalışmaya alındı. Bu hastaların sadece 1'inde mitral kapak hastalığı yoktu, diğerlerinin hepsinde mitral kapak hastalığına ilaveten 22'sinde beraberinde AVR, 9 hastaya CABG, 3 hastaya CABG + AVR operasyonu yapıldı. Hastalar 2 gruba ayrılmıştır. Grup 1= 63 hasta ile biodegradable ring takılan hastalar, grup 2= 57 hasta ile De Vega annuloplasti yapılan hastalardan oluşmakta idi. Hastalar postoperatif 1. ay, 4. ay ve 8. ay transtorasik ekokardiyografi ile takip edildiler. Bulgular: Her iki grup triküspit tamiri yapılan hastalarda komplikasyon az görülmüştür. Rezidüel triküspit yetmezliği biodegradable ring takılan hastalarda istatistiksel olarak daha az görülmüştür. Grup 1 hastaların 4'ünde 3. derecede rezidüel triküspit yetmezlik, grup 2'de 9 hastada (7'si 3. derecede, 2'si 4. derecede) rezidüel fonksiyone triküspit yetmezlik görüldü. Tartışma: Biodegradable ring ile annuloplasti tekniği triküspit yetmezliği tedavisinde kolay ve güvenli kullanılabilse de, bu sonuçları destekleyen uzun dönem klinik çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Triküspit kapak yetmezliği; kalp kapak hastalığı
ABSTRACT
 Objective: The aim of this study is to carry out a comparison of DeVega semicircular annuloplasty and biodegradable ring annuloplasty techniques in patients requiring surgical intervention of tricuspid valve disease with concomitant mitral valve disease. Material and Methods: From January 2004 to January 2008, 120 consecutive patients underwent annuloplasty procedures to correct tricuspid valve regurgitation during concomitant mitral valve operation requiring replacement. Additionally, 22 AVR operations, 9 CABG operations, 3 AVR + CABG operations, and 1 ASD closure operation were performed. The patients were assigned into 2 groups. Kalangos ring annuloplasty was performed in 63 patients (group 1). DeVega semicircular annuloplasty was performed in the remaining 57 patients (group 2). All patients were followed with transthoracic echocardiography at the 1.month, 4. month and 8. month. Results: Both tricuspid valve repair techniques resulted with low rate of complication. However, the number of patients developing residual tricuspid valve regurgitation were significantly lower in Kalangos ring annuloplasty group. At the four patients of group 1, third degree residüel tricuspid insufficiency, and at the nine patients of group 2 (7 patients third degree, 2 patients fourth degree) residual tricuspid valve insuffuciency were established. Conclusion: Biodegradable Ring annuloplasty technique can be used easily and safely in moderate and severe tricuspid valve regurgitation cases. However, larger clinical series are necessary to confirm our promising results.

Keywords: Tricuspid valve insufficiency; heart valve diseases

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30.03.2014

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