Kapalı Mitral Komissürotomi Esnasında Transözofajiyal Ekokardiyografinin Değeri
Yükleniyor...
Dosyalar
Tarih
2000
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Turgut Özal Tıp Merkezi Dergisi
Erişim Hakkı
Attribution 3.0 United States
Özet
İntraoperatif transözofajiyal ekokardiyografi eşliğinde kapalı mitral komissürotomi işlemi pür, non-kalsifik mitral stenozu tedavisinde değerli bir yaklaşımdır. Bu çalışmanın amacı, kapalı mitral komissürotomi esnasında transözofajiyal ekokardiyografinin değerini araştırmaktır.
Metot ve Bulgular: Kliniğimizde mitral stenozlu 39 olguya kapalı mitral komissürotomi uygulandı. Onbiri erkek 28’i kadın olan olguların ortalama yaşı 32.6±7.1 (dağılımı 18-45 yaş) idi. Preoperatif olarak tüm olgu NYHA class III-IV'de idi. Olguların hiçbirinde kapak kalsifikasyonu, sol atriyumda trombüs ve kapak altı apereyinde ciddi deformite yoktu. Doppler ekokardiyografi ile tayin edilen ortalama mitral orifis alanı 0.8±0.3 cm² (dağılımı 0.6-1.3 cm²) iken ortalama transvalvüler gradiyent 15.7±2.3 mmHg (dağılımı 12-20 mmHg) idi. Komissürotomi işleminden hemen sonra transözofajiyal ekokardiyografi ile mitral kapağın durumu değerlendirildi. İntraoperatif transözofajiyal ekokardiyografi bulguları olarak, ortalama mitral kapak orifis alanı 2.3±1.2 cm² (dağılımı 2.1-2.8 cm²) idi. Renkli Doppler ekokardiyografi ile hiçbir olguda önemli mitral regürjitasyonu saptanmadı.
Sonuç: Uygun olgularda, transözofajiyal ekokardiyografi kılavuzluğunda kapalı mitral komissürotomi operasyonunun güvenli, yararlı ve objektif bir işlem olduğuna inanmaktayız.
The procedure of closed mitral commissurotomy under intraope-rative transesophageal echocardiography with color flow Doppler imaging is a valuable approach for treating pure, non-calcific mitral stenosis. The aim of this study was to research the value of intraoperative transesophageal echocardiography during closed mitral commissurotomy. Methods and Results: Thirty-nine patients with mitral stenosis underwent closed mitral commissurotomy at our clinic. Eleven patients were male and 28 were female, and the average age was 32.6±7.1 years (range, 18-45 years). Preoperatively, all patients were NYHA class III-IV. There were no valve calcification, left atrial thrombus and severe deformity of subvalvular apparatus. The mean mitral valve orifice area as determined by Doppler pressure half time was 0.8±0.3 cm² (range, 0.6-1.3 cm²) with a mean transvalvular gradient of 15.7±2.3 mmHg (range, 12-20 mmHg). After commissurotomy, the valvular competence was assessed by transesophageal echocardiography. Intraopera-tive transesophageal echocardiography findings showed a mean mitral valve orifice area of 2.3±1.2 cm² (range, 2.1-2.8 cm²). None of the patients had significant mitral regurgitation as assessed by color flow Doppler imaging. Conclusion: In appropriate patients, we believe that transesophageal echocardiography gudiance makes closed mitral commissurotomy a safe, useful, and objective procedure.
The procedure of closed mitral commissurotomy under intraope-rative transesophageal echocardiography with color flow Doppler imaging is a valuable approach for treating pure, non-calcific mitral stenosis. The aim of this study was to research the value of intraoperative transesophageal echocardiography during closed mitral commissurotomy. Methods and Results: Thirty-nine patients with mitral stenosis underwent closed mitral commissurotomy at our clinic. Eleven patients were male and 28 were female, and the average age was 32.6±7.1 years (range, 18-45 years). Preoperatively, all patients were NYHA class III-IV. There were no valve calcification, left atrial thrombus and severe deformity of subvalvular apparatus. The mean mitral valve orifice area as determined by Doppler pressure half time was 0.8±0.3 cm² (range, 0.6-1.3 cm²) with a mean transvalvular gradient of 15.7±2.3 mmHg (range, 12-20 mmHg). After commissurotomy, the valvular competence was assessed by transesophageal echocardiography. Intraopera-tive transesophageal echocardiography findings showed a mean mitral valve orifice area of 2.3±1.2 cm² (range, 2.1-2.8 cm²). None of the patients had significant mitral regurgitation as assessed by color flow Doppler imaging. Conclusion: In appropriate patients, we believe that transesophageal echocardiography gudiance makes closed mitral commissurotomy a safe, useful, and objective procedure.
Açıklama
Turgut Özal Tıp Merkezi Dergisi.7 (1) :11-14,2000.
Anahtar Kelimeler
Mitral stenozu, Mitral stenozu, kapalı mitral komissürotomi, intraoperatif transözofajiyal ekokardiyografi
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Yavuz, Ş.;Celkan, A.;Bozat, T.;Özdemir, İ.A.;Turgut Özal Tıp Merkezi Dergisi.7 (1) :11-14,2000.
