Mitral kapak replasmanı sırasında posterior liflet korunmasının sol ventrikül fonksiyonu ve bütünlüğüne etkileri
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Dosyalar
Tarih
1997
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi Tıp Fakültesi Dergisi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kronik mitral yetmezliği sebebiyle alışılmış (posterior lifletin korunmadığı) mitral kapak replasmanı yapılan 10 olgu (grup 1) ile posterior lifletin korunduğu 7 hastada (grup 2) sol ventrikül fonksiyonları karşılaştırıldı. Sol ventrikül fonksiyonları doppler ekokardiografı ile değerlendirildi. Her iki grubta yaş, kapak patolojisi, pulmoner arter basıncı, aortik klemp süresi ve cerrahi işlem farklı değildi. Tüm hastalarda supraannüler pozisyonda biliflet kapakla mitral kapak replasmanı yapıldı. Sol ventrikül fonksiyonları, ameliyattan bir ay önce ve postoperatif 7-10. günler arasında değerlendirildi. Sol ventrikül ejeksiyon fraksiyonu 1. grupta 65,10±8,01 ’den 56,5017,52 ’e düştü (p<0,01) fakat 2. grupta değişmedi (64±8,66; 62,2919,14). Papiller kas-annülüs arasındaki diastolik mesafe 1. grupta belirgin olarak (p<0,05) azaldı (35,5014,70; 37,30± 5,60 mm) fakat 2. gruptaki azalma anlamlı değildi (45±7,70; 43,43±5,97 mm). Papiller kas-annülüs arasındaki sistolik mesafe 1. grupta belirgin olarak (p<0,01) arttı (28,9C±4,01; 32,20±4,16 mm) fakat 2. grupta değişmedi (33,43±4,79; 33,29±4,39 mm). Apeks ile annülüs arasındaki diastolik mesafe 1. grupta arttı (70,20±10,01; 73,30±9,30 mm; p<0,01) fakat 2. grupta istatistiksel olarak anlamsız bir azalma gösterdi (79,14±8,51; 76,71±5,85 mm). Sistolik mesafe ise 1. grupta arttı (57,50±11,87; 61,30±10,95 mm; p<0,05) fakat 2. grupta değişmedi (56,57±5,62; 56,57±5,94 mm; p>0,05). Bu bulgular, mitral kapak replasmanında posterior lifletin korunması ile annüloventriküler bütünlüğün sürdürülmesinin sol ventrikül fonksiyonlarında önemli rol oynadığını göstermektedir.
Left ventricular function was compared in 10 patients who had conventional mitral valve replacement (group 1) and 7 patients who had replacement with preservation of posterior leaflet (group 2) for isolated chronic mitral regurgitation. Left ventricular function was assessed by doppler echocardiography. The two groups were similar in term of age, valve pathology, pulmonary artery pressure, aortic occlusion time, and surgical procedure. All the patients had mitral valve replacement with a bileaflet prosthesis in the supra- annular position. Left ventricular function was assessed one month before and 7-10 days after the operation. Left ventricular ejection fraction decreased from 65.10±8.01 to 56.50±7.52 in group 1 (p<0.01) but did not change significantly in group 2 (from 64±8.66 to 62.29±9.14). Papillary muscle-annular diastolic distance changed significantly (p<0.05) in group 1 (from 35,50±4,70 to 37,30± 5,60 mm) but decreased insignificantly (p>0.05) in group 2 (from 45±7.730 to 43.43±5.97 mm). The sistolic distance increased (p<0.01) in group 1 (from 28.90±4.01 to 32.20±4.16 mm) but did not change significantly (p>0.05) in group 2 (from 33.43±4.79 to 33.29±4.39 mm). Apico-annular diastolic distance inreased from 70.20±10.01 to 73.30±9.30 mm in group 1 (p<0.05) but decreased insignificantly (from 79.14±8.51 to 76.71±5.85 mm) in group 2. The sistolic distance increased from 57.50±11.87 to 61.30±10.95 mm in group 1 (p<0.05) and did not change significantly (p>0.05) in group 2 (from 56.57±5.62 to 56.57±5.94 mm). These finding show that maintenance of the annuloventricular continuity by preservation of posterior leaflets plays an important role in the left ventricular functions in the mitral valve replacement.
Left ventricular function was compared in 10 patients who had conventional mitral valve replacement (group 1) and 7 patients who had replacement with preservation of posterior leaflet (group 2) for isolated chronic mitral regurgitation. Left ventricular function was assessed by doppler echocardiography. The two groups were similar in term of age, valve pathology, pulmonary artery pressure, aortic occlusion time, and surgical procedure. All the patients had mitral valve replacement with a bileaflet prosthesis in the supra- annular position. Left ventricular function was assessed one month before and 7-10 days after the operation. Left ventricular ejection fraction decreased from 65.10±8.01 to 56.50±7.52 in group 1 (p<0.01) but did not change significantly in group 2 (from 64±8.66 to 62.29±9.14). Papillary muscle-annular diastolic distance changed significantly (p<0.05) in group 1 (from 35,50±4,70 to 37,30± 5,60 mm) but decreased insignificantly (p>0.05) in group 2 (from 45±7.730 to 43.43±5.97 mm). The sistolic distance increased (p<0.01) in group 1 (from 28.90±4.01 to 32.20±4.16 mm) but did not change significantly (p>0.05) in group 2 (from 33.43±4.79 to 33.29±4.39 mm). Apico-annular diastolic distance inreased from 70.20±10.01 to 73.30±9.30 mm in group 1 (p<0.05) but decreased insignificantly (from 79.14±8.51 to 76.71±5.85 mm) in group 2. The sistolic distance increased from 57.50±11.87 to 61.30±10.95 mm in group 1 (p<0.05) and did not change significantly (p>0.05) in group 2 (from 56.57±5.62 to 56.57±5.94 mm). These finding show that maintenance of the annuloventricular continuity by preservation of posterior leaflets plays an important role in the left ventricular functions in the mitral valve replacement.
Açıklama
[Journal of Turgut Özal Medical Center 1997;4(2):165-170]
Anahtar Kelimeler
Mitral yetmezliği, Mitral kapak replasmanı, Annüloventriküler bütünlük, Mitral regurgitation, Mitral valve replacement, Annuloventricular continuity
Kaynak
Turgut Özal Tıp Merkezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
4
Sayı
2
Künye
Rıza, T.,Baltalarlı, A., Yılık, L.,Akçay, A.,Şağban, M.,(1997). Mitral kapak replasmanı sırasında posterior liflet korunmasının sol ventrikül fonksiyonu ve bütünlüğüne etkileri.Turgut Özal Tıp Merkezi Dergisi, 4 (2).165-170 ss.
