Dar aort annuluslu hastalarda yeni jenerasyon mekanik kapak: St. Jude regent aortik protez deneyimi
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Tarih
2001
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Türk Göğüs Kalp Damar Cerrahisi Dergisi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Öz: Amaç: St. Jude Regent kalp kapak protezi daha iyi hemodinamik performans, daha az gradiyent ve artırılmış kapak alanına sahiptir. Bu çalışmada aortik pozisyonda St. Jude Regent kalp kapak protezi kullandığımız ilk 12 hastanın erken hemodinamik ve klinik sonuçlarını vermekteyiz. Materyal ve Metod: Eylül 2000 - Aralık 2000 tarihleri arasında kliniğimizde 12 hastada aortik pozisyonda St. Jude Regent protez kapak implante edildi. Ortalama yaş 55.2±12.4 olup hastaların 7'si erkekti. Yedi hastada izole aort kapak replasmanı (AVR), 4 hastada AVR + mitral kapak replasmam, 1 hastada AVR + koroner bypass ameliyatı gerçekleştirildi. Hastalar klinik durum ve ekokardiyografik olarak ortalama 5±2 aylık takip sonrası değerlendirildi. Bulgular: Olguların 8'sinde 21 mm, 4'ünde 19 mm ölçüsünde kapak takıldı. Tüm olgularda aort annulusu dardı ve kapakta darlık ön plandaydı. Perioperatif mortalite gözlenmedi. Ortalama kros klemp zamanı 49.1 ± 22.7 dak, ortalama kardiyopulmoner bypass zamanı 62.2 ± 23.8 dak, ortalama yoğun bakım kalış süresi 1 gün, ortalama postoperatif hastane kalış süresi 6.7 ± 0.7 gün idi. Hastaların hiçbirinde erken postoperatif ve takip döneminde komplikasyon saptanmadı. Postoperatif ekokardiyografik değerlendirmede efektif kapak alanı 19 mm kapak için 1.5 ± 0.4 cm2, 21 mm kapak için 1.9 ± 0.6 cm2, ortalama maksimum gradient 19 mm için 27 ± 8 mmHg, 21 mm için 18 ± 4 mmHg olarak tespit edildi. Takip periyodunda tüm hastaların fonksiyonel kapasiteleri klas I'de idi. Sonuç: St. Jude Regent mekanik kapak protezi düşük transvalvular gradiyent ve artırılmış kapak alanına sahip olması bakımından dar aort annuluslu hastalarda daha iyi hemodinamik fonksiyon sağlamaktadır.
Abstract: Background: St. Jude Regent heart valve prosthesis has better hemodynamic performance, lesser gradient and increased effective orifice area. In this study, we present the early hemodynamic and clinical results of first 12 patients received St. Jude Regent heart valve prosthesis in aortic position. Methods: Between September 2000 - December 2000, St. Jude Regent heart valve prosthesis was replaced in aortic position in 12 patients. Mean age was 55.2 ± 12.4 years, and 7 of the patients were male. The procedures were isolated aortic valve replacement (AVR) in 7, AVR + mitral valve replacement in 4, and AVR + coronary artery bypass grafting in 1 patient. Patients were evaluated with echocardiography and also for clinical status in 5 ± 2 months of follow-up. Results: The valve size was 21 mm in 8, and 19 mm in 4 of the cases. In all patients the aortic annulus was small and valvular stenosis was the primary problem. There was no perioperative mortality. Mean cross clamp time was 49.1 ± 22.7 minutes, mean cardiopulmonary bypass time was 62.2 ±23.8 minutes, mean stay time in intensive care unit was 1 day, and mean hospital stay time was 6.7 ± 0.7 days. No complication was detected in the early postoperative period and during follow-up. In postoperative echocardiographic evaluation, effective orifice area was measured as 1.5 ±0.4 cm2 for 19 mm valve, and 1.9 ± 0.6 cm2 for 21 mm valve, also mean maximum gradient was measured as 27 ± 8 mmHg for 19 mm valve, and 18 ± 4 mmHg for 21 mm valve. All of the patients were in class I functional capacity during follow-up period. Conclusions: St. Jude Regent mechanical heart valve prosthesis provides better hemodynamic function due to lesser transvalvular gradient and increased effective orifice area in patients with small aortic annulus.
Abstract: Background: St. Jude Regent heart valve prosthesis has better hemodynamic performance, lesser gradient and increased effective orifice area. In this study, we present the early hemodynamic and clinical results of first 12 patients received St. Jude Regent heart valve prosthesis in aortic position. Methods: Between September 2000 - December 2000, St. Jude Regent heart valve prosthesis was replaced in aortic position in 12 patients. Mean age was 55.2 ± 12.4 years, and 7 of the patients were male. The procedures were isolated aortic valve replacement (AVR) in 7, AVR + mitral valve replacement in 4, and AVR + coronary artery bypass grafting in 1 patient. Patients were evaluated with echocardiography and also for clinical status in 5 ± 2 months of follow-up. Results: The valve size was 21 mm in 8, and 19 mm in 4 of the cases. In all patients the aortic annulus was small and valvular stenosis was the primary problem. There was no perioperative mortality. Mean cross clamp time was 49.1 ± 22.7 minutes, mean cardiopulmonary bypass time was 62.2 ±23.8 minutes, mean stay time in intensive care unit was 1 day, and mean hospital stay time was 6.7 ± 0.7 days. No complication was detected in the early postoperative period and during follow-up. In postoperative echocardiographic evaluation, effective orifice area was measured as 1.5 ±0.4 cm2 for 19 mm valve, and 1.9 ± 0.6 cm2 for 21 mm valve, also mean maximum gradient was measured as 27 ± 8 mmHg for 19 mm valve, and 18 ± 4 mmHg for 21 mm valve. All of the patients were in class I functional capacity during follow-up period. Conclusions: St. Jude Regent mechanical heart valve prosthesis provides better hemodynamic function due to lesser transvalvular gradient and increased effective orifice area in patients with small aortic annulus.
Açıklama
Yıl: 2001Cilt: 9Sayı: 4ISSN: 1301-5680 / 2149-8156Sayfa Aralığı: 193 - 196Metin Dili:Türkçe
Anahtar Kelimeler
Kaynak
Türk Göğüs Kalp Damar Cerrahisi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
9
Sayı
4
Künye
ERDİL N,ATEŞ M. Ş,ÇETİN L,DEMİRKILIÇ U,ŞENER E,TATAR H (2001). Dar aort annuluslu hastalarda yeni jenerasyon mekanik kapak: St. Jude regent aortik protez deneyimi. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 9(4), 193 - 196.
