Midterm evaluation of echocardiographic examination, cardiac catheterization findings and surgical results of patients with congenitally corrected transposition of great arteries: A single center experienceMustafa Orhan Bulut, İlker Kemal Yücel, Şevket Ballı, Emine Hekim Yılmaz, Ayhan Çevik, Ahmet ÇelebiDr. Siyami Ersek Chest And Cardiovascular Surgery Training & Research Hospital,
Introduction: Congenitally corrected transposition of the great arteries (cc-TGA), also termed as double discordance and ventricular inversion.
Material and method: We conducted the retrospective evaluation of medical records of 79 patient diagnosed and followed-up with congenital transposition of great arteries between December 1993 and January 2014 at our pediatric cardiology department.
Results: Of 79 patients included in the study, 46 (58.2%) were male, mean age at diagnosis was 40±39.25 months and the mean follow-up time was 56 ± 39.4 months. Thirteen (16.5%) patients had atrial situs inversus. The most common concomitant abnormality was found to be ventricular septal defet (29.1%). Fourty five patient had pulmonary stenosis either in the form of valvular, subvalvular or both together. Twelve (15.2%) patients had pulmonary atresia. Systemic atrioventricular valve (AV) regurgitation was present in 51 (64.6%) patients, whereas 2 (2.5%) patients had severe systemic AV valve regurgitation. Ebstein-like AV valve was detected in 5 (6.3%) patients. The transcatheter interventions were ductal stent implantation (5 patients, 6.3%), left ventricule –pulmonary artery conduit angioplasty (2 patients, 2.5%), RV-PA conduit angioplasty (1 patients, 1.3%) and pulmonary balloon valvuloplasty (2 patients, 2.5%), respectively.
Eleven (13.9%) patients underwent interventional therapeutic cardiac catheterization. Glenn anastomosis was performed in 16 (20.3%) patients. Nine (11.4%) patients required a permanent pacemaker implantation.
Conclusion: Individualization of treatments and managements for the patients is of prognostic importance for these patients needing lifelong follow-up due to the large number of accompanying anomalies and different degrees of abnormalities in cc-TGA patients. Keywords: Congenitally corrected transposition, pulmonary stenosıs, atrıoventricular block
Konjenital düzeltilmiş transpozisyonlu hastaların ekokardiyografik, kardiyak kateterizasyon ve cerrahi sonuçlarının orta dönem değerlendirilmesi: Tek merkez deneyimiMustafa Orhan Bulut, İlker Kemal Yücel, Şevket Ballı, Emine Hekim Yılmaz, Ayhan Çevik, Ahmet ÇelebiDr Siyami Ersek Göğüs Kalp Damar Cerrahisi Hastanesi
Giriş: Kongenital düzeltilmiş büyük arter transpozisyonu, atriyoventriküler, ventriküloarteryal diskordans olarak tanımlanır.
Materyal ve metod: Aralık 1993- Ocak 2015 tarihleri arasında pediyatrik kardiyoloji bölümünde takip edilen 64 hasta retrospektif olarak değerlendirildi.
Sonuçlar: Çalışmamız 79 hastadan oluştu. 46 ( %58.2)’ si erkek, ortalama tanı yaşı 40±39.25 ay, ortalama takip süresi 56±39.4 ay idi. 13 ( %16.5) hasta atriyal sitüs inversus idi. En sık eşlik eden anomali ventriküler septal defekt (%29.1) idi. 45 hastada valvular ve/veya subpulmoner stenoz vardı. Hastaların %15.2 si pulmoner atrezik idi. Sistemik atriyoventriküler kapak yetersizliği 2 hastada ağır idi. 5 hastada ( %6,3) Ebstein benzeri triküspid kapak yapısı tespit edildi. 5 hastada ductal stent, 2 hastada sol ventrikül-pulmoner arter (PA) konduit anjioplasti, 1 hastada sağ ventrikül-PA konduit anjioplasti, 2 hastada pulmoner balon anjioplasti uygulandı. 16 hastaya Glenn anastomozu uygulandı. Hastaların %11.4’ ünde kalıcı pil implantasyonu gerektiren atriyoventriküler tam blok saptandı.
Sonuç: Bu hastalarda farklı derecelerde anomalilerin eşlik etmesi nedeniyle ömür boyu takip ve tedavi prognostik öneme haizdir. Anahtar Kelimeler: Konjenital düzeltilmiş transpozisyon, pulmoner stenoz, atrıoventriküler blok
Mustafa Orhan Bulut, İlker Kemal Yücel, Şevket Ballı, Emine Hekim Yılmaz, Ayhan Çevik, Ahmet Çelebi. Midterm evaluation of echocardiographic examination, cardiac catheterization findings and surgical results of patients with congenitally corrected transposition of great arteries: A single center experience. J Behcet Uz Child Hosp. 2017; 7(2): 86-94
Corresponding Author: Şevket Ballı, Türkiye |
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