Konjenital Kalp Hastalığı ve Yandaş Kapak Lezyonlarında Cerrahi Tedavi ve Sonuçları
KONJENITAL KALP HASTALIGI VE YANDAS  KAPAK LEZYONLARINDA CERRAHI TEDAVI VE  SONUCLARI
Yazar: Uysalel, Adnan
Dergi: Ankara Üniversitesi Tıp Fakültesi Mecmuası, Vol. 45 No. 1, 1992
Anahtar kelimeler: Cardiology ; Kardiyoloji ; Congenital,Heart Diseases,Associated Valvular Diseases. ; Congenital,Heart Diseases,Associated Valvular Diseases.

1,1985 - 6.1991 tarihleri arasinda Ankara Universitesi [bn-i Sina Hastanesi Kalp ve Damar Cerrahisi Anabilim Dalinda cerrahi tedavi uygulanan 15 konjenital kalp hastaligi ve yandas kapak lezyonlu olgu incelenmistir.Olgularm 7 sinde konjenital lezyon sekundum tip atrial septal defekt idi. Bu olgularin 3’tinde mitral kapak prolapsusuna bagl mit- yetmezligi olusmustu. 3 olguda ise romatizmal orijinli mitral yet- mezligi vardi ve bunlardan birinde trikuspit yetmezligi tabloya ek- lenmisti. Bir oleu da da romatizmal sekel sonucu olusan aort yetmiz- bulunmaktaydi. Olgulardaki konjenital lezyonlar cerrahi olarak onarilarak mitral kapak replasmanlari yapildi. Bir olguda ise ek ola- rak triktispit annuloplasti uyguland.. Olgularm 2’sinde perimembranoz ventriktler septal defekt ve ro- matizmal orijinli aort yetmezligi bulunuyordu. Bu olgularda, defekt- ler patch ile onarilip aort kapak replasmani uygulandi. Bes olgudaki konjenital lezyon sinus valsalva anevrizmas idi. Bunlardan birisi sa& ventriktile riipttire idi. Olgularda anevrizma. ori- jinleri onarilip aort kapak lezyonlar1 nedeniyle aort kapak replasma- ni yapildi. Bir olguda mitral kapak replasmani da gerekti. Subvalviiler aort darlgi ve aort yetmezligi bulunan bir olguda aort kapak replasmani ve fibromuskuler rezeksiyon, aorto-sol ven- trikiiler ttinel ve aorta yetmezligi olan bir olguda da onarim ve aort kapak replasmani uyguiand, Oigulardan 2’si postoperatif erken dénemde kaybedilmistir.

Fiften cases who had congenital heart disease and concomitant valvular lesions have been surgically treated at Ankara University Tbn-i Sina Hospital, Cardiovascular Surgery Department, and discus- sed in this article. There were secundum type atrial septal defects in seven cases as the congenital heart lesion, Three of these patients had mitral insuffi- ciency due to valvular prolapsus while three had rheumatic mitral in- sufficiency, One patient had rheumatic aortic insufficiency. Conge- nital lesions were repaired and insufficient valves have been repla- ced in all cases.Two patients had ventricular septal defects and rheumatic aortic insufficiency concomittantiy. The ventricular septal defects were re- paired with patches and diseased aortic valves were replaced in these cases. There were congenital aneuryms of sinus valsalva in five patients. One of them was ruptured into the right ventricle. Aortic sites of the aneurysms were closed primarily or using a patch and diseased val- ves were replaced. In a case with supravalvular aortic stenosis and aortic insuffici- ency, aortic valve replacement and fibromuscular resection were per- formed. A case with aorto-left ventricular tunnel and concomittant aortic insufficiency treated by reparing the tunnel and replacing aor- tic valve. Two patients died in the early postoperative period.