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Fallot Tetralojisindeki Cerrahi Sonuçlarımız

Our Surgıcal Results of Tetralogy of Fallot

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Abstract (2. Language): 
The aim of this study is to evulate our surgical results of Tetralogy of Fallot. Between 2001–2009, 35 patients with Tetralogy of Fallot underwent to total correction at our department. Five of them had Down syndrome (%14.2), 3 had patent ductus arteriousus (%8.5), 2 had pulmonary atresia (%5.7), 1 had hypothyroidism (%2.8) and 1 had coronary artery anomaly (%2.8). Five patients had Blalock-Tausing shunt in their medical history. Transannular approach was avoided because of causing pulmonary valve insufficiency in late period, but it was obliged to apply in 12 patients. Early mortality occured in 3 cases (%8.5) after repair. Twenty three patients were followed for mean 6.7 years. One patient with pulmonary gradient underwent reoperation at postoperative 15th month and died due to multiple organ failure. There were no complet atrioventricular block and disrhythm in long term. Second degree pulmonary insufficiency that was developed in 12 patients who underwent transannular patch closure was followed up to day. We think that ventricular septal defect and infundibular stenosis could be corrected via transatrial approach, if necessary via transpulmonar approach and in long term, pulmonary insufficiency and right ventricular disfunction could be prevented.
Abstract (Original Language): 
Bu çalışmanın amacı, Fallot tetralojisinde (FT) tam düzeltme sonrası, cerrahi sonuçlarımızın değerlendirilmesidir. Kliniğimizde 2001–2009 yılları arasında 35 hasta, FT tanısıyla operasyona alındı. 5(%14.2) hastada Down sendromu, 3(%8.5) hastada patent duktus arteriozus, 2(%5.7) hastada pulmoner atrezi, 1 (% 2.8)hastada hipotroidi ve 1(%2.8) hastada koroner arter anomalisi mevcuttu. Ayrıca 5 hastaya daha önceden kliniğimizde modifiye Blalock-Tausing şant işlemi yapılmıştı. Komplet tamir yapılan hastaların geç dönemlerinde pulmoner kapakta yetmezlik oluşturmamak için transanuler girişim sınırlı yapılmakla beraber, 12(%34.2) hastada transanüler yama ile tamir uygulamak zorunda kalındı. Tamirden sonra erken mortalite 3(%8.5) hastada gelişti. 23 hasta ortalama 6.7 yıl süreyle takip edildi. Bir hasta, pulmoner gradient nedeniyle 15. ayda reoperasyona alındı, ancak multiorgan yetmezliğinden kaybedildi. Komplet atrioventriküler blok ve geç devre disritmi görülmedi. Transanüler yama yerleştirilen 12 hastada gelişen 2˚ pulmoner yetmezlikler izlemde kaldı. VSD ve infundibuler stenozun transatriyal yolla, gerekirse transpulmoner yolla düzeltilebileceği ve uzun dönemde de pulmoner yetmezlik ve sağ ventrikül disfonksiyonunun engellenebileceği düşüncesindeyiz.
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REFERENCES

References: 

1. Bailliard F, Anderson RH. Tetralogy of Fallot. Orphanet J Rare
Dis 2009;4:1-10.
2. Van Praagh R. The first Stella van Praagh memorial lecture:
the history and anatomy of tetralogy of Fallot. Semin Thorac
Cardiovasc Surg Pediatr Card Surg Annu. 2009;12:19-38.
3. Kouchoukos NT, Blackstone EH, Doty DB. Ventricular septal
defect with pulmonary stenosis or atresia.In Kirklin/Barratt –
Boyes (eds) Cardiac Surgery, 3rd edn. Churchhill Livingstone,
Philadelphia. 2003. Pp. 946-1073.
4. Starr JP. Tetralogy of Fallot: yesterday and today. World J Surg
2010;34(4):658-68.
5. Borowski A, Ghodsizad A, Litmathe J, Lawrenz W, Schmidt KG,
et al. Severe pulmonary regurgitation late after total repair of
tetralogy of Fallot: surgical considerations. Pediatr Cardiol
2004;25(5):466-71.
6. Giannopoulos NM, Chatzis AC, Bobos DP, Kirvassilis GV,
Tsoutsinos A, Sarris GE. Tetralogy of Fallot: influence of right
ventricular outflow tract reconstruction on late outcome. Int J
Cardiol 2004;97(1):87-90.
7. Bonchek LI, Starr A, Sunderland CO, Menashe VD. Natural
history of tetralogy of Fallot in infancy. Clinical classification
and therapeutic implications. Circulation 1973;48(2):392-7.
8. Di Donato RM, Jonas RA, Lang P, Rome JJ, Mayer JE Jr,
Castaneda AR. Neonatal repair of tetralogy of fallot with
and without pulmonary atresia. J Thorac Cardiovasc Surg.
1991;101(1):126-37.
9. Barratt-Boyes BG, Neutze JM. Primary repair of tetralogy of
Fallot in infancy using profound hypothermia with circulatory
arrest and limited cardiopulmonary bypass: a comparison
with conventional two stage management. Ann Surg
1973;178(4):406-11.
10. Pacifico AD, Bargeron LM Jr, Kirklin JW. Primary total
correction of tetralogy of Fallot in children less than four years
of age. Circulation 1973;48(5):1085-91.
11. Pigula FA, Khalil PN, Mayer JE, del Nido PJ, Jonas RA. Repair
of tetralogy of Fallot in neonates and young infants. Circulation
1999;100(19):157-61.
12. Tamesberger MI, Lechner E, Mair R, Hofer A, Sames-Dolzer E,
Tulzer G. Early primary repair of tetralogy of Fallot in neonates
and infants less than four months of age. Ann Thorac Surg
2008;86(6):1928-36.
13. Bove EL, Hirsch JC. Tetralogy of Fallot. In: Stark JF, de Leval
MR, Tsang VT (eds) Surgery for congenital heart defects. John
Wiley, Sons, West Sussex, UK. 2006 p399-410.
14. Bacha EA, Scheule AM, Zurakowski D, Erickson LC, Hung J,
Lang P, et al. Long-term results after early primary repair of
tetralogy of Fallot. J Thorac Cardiovasc Surg 2001; 122(1):154-
61.
15. Fraser CD, Mc Kenzie ED, Cooley DA. Tetralogy of Fallot:
Surgical management individualized to the patient. Ann Thorac
Surg 2001;71:1556-63.
16. Khairy P, Landzberg MJ, Gatzoulis MA, Lucron H, Lambert J,
Marçon F, et al. Value of programmed ventricular stimulation
after tetralogy of Fallot repair. a multicenter study. Circulation
2004;109(16):1994-2000.
17. Gatzoulis MA, Till JA, Somerville J, Redington AN.
Mechanoelectrical interaction in tetralogy of Fallot. QRS
prolongation relates to right ventricular size and predicts
malignant ventricular arrhythmias and sudden death.
Circulation 1995;92(2):231-7.
18. Steward RD, Backer CL, Young L, Mavroudis C. Tetralogy
of Fallot: results of a pulmonary valve sparing strategy. Ann
Thorac Surg 2005;80(4):1431-9.
19. He GW. Current strategy of repair of tetralogy of Fallot in
children and adults: emphasis on a new technique to create
a monocusp-patch for reconstruction of the right ventricular
outflow tract. J Card Surg 2008;23(6):592-9.
20. Voges I, Fischer G, Scheewe J, Scheewe J, Schumacher
M, Babu-Narayan SV, et al. Restrictive enlargement of the
pulmonary annulus at surgical repair of tetralogy of Fallot:
10-year experience with a uniform surgical strategy. Eur J
Cardiothorac Surg 2008;34(5):1041-5.
21. Brown JW, Ruzmetov M, Vijay P, Rodefeld MD, Turrentine
MW. Right ventricular outflow tract reconstruction with a
polytetrafluoroethylene monocusp valve: a twelve-year
experience. J Thorac Cardiovasc Surg 2007;133:1336-3.
22. Forbess JM. Conduit selection for right ventricular outflow tract
reconstruction: contemporary options and outcomes. Semin
Thorac Cardiovasc Surg Pediatr Card Surg Annu 2004;7:115-
24.

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