Perkütan mitral balon valvüloplasti kısa dönem takip sonuçları: Tek merkez deneyimi

Amaç: Bu çalışmada kliniğimizdeki romatizmal mitral darlıklı (MD) erişkin hastalara uygulanan perkütan mitral balon valvüloplastinin (PMBV) erken dönem klinik, ekokardiyografik ve hemodinamik sonuçlarını değerlendirmeyi amaçladık. Yöntemler: Kliniğimizde Ocak 2010-Ekim 2014 tarihleri arasında orta ya da ciddi MD nedeniyle PMBV uygulanan 53 hasta (49 kadın, 5 erkek; ortalama yaş 38±11 yıl) geriye dönük olarak değerlendirildi. İşlem başarısı, işlem sonrası mitral kapak alanının (MKA) >1,5 cm2 olması ve 3. derece mitral yetersizlik (MY) olmaması olarak kabul edildi. Bulgular: Toplam 53 hastadan 48inde (%91) PMBV iş- lemi uygulanabildi ve tamamlanabilen tüm işlemler ba- şarılı oldu. Hastalardan 3üne kapak geçilememesi, 1ine membranöz obstrüktif vena kava, 1ine de septostomi yapılamaması nedeniyle PMBV uygulanamadı. Başarılı PMBV uygulanan 2 hastaya ortalama 14 ay sonra semptomatik orta-ciddi MD nedeniyle mitral kapak replasmanı yapıldı. Ortalama 13±8 ay boyunca izlenen hastalarda atrial fibrilasyon gelişmesi veya embolik komplikasyonlar izlenmedi. Sonuç: Perkütan mitral balon valvüloplasti işlemi deneyimli merkezlerde yüksek başarı ve düşük komplikasyon oranları ile etkin ve güvenli bir tedavi yaklaşımıdır.

Short-term follow-up results of percutaneous mitral balloon valvuloplasty: A single-center experience

Objective: We sought to analyze short-term clinical, echocardiographic, and hemodynamic consequences of percutaneous mitral balloon valvuloplasty (PMBV) in the treatment of rheumatic mitral stenosis (MS) in our clinic. Methods: We retrospectively reviewed 53 patients (49 females, 5 males; mean age 38±11 years) who underwent PMBV for moderate or severe MS between January 2010 and October 2014. Procedural success was defined as the reaching a mitral valve area (MVA) >1.5 cm2 and absence of grade 3 mitral regurgitation. Results: We were able to perform PMBV in 48 of 53 patients (91%) and all the procedures that were completed were successful. PMBV couldn’t be performed in 3 patients due to inability to pass the mitral valve, 1 patient due to membranous obstructive vena cava and 1 patient due inability to perform septostomi. Two patients who underwent successful PMBV became symptomatic after an average of 14 months follow-up and mitral valve replacement was performed due to moderate-to-severe MS. Patients were followed for an average of 13 ± 8 months and atrial fibrillation development or embolic complications were not observed. Conclusion: Percutaneous mitral balloon valvuloplasty procedure is a safe and effective treatment approach with high success and low complication rates in experienced centers.

___

  • 1. Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thoracic Cardiovasc Surg 2014;148:e1-e132.
  • 2. Mrozowska E, Krzeminska-Pakula M, Rogowski W, et al. [Atrial fibrillation in mitral valve disease--risk factors]. Polskie Archiwum Medycyny Wewnetrznej 1999;101:45- 53.
  • 3. Acarturk E, Usal A, Demir M, et al. Thromboembolism risk in patients with mitral stenosis. Japan Heart J 1997;38:669- 675.
  • 4. Walston A, Peter RH, Morris JJ, et al. Clinical implications of pulmonary hypertension in mitral stenosis. Am J Cardiol 1973;32:650-655.
  • 5. Inoue K, Owaki T, Nakamura T, et al. Clinical application of transvenous mitral commissurotomy by a new balloon catheter. The Journal of thoracic and cardiovascular surgery 1984;87:394-402.
  • 6. Multicenter experience with balloon mitral commissurotomy. NHLBI Balloon Valvuloplasty Registry Report on immediate and 30-day follow-up results. The National Heart, Lung, and Blood Institute Balloon Valvuloplasty Registry Participants. Circulation 1992;85:448-461.
  • 7. Korkmaz S, Aksu T, Sasmaz H, et al. [Acute results of percutaneous mitral balloon valvuloplasty]. Turk Kardiyol Dern Ars 2011;39:137-142.
  • 8. Chen CR, Cheng TO. Percutaneous balloon mitral valvuloplasty by the Inoue technique: a multicenter study of 4832 patients in China. Am Heart J 1995;129:1197-203.
  • 9. Cohen DJ, Kuntz RE, Gordon SP, et al. Predictors of longterm outcome after percutaneous balloon mitral valvuloplasty. N Engl J Med 1992;327:1329-1335.
  • 10. Dean LS, Mickel M, Bonan R, et al. Four-year follow-up of patients undergoing percutaneous balloon mitral commissurotomy. A report from the National Heart, Lung, and Blood Institute Balloon Valvuloplasty Registry. J Am Coll Cardiol 1996;28:1452-1457.
  • 11. Fawzy ME, Hegazy H, Shoukri M, et al. Long-term clinical and echocardiographic results after successful mitral balloon valvotomy and predictors of long-term outcome. Eur Heart J 2005;26:1647-1652.
  • 12. Baumgartner H, Hung J, Bermejo J, et al. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. J Am Soc Echocardiogr 2009;22:1-23.
  • 13. Wilkins GT, Weyman AE, Abascal VM, et al. Percutaneous balloon dilatation of the mitral valve: an analysis of echocardiographic variables related to outcome and the mechanism of dilatation. Br Heart J 1988;60:299-308.
  • 14. Song JK, Song JM, Kang DH, et al. Restenosis and adverse clinical events after successful percutaneous mitral valvuloplasty: immediate post-procedural mitral valve area as an important prognosticator. Eur Heart J 2009;30:1254-1262.
  • 15. Gurkaynak F, Ozer C, Cehreli S, et al. Perkutan balon mitral valvuloplastinin erken ve kısa dönemlerdeki etkinliğinin noninvaziv olarak değerlendirilmesi. Türkiye Klinikleri Kardiyoloji 1990;3:240-246.
  • 16. San M, Bozkurt A, Usal A, ve ark. Perkutan mitral balon valvüloplasti olgularımızın erken dönem sonuçları. Gaziantep Universitesi Tip Fakultesi Dergisi 1998;9:33-37.
  • 17. Guray Y, Guray U, Demirkan B, et al. Effect of percutaneous mitral balloon valvuloplasty in various age groups. Turkiye Klinikleri J Cardiovasc Sci 2006;18:103-106.
Dicle Tıp Dergisi-Cover
  • ISSN: 1300-2945
  • Yayın Aralığı: 4
  • Başlangıç: 1963
  • Yayıncı: Cahfer GÜLOĞLU
Sayıdaki Diğer Makaleler

Kolorektal kanserlerde prognostik faktörler

Ahmet TÜRKOĞLU, Ziya ÇETİNKAYA, Mustafa GİRGİN, REFİK AYTEN, BURHAN HAKAN KANAT, Kenan BİNNETOĞLU, Ali AKSU

Ankilozan spondilitli hastalarda komorbit hastalıkların değerlendirmesi

Serda EM, Mehtap BOZKURT, MEHMET ÇAĞLAYAN, PELİN OKTAYOĞLU, Mehmet KARAKOÇ, Kemal NAS

A case of giant ethmoidal osteoma with orbital invasion treated via endonasal endoscopic approach

Eda ŞİMŞEK, ZÜLKÜF KAYA, M. Sıtkı GÖZELER, CÜNEYT KUCUR

Gebelikte akut kolesistit: 21 hastanın retrospektif değerlendirilmesi

Ahmet ŞEKER, Yusuf YÜCEL, Adnan İNCEBIYIK, Orhan GÖZENELİ, NURAY ALTAY, Alpaslan TERZİ, Abdullah ÖZGÖNÜL, ALİ UZUNKÖY

Posttraumatic basal ganglia infarction: A rare complication in a child after mild head injury

Ahmet METE, Duçem METE, SEDAT IŞIKAY

Evaluation of physical and mental health of sexual assault cases applied to forensic medicine department

Cem UYSAL, Yaşar TIRAŞÇI, Süleyman SİVRİ, Kasım BULUT, Kenan HASPOLAT, İsmail BOZKURT, Mustafa KORKMAZ, Şeref ŞİMŞEK

Comparison of hair and nail ethyl glucuronide concentrations

Ramazan KARANFİL, Alper KETEN, Cem ZEREN, Emine Nur RİFAİOĞLU, M. Tuğrul GÖKTAŞ

Desfluran ve remifentanil anestezisi ile desfluran'a kombine edilmiş lomber epidural analjezinin derlenme üzerine olan etkileri

CELALEDDİN SOYALP, Ayşenur DOSTBİL, Mine ÇELİK, ALİ AHISKALIOĞLU, MEHMET AKSOY, İLKER İNCE, Muhammet Ahmet KARAKAYA

Suriye\'deki iç savaşta damar cerrahisi deneyimlerimiz

İyad FANSA, Mehmet ACIPAYAM, Celalettin KARATEPE, Cem LALE

Postkolesistektomi sendromunun nadir bir nedeni: Remnant safra kesesinin manyetik rezonans kolanjiopankreatografi bulguları

Murat UÇAR, Pınar İlhan DEMİR, Fatma UÇAR, Nil TOKGÖZ