Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass

Atay, Yuksel; Ayik, Mehmet Fatih; BALAKISHIEV, Mahir; Akyuz, Muhammet; Işık, Onur

Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass

Mehmet Fatih AYIK, (Ege Üniversitesi, Tıp Fakültesi, Göğüs Kalp ve Damar Cerrahisi Anabilim Dalı, İzmir, Türkiye)

Onur IŞIK, (Ege Üniversitesi, Tıp Fakültesi, Göğüs Kalp ve Damar Cerrahisi Anabilim Dalı, İzmir, Türkiye)

Muhammet AKYÜZ, (Ege Üniversitesi, Tıp Fakültesi, Göğüs Kalp ve Damar Cerrahisi Anabilim Dalı, İzmir, Türkiye)

Mahir BALAKISHIEV, (Ege Üniversitesi, Tıp Fakültesi, Göğüs Kalp ve Damar Cerrahisi Anabilim Dalı, İzmir, Türkiye)

Yüksel ATAY (Ege Üniversitesi, Tıp Fakültesi, Göğüs Kalp ve Damar Cerrahisi Anabilim Dalı, İzmir, Türkiye)

Türk Göğüs Kalp Damar Cerrahisi Dergisi

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Yıl: 2015 Cilt: 23 Sayı: 4 Sayfa Aralığı: 613 - 616 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass

Öz:

Amaç: Bu çalışmada bidireksiyonel kavopulmoner anastomoz oluşturmak için atan kalpte kavoatriyal şant tekniğinin sonuçları sunuldu. Çalışmaplanı:Nisan 2003 - Kasım 2012 tarihleri arasında tek ventrikül kalp fizyolojisi olan 38 ardışık hastaya(18 erkek, 20 kız; ort. yaş 14.9±16.8 ay; dağılım 4 ay - 2.5yıl) atan kalpte bidireksiyonel kavopulmoner anastomozuygulandı. Ameliyat sırasında ortalama vücut ağırlığı8.3±3.6 kg idi. Ameliyat öncesi ortalama oksijen satürasyonu ve pulmoner arter basıncı sırasıyla %70.7±9.4 ve14.0±3.8 mmHg idi. Bul gu lar: Ameliyata bağlı mortalite görülmedi. Ortalamavena kava superior klemp zamanı ve klemp sırasında venakava basıncı sırasıyla 24.3±4.7 dakika ve 26.9±5.5 mmHgidi. Ameliyat sonrası nörolojik komplikasyon veya ritimbozuklukları görülmedi. Ameliyat sonrası oksijen satürasyonu %85.9±5.9 idi. Ameliyat sonrası dört hasta kaybedildi. Ortalama yoğun bakım ünitesinde kalış süresi ikigün idi. Takip ekokardiyografisinde herhangi bir tıkanıklık olmaksızın, fonksiyonel bidireksiyonel kavopulmoneranastomoz izlendi. So nuç: Kavoatriyal şant desteği ile kardiyopulmonerbaypas kullanılmadan bidireksiyonel kavopulmoner anastomozu uygulanabilir ve güvenli bir yöntemdir. Ayrıca,kardiyopulmoner baypasın olumsuz etkilerini de ortadankaldırır.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi Cerrahi

Kardiyopulmoner baypassız bidireksiyonel kavopulmoner anastomoz

Öz:

Background: In this article, we present the results of an off- pump cavoatrial shunt technique to creat a cavopulmonarybidirectional anastomosis. Methods: Thirty-eight consecutive patients (18 boys, 20girls; mean age 14.9±16.8 months; range 4 months to 2.5years) with univentricular heart physiology underwentan off-pump cavopulmonary bidirectional anastomosisbetween April 2003 and November 2012. The mean weightduring surgery was 8.3±3.6 kg. The mean preoperativeoxygen saturation and pulmonary artery pressure were70.7±9.4% and 14.0±3.8 mmHg, respectively. Results: There was no surgery-related mortality. Themean superior vena cava clamping time and the mean venacava pressure during clamping were 24.3±4.7 minutes and26.9±5.5 mmHg, respectively. There were no postoperativeneurological complications or dysrhythmias. The meanpostoperative saturation was 85.9±5.9%. There were fourpostoperative deaths. The mean length of intensive care unitstay was two days. Follow-up echocardiography showedfunctioning cavopulmonary bidirectional anastomosiswithout any obstruction. Conclusion: The cavopulmonary bidirectionalanastomosis without cardiopulmonary bypass with thesupport of a cavoatrial shunt is a feasible and safe method.It also eliminates the adverse effects of cardiopulmonarybypass.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Glenn WW. Circulatory bypass of the right side of the heart. IV. Shunt between superior vena cava and distal right pulmonary artery; report of clinical application. N Engl J Med 1958;259:117-20.
2. Villagrá F, Gómez R, Ignacio Herraiz J, Larraya FG, Moreno L, Sarrais P. The bidirectional cavopulmonary (Glenn) shunt without cardiopulmonary bypass: a safe and advisable technique. Rev Esp Cardiol 2000;53:1406-9.
3. Tireli E, Basaran M, Kafali E, Harmandar B, Camci E, Dayioglu E, et al. Peri-operative comparison of different transient external shunt techniques in bidirectional cavo- pulmonary shunt. Eur J Cardiothorac Surg 2003;23:518-24.
4. Reddy VM, Liddicoat JR, Hanley FL. Primary bidirectional superior cavopulmonary shunt in infants between 1 and 4 months of age. Ann Thorac Surg 1995;59:1120-5.
5. van de Wal HJ, Ouknine R, Tamisier D, Lévy M, Vouhé PR, Leca F. Bi-directional cavopulmonary shunt: is accessory pulsatile flow, good or bad? Eur J Cardiothorac Surg 1999;16:104-10.
6. Uemura H, Yagihara T, Yamashita K, Ishizaka T, Yoshizumi K, Kawahira Y. Establishment of total cavopulmonary connection without use of cardiopulmonary bypass. Eur J Cardiothorac Surg 1998;13:504-7.
7. Lamberti JJ, Spicer RL, Waldman JD, Grehl TM, Thomson D, George L, et al. The bidirectional cavopulmonary shunt. J Thorac Cardiovasc Surg 1990;100:22-9.
8. Lal M, Mahant TS. A modified technique of venoatrial bypass in bidirectional Glenn shunt. Asian Cardiovasc Thorac Ann 1996;4:23-5.
9. Murthy KS, Coelho R, Naik SK, Punnoose A, Thomas W, Cherian KM. Novel techniques of bidirectional Glenn shunt without cardiopulmonary bypass. Ann Thorac Surg 1999;67:1771-4.
10. Jahangiri M, Keogh B, Shinebourne EA, Lincoln C. Should the bidirectional Glenn procedure be performed through a thoracotomy without cardiopulmonary bypass? J Thorac Cardiovasc Surg 1999;118:367-8.
11. Luo XJ, Yan J, Wu QY, Yang KM, Xu JP, Liu YL. Clinical application of bidirectional Glenn shunt with off-pump technique. Asian Cardiovasc Thorac Ann 2004;12:103-6.
12. Hussain ST, Bhan A, Sapra S, Juneja R, Das S, Sharma S. The bidirectional cavopulmonary (Glenn) shunt without cardiopulmonary bypass: is it a safe option? Interact Cardiovasc Thorac Surg 2007;6:77-82.
13. Liu J, Lu Y, Chen H, Shi Z, Su Z, Ding W. Bidirectional Glenn procedure without cardiopulmonary bypass. Ann Thorac Surg 2004;77:1349-52.

APA	Ayik M, Işık O, Akyuz M, BALAKISHIEV M, Atay Y (2015). Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass. , 613 - 616.
Chicago	Ayik Mehmet Fatih,Işık Onur,Akyuz Muhammet,BALAKISHIEV Mahir,Atay Yuksel Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass. (2015): 613 - 616.
MLA	Ayik Mehmet Fatih,Işık Onur,Akyuz Muhammet,BALAKISHIEV Mahir,Atay Yuksel Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass. , 2015, ss.613 - 616.
AMA	Ayik M,Işık O,Akyuz M,BALAKISHIEV M,Atay Y Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass. . 2015; 613 - 616.
Vancouver	Ayik M,Işık O,Akyuz M,BALAKISHIEV M,Atay Y Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass. . 2015; 613 - 616.
IEEE	Ayik M,Işık O,Akyuz M,BALAKISHIEV M,Atay Y "Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass." , ss.613 - 616, 2015.
ISNAD	Ayik, Mehmet Fatih vd. "Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass". (2015), 613-616.

APA	Ayik M, Işık O, Akyuz M, BALAKISHIEV M, Atay Y (2015). Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 23(4), 613 - 616.
Chicago	Ayik Mehmet Fatih,Işık Onur,Akyuz Muhammet,BALAKISHIEV Mahir,Atay Yuksel Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass. Türk Göğüs Kalp Damar Cerrahisi Dergisi 23, no.4 (2015): 613 - 616.
MLA	Ayik Mehmet Fatih,Işık Onur,Akyuz Muhammet,BALAKISHIEV Mahir,Atay Yuksel Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass. Türk Göğüs Kalp Damar Cerrahisi Dergisi, vol.23, no.4, 2015, ss.613 - 616.
AMA	Ayik M,Işık O,Akyuz M,BALAKISHIEV M,Atay Y Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2015; 23(4): 613 - 616.
Vancouver	Ayik M,Işık O,Akyuz M,BALAKISHIEV M,Atay Y Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2015; 23(4): 613 - 616.
IEEE	Ayik M,Işık O,Akyuz M,BALAKISHIEV M,Atay Y "Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass." Türk Göğüs Kalp Damar Cerrahisi Dergisi, 23, ss.613 - 616, 2015.
ISNAD	Ayik, Mehmet Fatih vd. "Bidirectional cavopulmonary anastomosis without cardiopulmonary bypass". Türk Göğüs Kalp Damar Cerrahisi Dergisi 23/4 (2015), 613-616.