Cerrahi Dışı Perikardial Effüzyona Sekonder Gelişen Kardiak Tamponadın Cerrahi Tedavisi
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Tarih
2014
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Namık Kemal Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç Perikardiyal effüzyona bağlı tamponad gelişen hastalarda çeşitli tedavi seçenekleri bulunmaktadır. Nedenin belirlenmesinde effüzyon sitolojisinin incelenmesi önemlidir. Materyal ve Metod Selçuk Üniversitesi Etik Kurul Komitesi’nden etik kurul onayı alındı. Ocak 2009 –Nisan 2012 tarihleri arasında Konya Eğitim ve Araştırma Hastanesi Kalp Damar Cerrahisi Kliniği’nde cerrahi dışı perikardiyal efüzyon ve eşlik eden kardiyak tamponad nedeniyle subksifoid yaklaşım ile opere edilen 21 hasta retrospektif olarak incelendi. Bulgular 21 hastadan 18 tanesi semptomatik idi; 3 hastaya semptomları olmamasına rağmen yaygın perikardiyal effüzyon nedeniyle müdahale edildi. Etyolojide 14 hastada İdiyopatik (%66.66), 5 hastada malignite (%23.8), 1 hastada İmmunosupresyon (Bruton Agammaglobulinemi) ve 1 hastada geçirilmiş tüberküloz tespit edildi. Üç hastada rekürrens nedeniyle tekrar tüp takıldı; bu hastaların hepsinde malignite mevcuttu. Sonuç Perikardiyal tamponat kardiyak acillerden biridir ve hastanın klinik durumu hızlıca kötüleşebilir. Nedenden bağımsız olarak, tedavi konusunda hızlı karar verilmesi gerekli olmaktadır. Subksifoidal perikardiyal yaklaşım, uygun hastalarda, düşük mortalite, morbidite, komplikasyon ve rekürrens oranlarıyla birlikte güvenilir ve yararlı bir tedavi şeklidir.
Aim There are various treatment options for cardiac tamponade due to pericardial effusion. Effusion cytology sampling is important to address the cause. Materials and Methods This retrospective study was approved by the Selçuk University Ethics Committee and includes the results of 21 patients who underwent surgery for cardiac tamponade due to non-surgical pericardial effusion in Konya Education and Research Hospital Cardiovascular Surgery Department between January 2009 and April 2012. Results Eighteen of 21 patients were symptomatic; the other 3 patients had extensive pericardial effusion. Etiology of the effusion was idiopathic in 14 patients (66.66%), malignancy was seen in 5 patients (23.8%), 1 patient had immunosuppression (Bruton agammaglobulinemia) and 1 patient had tuberculosis history. Recurrent effusion was seen in 3 patients and they all had malignancy. Conclusion Pericardial tamponade is a cardiac emergency that patient’s clinical condition may deteriorate rapidly. Regardless of the main cause, it is important to decide operation quickly for treatment. Subxiphoidal pericardial approach is a safety and effective procedure with low mortality, morbidity, complication and recurrence rates for appropriate patients.
Aim There are various treatment options for cardiac tamponade due to pericardial effusion. Effusion cytology sampling is important to address the cause. Materials and Methods This retrospective study was approved by the Selçuk University Ethics Committee and includes the results of 21 patients who underwent surgery for cardiac tamponade due to non-surgical pericardial effusion in Konya Education and Research Hospital Cardiovascular Surgery Department between January 2009 and April 2012. Results Eighteen of 21 patients were symptomatic; the other 3 patients had extensive pericardial effusion. Etiology of the effusion was idiopathic in 14 patients (66.66%), malignancy was seen in 5 patients (23.8%), 1 patient had immunosuppression (Bruton agammaglobulinemia) and 1 patient had tuberculosis history. Recurrent effusion was seen in 3 patients and they all had malignancy. Conclusion Pericardial tamponade is a cardiac emergency that patient’s clinical condition may deteriorate rapidly. Regardless of the main cause, it is important to decide operation quickly for treatment. Subxiphoidal pericardial approach is a safety and effective procedure with low mortality, morbidity, complication and recurrence rates for appropriate patients.
Açıklama
Anahtar Kelimeler
Perikardial effüzyon, kardiak tamponad, Pericardial effusion, cardiac tamponade
Kaynak
Namık Kemal Tıp Dergisi (International Journal of Basic and Clinical Medicine)
WoS Q Değeri
Scopus Q Değeri
Cilt
2
Sayı
1
