Kalp Yetersizliğinin Cerrahi Tedavisinde Yeni Bir Alternatif: Parsiyel Sol Ventrikülektomi (Batista Ameliyatı)

TAŞDEMİR, Oğuz; KÜÇÜKAKSU, Süha; VURAL, Kerem; KARAGÖZ, Haldun; BAYAZIT, Kemal

Oğuz TAŞDEMİR¹, Süha KÜÇÜKAKSU¹, Kerem VURAL¹, Haldun KARAGÖZ¹, Kemal BAYAZIT¹

Türkiye Yüksek İhtisas Hastanesi, Kardiyovasküler Cerrahi Kliniği, Ankara

Son dönem kalp yetersizliklerinin cerrahi tedavisinde yeni bir alternatif metod olarak Dr. Randos Batista tarafından tanımlanan "parsiyel sol ventrikülektomi" işlemine ait Türkiye'nin ilk klinik olgularından biri takdim edilmektedir. İdiyopatik dilate kardiyomiyopatili 54 yaşındaki erkek hasta NYHA klas IV'te idi. Preoperatif olarak sol ventrikül end-diyastolik volümü 530 mL, end-diyastolik çap 10.5 cm ve MUGA ile ölçülen ejeksiyon fraksiyonu % 11 idi. Kardiyopulmoner bypass altında çarpan kalpte sol ventrikül lateral duvarı ile mitral lifletler rezekte edilerek, primer onarıldı. Postoperatif 1. haftanın sonunda, klinik ve hemodinamik verilerde önemli düzelmeler saptandı. Postoperatif 8. günde hastaneden taburcu edilen hasta halen 2. ayında hayattadır.

Anahtar Kelimeler:

An Alternative New Method in Surgical Treatment of Heart Failure: Partial Left Ventriculectomy (Batista operation):

Oğuz TAŞDEMİR¹, Süha KÜÇÜKAKSU¹, Kerem VURAL¹, Haldun KARAGÖZ¹, Kemal BAYAZIT¹

This report is on one of the first clinical applications of partial left ventriculectomy operation in Turkey. The procedure was deseribed by R. Batista as an alternative new method in surgical treatment of heart failure. The 54-year-old male patient with idiopathic dilated cardiomyopathy, was in NYHA class IV. Preoperatively, left ventricular end-diastolic volume was 530 mL and end-diastolic diameter was 10.5 cm on echocardiographic evaluation. The left ventricular ejection fraction estimated by MUGA was 11%. At operation, left ventricular lateral wall and mitral leaflets were resected in the beating heart with cardiopulmonary bypass. Mitral valve was replaced with a prosthetic valve and the left ventricle was repaired primarily with suture. We have observed an İmportant improvement in clinical and hemodynamic findings after one week. He was discharged from hospital at the postoperative 8th day and is presently surviving in the postoperative second month.

Oğuz TAŞDEMİR, Süha KÜÇÜKAKSU, Kerem VURAL, Haldun KARAGÖZ, Kemal BAYAZIT. An Alternative New Method in Surgical Treatment of Heart Failure: Partial Left Ventriculectomy (Batista operation):. . 1997; 25(7): 393-400