Surgical principles in repair of partial atrioventricular canal defect and short-term results

Parsiyel atrioventriküler kanal defekti (PAVKD) nadir görülen bir kardiak anomali olup tüm atrial septal defekt olgularının yaklaşık % 5 'ini oluşturur. Bu olguların cerrahi tedavisinde izlenen prensipler halen bir taktım farklılıklar göstermektedir. Mitral kapak fonksiyon bozukluğunun onarımda gözetilen prensipler ve atrial septal defektin kapatılmasında ileti sisteminin korunmasına yönelik cerrahi yaklaşımlar halen tartışmalı konulardır. Bu çalışmada İzmir Atatürk Devlet Hastanesi Kalp ve Damar Cerrahisi Kliniğinde 1992 ve 1993 yıllarında opere edilen 8 PAVKD olgusu değerlendirilmiştir. Bu olgularda uygulanan cerrahi teknik, erken postoperatif dönemde izlenen komplikasyonlar ve 1 yıllık poliklinik izlem bulguları sunulmuştur. Tüm olgularda ostium primum defekti yama ile kapatıldı. ileti sisteminin korunması için sütürler yüzeysel olarak defekt dudağımın solunda, mitral annulus üzerinde bırakıldı. Tüm olgularda mitral kleft tek tek sütürlerle kapatıldı. İki olguda postoperatif erken dönemde geçici ritm ve ileti bozuklukları gelişti ve tamamen kayboldu. Hiçbir olguda hastane mortalitesi ve bir yıllık özlerinde mortaliteye rastlanmadı. Preoperatif dönemde çeşitli derecelerde mitral kapak yetmezliği gösteren 5 olgudan 4 'ünde postoperatif dönemde mitral yetmezlik tamamen ortadan kalktı, 1 olguda ise mitral yetmezliği operasyon öncesi orta derecede iken postoperatif dönemde hafif derece olarak sürdü.Parfait atrioventricular canal defects (PAVCD) are unusual cardiac anomalies, representing about 5 percent of all atrial septal defects. There are still some controversies in some principal objectives in the surgical treatment of these patients. The principles in repair of mitral valve dysfunction and the surgical strategies to avoid heart block during patch closure of the atrial septal defect are still controversial issues. In this study, 8 PAVCD cases operated in İzmir Atatürk State Hospital Cardiovascular Surgery Clinic in 1992 and 1993 are included Operative techniques, early postoperative complications and one year follow-up results are presented Ostium primum defect was closed with patch in all cases. To avoid heart black, sutures were placed superficially to the lefi of the rim of the defect, directly in the annulus of the mitral valve. Mitral valve cleft was repaired with interrupted sutures in all patients. Transient arrhythmia and conduction disturbances developed in 2 patients in the early postoperative period and resolved completely. There was no mortality in hospital and one year follow-up period Four of 5 patients who had mitral insufficiency in arioıts degrees preoperatively improved completely. Mitral insufficiency decreased but persisted in one patient to a mild degree

Approach to scorpion stings in pregnancy: A retrospective case series and literature review

Abstracts: Objective: Scorpion stings remain a serious health problem in many parts of the world. There is very limited information regarding the effects of therapies delivered for scorpion stings in pregnant women on the mother and fetus. They can cause acute conditions such as fetal loss, preterm delivery, or placental abnormalities and can also result in other conditions that may have an effect on the baby in the long term. Materials and methods: In this study the medical records of 24 pregnant women who were admitted to the emergency room at Suruç State Hospital due to scorpion stings between January 1, 2013 and January 1, 2014 were retrospectively reviewed. Age, gestational week, monthly distribution of the cases, type of delivery, status of the fetus, affected body sites, and local and systemic findings were evaluated. The clinical severity of each case was assessed using Abroug's classification. A fetal biophysical profile test was administered in pregnant women above 24 weeks of gestation. The newborns underwent follow-up for mental and motor functions in the pediatric department at three-month intervals for 12 months. Results: 24 patients, with a mean age of 26.1 ± 2.4 years, were included in the study. The most common region stung by scorpions was Lower extremity (58.3%). The most common symptom occurred in cases was immediate localized pain (58%). In terms of gestational age, 41.6% of scorpion sting were within the third trimester. Biophysical profile scores were 8 and above. Only symptomatic treatment, without use of anti-venom, was done to all the patients in this study. And neither death nor major sequel happened. Conclusion: Scorpion stings during pregnancy may not have significant adverse effects on the fetus and the mother. Decisions regarding the use of anti-venom in pregnant women should be considered carefully when only limited safety information, especially in those patients with only local symptoms. Keywords: Emergency department, Fetus, Pregnancy, Scorpion sting