Opere PDA Sonrası Oluşan Aortapulmoner Pencere Onarımının Transosefageal Ekokardiyografi (TOE) ile Monitorizasyonu (olgu sunumu)

(göğüs-kalp damar anestezi ve yoğun bakım derneği dergisi - cilt 8 - 2002, sayı 1 ocak-temmuz 2002: )

Summary: Recurrent PDA; Repairing of The Aortapulmonary Window and its Monitorisation with Transesophageal Echocardiography (Case Report). A 13 years old female patient operated of patent ductus arteriosus (PDA) in her childhood, was admitted with recurrent PDA. There was a massive blood transition in the preoperative transthoracic echocardiography (TTE) and angiographic study. It was thus reasonably assumed that there was a large defect between aorta and pulmonary artery. Although the defect type and its relation with the surrounding tissues could not have been determined in detail by TTE. The differantial diagnosiswas between an incomplete ligation or the recanalizationof the former PTA. Lateral thoracotomy approach was planned under cardiopulmonary by-pass (CPB). After the anesthetic induction, in the routine intraoperative transesophageal echocardiography (TEE), a 6.2 cm. Aortopulmonary window was observed and not a ductus formation. Since there was a close relation-shib between aorta and pulmonary artery, median sternotomy under CPB in deep hypothermia with pulmonary artery exploration was preferred to a classical lateral thoracotomy approach. Although PDA can be easily identified by TTE in neonate and infants, this technique is not of good value in adults. Thus (intraoperative) TEE should be considered in order to obtain full information about this posterior cardiovascular region before any surgical approach