İrfan Levent Saltik

Mitral perforation: a rare cause of congenital mitral regurgitation.

In a 4-year-old boy with severe mitral regurgitation, cross sectional echocardiography combined with Doppler interrogation confirmed the presence of isolated perforation of the aortic leaflet of the mitral valve. The perforation was closed with a patch of fresh autologous pericardium. Serial echocardiograms taken postoperatively showed no regurgitation across the mitral valve.

Percutaneous transcatheter snare vegetectomy in a child.

Surgical vegetectomy may be indicated in patients with unresolving sepsis, heart failure, recurrent embolism, or the presence of large vegetations >10 mm in size. Percutaneous vegetectomy using a snare may be a reasonable option instead of open-heart surgery in selected patients. We describe the case of a patient with operated tetralogy of Fallot and infective endocarditis who underwent vegetectomy via a percutaneous approach.

P3 GLENN ŞANTI YAPILAN FONKSİYONEL TEK VENTRİKÜLLÜ HASTALARDA KATETER ANJİOGRAFİ SONUÇLARIMIZ

Cinsel istismar cocuk istismari olgularinda saptanmasi en zor olan ve dolayisiyla en gizli kalan tiplerden biridir Ozellikle cocuk ve ergenler uzerindeki travmatik etkileri ve surekli olarak artan vaka sayilari nedeniyle cocukta cinsel istismar butun toplumu etkileyen bir problem olmaktadir Bu arastirma cinsel istismara maruz kalmis ve kalmamis ergenlerin depresyon kaygi ve benlik algisi duzeylerini karsilastirmak amaciyla yapilmistir Arastirma grubu olarak Istanbul rsquo;un Yenibosna ilcesindeki Adli Tip Kurumu rsquo;na cinsel istismara maruz kalma nedeniyle basvuran 15 24 yas araligindaki 46 rsquo;si kiz 4 rsquo;u erkek olan 50 ergen karsilastirma grubu olarak ise Istanbul rsquo;un Maltepe ilcesinde cesitli hizmet sektorlerinde calisan cinsel istismara ugramamis 42 rsquo;si kiz 8 rsquo;i erkek olan 50 ergen secilmistir Calismaya katilan adolesanlara sosyo demografik degiskenlerini ogrenmek icin Kisisel Bilgi Formu depresyon belirti duzeyini olcmek icin Beck Depresyon Envanteri anksiyete belirti duzeyini olcmek icin Beck Anksiyete Envanteri ve benlik algisini degerlendiren Sosyal Karsilastirma Olcegi uygulanmistir Veri toplama araclari ile elde edilen arastirma bilgilerini degerlendirilebilmesi icin SPSS 15 paket programi kullanilmistir Verilerin analizi icin betimleyici istatistikler yani sira Iki Orneklem Icin Ki Kare Testi Tek Orneklem icin ise Ki kare Testi ve Bagimsiz Orneklemler Icin T Testi kullanilmistir Arastirmanin sonuclarina gore cinsel istismara maruz kalan ergenlerin Beck Depresyon Olcegi ve Beck Anksiyete Envanterinden aldigi puanlar cinsel istismara maruz kalmamis ergenlere gore daha yuksektir ancak cinsel istismara maruz kalan ergenlerin Sosyal Karsilastirma Olceginden aldiklari puanlar ise cinsel istismara maruz kalmamis ergenlere gore daha dusuktur Depresyon anksiyete ve benlik algisi duzeyi bakimindan iki grup arasindaki farkin anlamli oldugu tespit edilmistir Cinsel istismar uzun ve kisa vadede yol actigi zararli etkiler nedeniyle hem magduru ve ailesi hem de eylemin nitelikleri bakimindan cok yonlu olarak ele alinmasi gereken bir problemdir Ozellikle risk etkenlerinin anlasilabilmesi ve soruna bir cozum bulunabilmesi icin Turkiye rsquo;de cocukta cinsel istismari konusu ile ilgili calismalarin arttirilmasina ihtiyac vardir

685 Ventriküler septal defektli olguda ekokardiyografi ile 11 yıla varan izlemde kendiliğinden kapanma sağ atriyuma şant ve subaortik çıkıntı gelişimi aort kapak prolapsusu

Kendiliginden kapanma sol ventrikul sag atriyum santi subaortik cikinti ve aort kapak prolapsusunu saptamak icin 685 ventrikuler septal defektli hastanin kayitlari incelendi Hastalar ekokardiyografi ile 1 ay ile 10 9 yil ortalama 3±2 5 yil izlendi Ventrikuler septal defekt 450 sinde perimembranoz 65 7 5 inde muskuler giris 0 7 211 inde trabekuler muskuler 30 8 16 sinda muskuler cikis 2 3 ve 3 unde doubly committed subarterial di 0 5 685 hastanin 186 sinda ventrikuler septal defekt 40 gun ile 13 7 yas arasinda degisen yaslarda ortalama 2 1±2 22 yas ortanca 1 3 yas kendiliginden kapandi 27 450 perimembranoz defektin 68 i 15 ve 211 trabekuler muskuler defektin 118 i 56 kendiliginden kapandi p lt;0 005 Perimembranoz defektlerin kapanma yasi ortalama 2 8±2 3 yas trabekuler muskuler defektlerin kapanma yasindan ortalama 1 8±2 1 yas daha buyuktu p lt;0 003 450 perimembranoz defektli hastanin 254 unde 56 anevrizmal degisim 38 inde sol ventrikul sag atriyum sant 8 4 26 sinda subaortik cikinti 5 8 53 unde aort kapak prolapsusu 11 7 ve 33 unde aort yetersizligi 7 3 saptandi Aort kapak prolapsusu 16 muskuler cikis defektli hastanin 5 inde 31 ve 3 doubly committed subarterial defektli hastanin birinde saptandi Perimembranoz defektli hastalarda defektin kapanma yasi ile anevrizmal degisim saptanma yasi arasinda istatistiksel farklilik saptanmadi p=0 25 Anevrizmal degisim saptanma yasi sol ventrikul sag atriyum santi subaortik cikinti ve aort kapak prolapsusu saptanma yasindan daha kucuktu sirasiyla p lt;0 03 0 05 ve 0 0007 Anahtar kelimeler: Ventrikuler septal defekt subaortik cikinti aort kapak prolapsusu

Total correction of tetralogy of Fallot without “routine”preoperative cardiac catheterization—management of 99 patients

Between January 1989 and March 1993, total correction was performed in 99 patients with tetralogy of Fallot without submitting them to prior cardiac catheterization. The age of the patients ranged from 1.33 to 18 years (mean 5.33±3.77). After complete echocardiographic examination, the diameters of the right and left pulmonary arteries at the prebranching point and the descending thoracic aorta at the diaphragm were measured by cross-sectional echocardiography and the McGoon ratio was calculated. Total correction was performed in all patients with a McGoon ratio greater than 1.7. In none of the patients were the sizes of the pulmonary artery measured by echocardiography smaller than the measurements obtained during surgery. Transannular patching was performed in 76 patients. A conduit from the right ventricle to the pulmonary arteries was constructed in two patients with coronary arterial anomalies. Postrepair right ventricular to left ventricular systolic pressure ratios were between 0.25 and 0.85 (mean 0.54±0.13). There were two hospital deaths, neither being related to the diagnostic method used nor the criteria for surgery. We conclude that the diagnosis of tetralogy of Fallot together with measurements of pulmonary arteries and descending thoracic aorta can safely and reliably be achieved echocardiographically. The McGoon ratio can be adapted to echocardiography and total correction can be performed successfully based on echocardiographic examination.