{"id":4876,"date":"2020-02-20T14:26:54","date_gmt":"2020-02-20T11:26:54","guid":{"rendered":"http:\/\/blog.ulubat.org\/?p=4876"},"modified":"2020-02-20T14:26:56","modified_gmt":"2020-02-20T11:26:56","slug":"insidental-fark-edilen-parasut-mitral-kapak-pmk-vaka-bildirimi-yusuf-can-kenan-mustafayev-nilay-nur-onder-sakarya-universitesi-tip-fakultesi-merkez-egitim-ve-arastirma-hastanesi-kardiyoloji-anabi","status":"publish","type":"post","link":"https:\/\/blog.ulubat.org\/index.php\/gunceller\/insidental-fark-edilen-parasut-mitral-kapak-pmk-vaka-bildirimi-yusuf-can-kenan-mustafayev-nilay-nur-onder-sakarya-universitesi-tip-fakultesi-merkez-egitim-ve-arastirma-hastanesi-kardiyoloji-anabi\/","title":{"rendered":"\u0130NS\u0130DENTAL FARK ED\u0130LEN PARA\u015e\u00dcT M\u0130TRAL KAPAK (PMK): VAKA B\u0130LD\u0130R\u0130M\u0130 YUSUF CAN, KENAN MUSTAFAYEV, N\u0130LAY NUR \u00d6NDER SAKARYA \u00dcN\u0130VERS\u0130TES\u0130 TIP FAK\u00dcLTES\u0130 MERKEZ E\u011e\u0130T\u0130M VE ARA\u015eTIRMA HASTANES\u0130 KARD\u0130YOLOJ\u0130 ANAB\u0130L\u0130M DALI"},"content":{"rendered":"\n

<\/p>\n\n\n\n

\"\"
(series of 45 children published in 2013) 4. coarctation of aorta supravalvar mitral ring. subaortic stenosis. 2. parachute mitral valve. AATS 2015 Parachute and Hammock Valves| Seattle<\/figcaption><\/figure>\n\n\n\n

Giri\u015f<\/strong><\/p>\n\n\n\n

Para\u015f\u00fct mitral kapak (PMK), mitral kapak korda\ntendineas\u0131n\u0131n tek veya bask\u0131n bir papiller kasa tutunmas\u0131yla meydana gelen\nkonjenital kapak anomalisidir. Korda tendinealar normalden daha k\u0131sa ve\nkal\u0131nd\u0131r. Para\u015f\u00fct mitral kapak anomalisine \u00e7o\u011funlukla kalbin sol taraf\u0131ndaki\nobstr\u00fcktif lezyonlar (supravalv\u00fcler mitral halka, subaortik darl\u0131k ve aort\nkoarktasyonu) e\u015flik eder ve bu olaya Shone kompleksi denir. Shone kompleksi\n\u00e7o\u011funlukla bebeklerde ve \u00e7ocuklarda g\u00f6r\u00fcl\u00fcr. Hemodinamik a\u00e7\u0131dan riskli olaylara\n(kan\u0131n diyastol s\u0131ras\u0131nda sol ventrik\u00fcle akmamas\u0131) sebep olabilece\u011fi i\u00e7in\ny\u00fcksek mortalite oran\u0131na sahiptir.<\/p>\n\n\n\n

Posterimizde sizlere insidental rastlad\u0131\u011f\u0131m\u0131z para\u015f\u00fct mitral kapak olgusunu sunuyoruz.<\/p>\n\n\n\n

Olgu<\/strong><\/p>\n\n\n\n

32 ya\u015f\u0131nda erkek hasta, askeri okul s\u0131nav\u0131n\u0131n zorunlu k\u0131ld\u0131\u011f\u0131 sa\u011fl\u0131k kontrol\u00fc nedeniyle kardiyoloji poliklini\u011fimize ba\u015fvurdu,\u00a0 kardiyak herhangi bir \u015fikayeti yoktu. Elektrokardiyografisi (EKG) ve akci\u011fer grafisi normaldi. Transtorasik ekokardiyografi (TTE) sol ventrik\u00fcl uzun eksen g\u00f6r\u00fcnt\u00fcs\u00fcnde korda tendinean\u0131n tek bir papiller kasa tutundu\u011fu fark edildi, k\u0131sa eksen g\u00f6r\u00fcnt\u00fcs\u00fcnde ise tek papiller kas ve bazal seviyede para\u015f\u00fct yaprak\u00e7\u0131klar\u0131 g\u00f6r\u00fcld\u00fc. Kardiyak odac\u0131klar normal boyuttayd\u0131. D\u00f6rt odac\u0131kl\u0131 g\u00f6r\u00fcn\u00fcmde, diyastolik kubbe \u015feklinde armut bi\u00e7imli mitral yap\u0131 g\u00f6r\u00fcld\u00fc (\u015eekil 1)<\/strong>. Ekokardiyografide mitral kapak yetersizli\u011fi ve mitral darl\u0131k saptanmad\u0131. \u0130li\u015fkili ba\u015fka herhangi bir patolojiye rastlanmad\u0131. Ek olarak \u00fc\u00e7 boyutlu transtorasik ekokardiyografi ile tek papiller kas varl\u0131\u011f\u0131 do\u011fruland\u0131.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Tart\u0131\u015fma<\/strong><\/p>\n\n\n\n

Yeti\u015fkin PMK, son yar\u0131m y\u00fczy\u0131lda literat\u00fcre\nbildirilmi\u015f az vaka olmas\u0131 sebebiyle nadir g\u00f6r\u00fclen konjenital kapak\nanomalisidir. Asemptomatik hastalar ancak ekokardiyografi ile tesad\u00fcfen\nke\u015ffedilebilir.  Mitral kapa\u011f\u0131n a\u00e7\u0131lmas\u0131\ns\u0131n\u0131rl\u0131 oldu\u011fu i\u00e7in PMK\u2019de mitral darl\u0131k semptomatik hastalar\u0131n \u00e7o\u011funda\ng\u00f6r\u00fcl\u00fcr. Bu hastalar bize genellikle atriyal fibrilasyon aritmisi ve dispne\nsemptomlar\u0131 ile gelir. Mitral yetersizlik ise daha az g\u00f6r\u00fcl\u00fcr ancak mitral\ndarl\u0131k zamanla yetersizli\u011fe sebep olabilece\u011fi i\u00e7in hasta takibi \u00f6nemlidir. Ani\nkardiyak \u00f6l\u00fcm riski Shone kompleksi dedi\u011fimiz birden fazla obstr\u00fcksiyona sahip\nolan hastalarda daha fazlad\u0131r. <\/p>\n\n\n\n

Konservatif cerrahi tedavi, mitral darl\u0131\u011f\u0131 olan hastalarda kommiss\u00fcrotomi veya b\u00fct\u00fcn PMK hastalar\u0131nda papiller kas b\u00f6l\u00fcnmesi i\u015flemleriyle yap\u0131labilir. \u0130leri mitral yetmezli\u011fi olan hastalarda ise kapak ameliyatlar\u0131 d\u00fc\u015f\u00fcn\u00fclebilir. Prognoz genellikle k\u00f6t\u00fcd\u00fcr ve cerrahi onar\u0131mdan sonra tatmin edici sonu\u00e7lar bildirilmemi\u015ftir. Bununla birlikte, ekokardiyografik de\u011ferlendirmede \u00f6nemli mitral darl\u0131k veya yetersizlik olmadan Shone kompleksli obstr\u00fcktif PMK vakalar\u0131nda da cerrahi d\u00fczeltme yap\u0131labilir. Amerikan ve Avrupa ekokardiyografi topluluklar\u0131, PMK olan yeti\u015fkinlerin uluslararas\u0131 bir \u015fekilde kaydedilmesi hem tan\u0131y\u0131 kolayla\u015ft\u0131rmada hem de nadir g\u00f6r\u00fclen bu konjenital anomalinin seyrini izlemede yararl\u0131 oldu\u011funu d\u00fc\u015f\u00fcn\u00fcyor ve PMK hastalar\u0131n\u0131n bildirilmesi gerekti\u011fini vurguluyor.<\/p>\n\n\n\n

Sonu\u00e7<\/strong><\/p>\n\n\n\n

Hastam\u0131z\u0131n TTE\u2019sinde mitral kapakta darl\u0131k\ng\u00f6zlenmedi. Hastam\u0131z asemptomatik yani PMK hastan\u0131n ya\u015fam\u0131na herhangi bir\ns\u0131k\u0131nt\u0131 vermedi\u011fi i\u00e7in klinik takip \u00f6nerildi. Fakat hastam\u0131z\u0131n istenilen sa\u011fl\u0131k\nkontrol\u00fcnde konjenital kalp hastal\u0131\u011f\u0131 fark edildi\u011fi i\u00e7in askeri okula ba\u015fvurusu\nreddedildi. <\/p>\n\n\n\n

Anahtar Kelimeler: Konjenital kalp hastal\u0131\u011f\u0131, mitral kapak, insidental<\/p>\n\n\n\n

.<\/p>\n\n\n\n

.<\/p>\n\n\n\n

.<\/p>\n\n\n\n

Incidentally\n<\/strong>Finding<\/strong> Parachute Mitral Valve: Case Report<\/strong><\/p>\n\n\n\n

Case Report<\/p>\n\n\n\n

32-yeart-old man presented with outpatient clinic\nwithout any symptoms for military school admission. He had normal\nelectrocard\u0131ography and chest radiography. LV long-axis view elongated chordae\nconverge into a single papillary muscle. Transthoracic echocardiography in the\nshort-axis view at mid-papillary level revealed single papillary muscle and at\nbasal level showed parachute leaflets. Cardiac chambers were in normal size. In\nfour-chamber view reveal pear-shaped mitral configuration with a diastolic dome\nshape.  Echocardiography showed no mitral\nvalve regurgitation and mitral stenosis. <\/p>\n\n\n\n

Conclusions<\/p>\n\n\n\n

There no\nev\u0131dence for any pathology other valvular and vascular stenosis. As the presence of\nparachute mitral valve had no impact on the patient\u2019s management,  medical follow-up was scheduled. The patient\nwas not admitted to military school due to congenital heart disease.<\/p>\n\n\n\n

Key Words: congenital heart disease, mitral valve, incidentally\n<\/p>\n","protected":false},"excerpt":{"rendered":"

Giri\u015f Para\u015f\u00fct mitral kapak (PMK), mitral kapak korda tendineas\u0131n\u0131n tek veya bask\u0131n bir papiller kasa tutunmas\u0131yla meydana gelen konjenital kapak<\/p>\n","protected":false},"author":149,"featured_media":4881,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[165],"tags":[],"acf":[],"views":1337,"_links":{"self":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/4876"}],"collection":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/users\/149"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/comments?post=4876"}],"version-history":[{"count":4,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/4876\/revisions"}],"predecessor-version":[{"id":4885,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/4876\/revisions\/4885"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media\/4881"}],"wp:attachment":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media?parent=4876"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/categories?post=4876"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/tags?post=4876"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}