As\u0131l ger\u00e7ek, ameliyat masas\u0131nda ortaya \u00e7\u0131kt\u0131. Akci\u011fer damarlar\u0131n\u0131n neredeyse tamam\u0131 “p\u0131ht\u0131” ile de\u011fil, d\u00fcnyada da nadir te\u015fhis edilebilen bir t\u00fcm\u00f6r ile t\u0131kanm\u0131\u015ft\u0131. \u00dcstelik t\u00fcm\u00f6r, kalp kapa\u011f\u0131n\u0131 da sarm\u0131\u015ft\u0131. 8 saat s\u00fcren bir operasyonla gen\u00e7 adam\u0131n akci\u011fer damarlar\u0131ndaki t\u00fcm\u00f6rler temizlendi, e\u015f zamanl\u0131 olarak kalp kapa\u011f\u0131 kendi dokusu ile tamir edildi. Batur, ameliyatta kullan\u0131lan teknikler ve Kovid sonras\u0131 ortaya \u00e7\u0131kan “pulmoner sarkom” (akci\u011fer damar\u0131 t\u00fcm\u00f6r\u00fc) te\u015fhisi alan ilk vaka olarak literat\u00fcre de girecek.<\/p>\n
Samsun’da avukat katibi olarak \u00e7al\u0131\u015fan bir \u00e7ocuk babas\u0131 28 ya\u015f\u0131ndaki Ra\u015fit Batur’un hayat\u0131, ge\u00e7ti\u011fimiz May\u0131s ay\u0131nda ge\u00e7irdi\u011fi Kovid enfeksiyonunun ard\u0131ndan tamamen de\u011fi\u015fti. Basit bir nefes darl\u0131\u011f\u0131 ile ba\u015flayan \u015fikayetleri ba\u015fta Kovid etkisi san\u0131ld\u0131, uzun bir s\u00fcre do\u011fru te\u015fhisi alamad\u0131. \u00dczerine bir de zat\u00fcrre ge\u00e7iren Batur, bir t\u00fcrl\u00fc ge\u00e7meyen nefes darl\u0131\u011f\u0131 ve halsizlik ile aylar sonra tekrar doktora ba\u015fvurunca, \u00e7ekilen tomografisinde akci\u011fer damarlar\u0131nda “emboli”(p\u0131ht\u0131) oldu\u011fu d\u00fc\u015f\u00fcn\u00fcld\u00fc. Kovid’den kaynakland\u0131\u011f\u0131 zannedilen p\u0131ht\u0131lar\u0131n ameliyat ile acilen \u00e7\u0131kar\u0131lmas\u0131 gerekiyordu. \u00c7\u00fcnk\u00fc p\u0131ht\u0131 atarsa aniden ya\u015fam\u0131n\u0131 yitirebilirdi.<\/p>\n
Batur, “pulmoner endarterektomi” ad\u0131 verilen bu ameliyat\u0131, T\u00fcrkiye’de en \u00e7ok yapan merkez olan \u0130stanbul’daki Marmara \u00dcniversitesi T\u0131p Fak\u00fcltesi E\u011fitim ve Ara\u015ft\u0131rma Hastanesi’ne sevk edildi. Ge\u00e7ti\u011fimiz ay hem G\u00f6\u011f\u00fcs Cerrahisi hem de Kalp Damar Cerrahisi ekipleri taraf\u0131ndan acilen ameliyata al\u0131nd\u0131\u011f\u0131nda, as\u0131l ger\u00e7ek ameliyat masas\u0131nda ortaya \u00e7\u0131kt\u0131: d\u00fcnyada da \u00e7ok nadiren g\u00f6r\u00fclen ve zaman\u0131nda do\u011fru te\u015fhisi konulabilen bir t\u00fcm\u00f6r nedeniyle akci\u011fer damarlar\u0131n\u0131n neredeyse tamamen t\u0131kand\u0131\u011f\u0131 anla\u015f\u0131ld\u0131. “Pulmoner arter sarkomu” ad\u0131 verilen bu hastal\u0131k nedeniyle, akci\u011fer damarlar\u0131 y\u00fczde 90 t\u0131kanm\u0131\u015f, t\u00fcm\u00f6r, kalp kapa\u011f\u0131na kadar ula\u015fm\u0131\u015ft\u0131.<\/p>\n
“KOV\u0130D GE\u00c7\u0130RMESEYD\u0130 TE\u015eH\u0130S\u0130 GE\u0130CK\u0130RD\u0130”<\/strong><\/p>\n Marmara \u00dcniversitesi T\u0131p Fak\u00fcltesi E\u011fitim ve Ara\u015ft\u0131rma Hastanesi G\u00f6\u011f\u00fcs Cerrahisi Anabilim Dal\u0131 Ba\u015fkan\u0131 Prof. Dr. Bedrettin Y\u0131ld\u0131zeli, “Hastam\u0131z Kovid ge\u00e7irdikten sonra ge\u00e7meyen nefes darl\u0131\u011f\u0131 \u015fikayetiyle bir tomografi \u00e7ektiriyor ve pulmoner damarlar\u0131ndaki p\u0131ht\u0131 sebebiyle bize ba\u015fvuruyor. Kovid d\u00f6neminde ‘pulmoner emboli’ dedi\u011fimiz akci\u011fer damarlar\u0131nda p\u0131ht\u0131, \u00e7ok s\u0131k g\u00f6r\u00fclen bir durum oldu. Kovid-19’un kendine \u00f6zg\u00fc sebeplerinden dolay\u0131, b\u00fct\u00fcn v\u00fccuttaki damarlar etkileniyor. Hastam\u0131zda da bu d\u00fc\u015f\u00fcn\u00fclm\u00fc\u015f ba\u015fta. Oysa biz ameliyatta g\u00f6rd\u00fck ki bu p\u0131ht\u0131 de\u011fil, ‘pulmoner arter sarkomu’ ad\u0131n\u0131 verdi\u011fimiz, akci\u011fer damarlar\u0131n\u0131n bir t\u00fcm\u00f6r\u00fc. Hem akci\u011fer damarlar\u0131n\u0131 tutmu\u015f, hem de kalp kapa\u011f\u0131nda bir problem yaratm\u0131\u015ft\u0131. Hastam\u0131z\u0131n hem kalp kapa\u011f\u0131n\u0131 (onararak) de\u011fi\u015ftirdik, hem de damarlar\u0131n\u0131 temizledik. \u015eu an onkoloji tedavisi alacak. Burada \u00f6nemli olan, Kovid-19 ge\u00e7irmemi\u015f olsayd\u0131 bu hasta muhtemelen bize de m\u00fcracaat etmeyecekti. Kovid’e ba\u011fl\u0131 bir akci\u011fer ambolisi zannedildi ama alt\u0131ndan t\u00fcm\u00f6r \u00e7\u0131kt\u0131” dedi.<\/p>\n “\u0130LERLED\u0130\u011e\u0130NDE KALP YETMEZL\u0130\u011e\u0130 HATTA AN\u0130 \u00d6L\u00dcME YOL A\u00c7AB\u0130L\u0130YOR”<\/strong><\/p>\n Ge\u00e7meyen nefes darl\u0131\u011f\u0131 ya da g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 \u015fikayetlerinde mutlaka bu konuda uzman doktorlara m\u00fcracaat edilmesi gerekti\u011fini vurgulayan Prof. Dr. Y\u0131ld\u0131zeli, “Kovid’e ba\u011fl\u0131 olsa da olmasa da, ba\u015fka hastal\u0131klar\u0131n da \u00e7\u0131kabilece\u011fi unutulmamal\u0131” dedi. Batur’un Kovid ge\u00e7irmi\u015f olmas\u0131n\u0131n, \u015fans eseri te\u015fhis almas\u0131n\u0131 h\u0131zland\u0131rd\u0131\u011f\u0131na da i\u015faret eden Prof. Dr. Y\u0131ld\u0131zeli, \u00e7ok nadir g\u00f6r\u00fclen ve genellikle sinsice ilerleyen pulmoner arter sarkomunun ani \u00f6l\u00fcmlere de yol a\u00e7abildi\u011fini s\u00f6yleyerek \u015fu bilgileri verdi: “Bu hastal\u0131k ilerledik\u00e7e sa\u011f kalp yetmezli\u011fi yapacak ve hasta bize bir g\u00fcn, aniden bay\u0131lma ile gelecekti. Biz o zaman da yine ara\u015ft\u0131rma yapacakt\u0131k ve yine bu hastal\u0131\u011f\u0131 bulacakt\u0131k. Ama o d\u00f6nemde hasta aniden vefat edebilirdi, b\u00f6yle bir riski var. Akci\u011fer damar\u0131 t\u00fcm\u00f6r\u00fc \u00e7ok nadir g\u00f6r\u00fcl\u00fcyor. D\u00fcnyada da 200’den fazla vaka yok. Bu nedenle bu hastal\u0131\u011f\u0131n en b\u00fcy\u00fck problemi, do\u011fru tan\u0131 konmas\u0131. Bu da ancak ameliyatla m\u00fcmk\u00fcn oluyor. Tan\u0131 konulduktan sonra endarterektomi ad\u0131n\u0131 verdi\u011fimiz ameliyatla hastalar\u0131n sa\u011f kal\u0131m\u0131 art\u0131yor, ameliyattan sonra kemoterapi al\u0131yorlar. Tabii ki hastalar\u0131n uzun d\u00f6nem takipleri de \u00e7ok \u00f6nemli.”<\/p>\n “\u0130K\u0130S\u0130 B\u0130R ARADA ZOR B\u0130R AMEL\u0130YAT OLARAK L\u0130TERAT\u00dcRE G\u0130RECEK”<\/strong><\/p>\n Kalp Damar Cerrahisi Anabilim Dal\u0131’ndan Prof. Dr. Koray Ak ise “T\u00fcm\u00f6r\u00fcn hem damar\u0131 tutmas\u0131, hem de kapaktan kaynaklanmas\u0131 nedeniyle t\u00fcm\u00f6r\u00fc \u00e7\u0131kard\u0131ktan sonra tabii kalp kapa\u011f\u0131na bir m\u00fcdahale yapmak gerekiyordu. Ozaki y\u00f6ntemi ad\u0131 verilen bir prosed\u00fcrle hastan\u0131n kendi kalp zar\u0131ndan bir kapak yapma y\u00f6ntemini se\u00e7tik. Biz normalde bu y\u00f6ntemi, kalp ameliyat\u0131 yapt\u0131\u011f\u0131m\u0131z hastalarda, \u00e7ocukluk d\u00f6nemi kalp hastalar\u0131n\u0131n cerrahisinde de kullan\u0131yoruz. Ama aort kapak i\u00e7in uygulan\u0131r Ozaki prosed\u00fcr\u00fc. Bu hastam\u0131zda ‘pulmoner kapak i\u00e7in’ Ozaki y\u00f6ntemini kulland\u0131k. Zannediyorum d\u00fcnya literat\u00fcr\u00fcnde de \u00e7ok nadiren yap\u0131lan bir i\u015flem. Ama hem akci\u011fer damarlar\u0131nda t\u00fcm\u00f6r olmas\u0131 ve ona m\u00fcdahale edilirken e\u015fzamanl\u0131 olarak Ozaki ameliyat\u0131, bir ilk. Bu ba\u015far\u0131y\u0131 d\u00fcnya literat\u00fcr\u00fcne kazand\u0131rmak i\u00e7in de makale haline d\u00f6n\u00fc\u015ft\u00fcr\u00fcyoruz. 7-8 saat s\u00fcren olduk\u00e7a uzun ve zor bir ameliyat oldu” dedi.<\/p>\n “AZ KALSIN YANLI\u015e TEDAV\u0130 G\u00d6RECEKT\u0130M”<\/strong><\/p>\n Ameliyat\u0131n ard\u0131ndan birka\u00e7 hafta \u00f6nce taburcu olan ve onkoloji tedavisine y\u00f6nlendirilen Ra\u015fit Batur ise “Bir g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 ile geldim, alt\u0131ndan neler \u00e7\u0131kt\u0131\u00f6 diyerek ya\u015fad\u0131klar\u0131n\u0131 \u015f\u00f6yle \u00f6zetledi: “Kovid ge\u00e7irdim 19 May\u0131s’ta. G\u00f6\u011f\u00fcs a\u011fr\u0131m devam etti. Sonra zat\u00fcrre’ye d\u00f6nd\u00fc. Zat\u00fcrrenin sonunda gene g\u00f6\u011f\u00fcs a\u011fr\u0131m devam etti. Samsun’daki doktorum Bedrettin (Y\u0131ld\u0131zeli) Bey ile ileti\u015fime ge\u00e7erek KTEPH (Kronik Tromboembolik Pulmoner Hipertansiyon, akci\u011fer damarlar\u0131n\u0131n t\u0131kanmas\u0131na ba\u011fl\u0131 olarak geli\u015fen akci\u011fer tansiyonu) te\u015fhisi koydu. KTEPH te\u015fhisinden sonra direkt \u0130stanbul’a randevu al\u0131p geldim. Nefes darl\u0131\u011f\u0131m, y\u00fcr\u00fcyememe zorlu\u011fum da vard\u0131. Zaten Kovid’e ba\u011flad\u0131k hep. Ben \u00e7ok \u015fa\u015f\u0131rd\u0131m, yani bir g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 ile geldik, neler neler \u00e7ektik. Akci\u011fer damarlar\u0131m y\u00fczde 90 t\u0131kal\u0131ym\u0131\u015f. ‘seni acilen ameliyata almam\u0131z laz\u0131m p\u0131ht\u0131 atarsa \u00f6l\u00fcm tehlikesi var’ dediler direkt. Ba\u015fta kuvvetli bir kan suland\u0131r\u0131c\u0131 verip tedaviyi \u00f6yle yapacaklard\u0131 Samsun’da. Allahtan Bedrettin Hoca ile irtibata ge\u00e7tiler ve hemen ameliyat edildim. \u015eimdi kemoterapi ve \u0131\u015f\u0131n tedavisine ba\u015flayaca\u011f\u0131z.”<\/p>\n","protected":false},"excerpt":{"rendered":" Samsun’da ya\u015fayan Ra\u015fit Batur (28), 9 ay \u00f6nce Kovid ge\u00e7irdi. \u015eikayetleri aylarca ge\u00e7medi. Tekrar tomografi \u00e7ekildi, akci\u011fer damarlar\u0131n\u0131n neredeyse y\u00fczde 90’\u0131n\u0131n “p\u0131ht\u0131 ile” t\u0131kand\u0131\u011f\u0131 san\u0131ld\u0131. Acilen ameliyat olmas\u0131 i\u00e7in \u0130stanbul’a sevk edildi.<\/p>\n","protected":false},"author":6,"featured_media":8538,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[53],"tags":[1572,73,2110,1817],"class_list":["post-8536","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-saglik","tag-ameliyat","tag-manset","tag-rasit-batur","tag-samsun"],"_links":{"self":[{"href":"https:\/\/www.ihm.tr\/tr-int\/wp-json\/wp\/v2\/posts\/8536","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ihm.tr\/tr-int\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ihm.tr\/tr-int\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ihm.tr\/tr-int\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ihm.tr\/tr-int\/wp-json\/wp\/v2\/comments?post=8536"}],"version-history":[{"count":1,"href":"https:\/\/www.ihm.tr\/tr-int\/wp-json\/wp\/v2\/posts\/8536\/revisions"}],"predecessor-version":[{"id":8539,"href":"https:\/\/www.ihm.tr\/tr-int\/wp-json\/wp\/v2\/posts\/8536\/revisions\/8539"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.ihm.tr\/tr-int\/wp-json\/wp\/v2\/media\/8538"}],"wp:attachment":[{"href":"https:\/\/www.ihm.tr\/tr-int\/wp-json\/wp\/v2\/media?parent=8536"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ihm.tr\/tr-int\/wp-json\/wp\/v2\/categories?post=8536"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ihm.tr\/tr-int\/wp-json\/wp\/v2\/tags?post=8536"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}