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Samsun 'da avukat katibi olarak çalışan bir çocuk babası 28 yaşındaki Raşit Batur 'un hayatı, geçtiğimiz Mayıs ayında geçirdiği Kovid enfeksiyonunun ardından tamamen değişti. Basit bir nefes darlığı ile başlayan şikayetleri başta Kovid etkisi sanıldı, uzun bir süre doğru teşhisi alamadı. Üzerine bir de zatürre geçiren Batur, bir türlü geçmeyen nefes darlığı ve halsizlik ile aylar sonra tekrar doktora başvurunca, çekilen tomografisinde akciğer damarlarında "emboli"(pıhtı) olduğu düşünüldü. Kovid'den kaynaklandığı zannedilen pıhtıların ameliyat ile acilen çıkarılması gerekiyordu. Çünkü pıhtı atarsa aniden yaşamını yitirebilirdi.
Batur, "pulmoner endarterektomi" adı verilen bu ameliyatı, Türkiye 'de en çok yapan merkez olan İstanbul 'daki Marmara Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi 'ne sevk edildi. Geçtiğimiz ay hem Göğüs Cerrahisi hem de Kalp Damar Cerrahisi ekipleri tarafından acilen ameliyata alındığında, asıl gerçek ameliyat masasında ortaya çıktı: dünyada da çok nadiren görülen ve zamanında doğru teşhisi konulabilen bir tümör nedeniyle akciğer damarlarının neredeyse tamamen tıkandığı anlaşıldı. "Pulmoner arter sarkomu" adı verilen bu hastalık nedeniyle, akciğer damarları yüzde 90 tıkanmış, tümör, kalp kapağına kadar ulaşmıştı.
"KOVİD GEÇİRMESEYDİ TEŞHİSİ GECİKİRDİ" Marmara Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi Göğüs Cerrahisi Anabilim Dalı Başkanı Prof. Dr. Bedrettin Yıldızeli , "Hastamız Kovid geçirdikten sonra geçmeyen nefes darlığı şikayetiyle bir tomografi çektiriyor ve pulmoner damarlarındaki pıhtı sebebiyle bize başvuruyor. Kovid döneminde 'pulmoner emboli' dediğimiz akciğer damarlarında pıhtı, çok sık görülen bir durum oldu. Kovid-19'un kendine özgü sebeplerinden dolayı, bütün vücuttaki damarlar etkileniyor. Hastamızda da bu düşünülmüş başta. Oysa biz ameliyatta gördük ki bu pıhtı değil, 'pulmoner arter sarkomu' adını verdiğimiz, akciğer damarlarının bir tümörü. Hem akciğer damarlarını tutmuş, hem de kalp kapağında bir problem yaratmıştı. Hastamızın hem kalp kapağını (onararak) değiştirdik, hem de damarlarını temizledik. Şu an onkoloji tedavisi alacak. Burada önemli olan, Kovid-19 geçirmemiş olsaydı bu hasta muhtemelen bize de müracaat etmeyecekti. Kovid'e bağlı bir akciğer ambolisi zannedildi ama altından tümör çıktı" dedi.
"İLERLEDİĞİNDE KALP YETMEZLİĞİ HATTA ANİ ÖLÜME YOL AÇABİLİYOR" Geçmeyen nefes darlığı ya da göğüs ağrısı şikayetlerinde mutlaka bu konuda uzman doktorlara müracaat edilmesi gerektiğini vurgulayan Prof. Dr. Yıldızeli, "Kovid'e bağlı olsa da olmasa da, başka hastalıkların da çıkabileceği unutulmamalı" dedi. Batur'un Kovid geçirmiş olmasının, şans eseri teşhis almasını hızlandırdığına da işaret eden Prof. Dr. Yıldızeli, çok nadir görülen ve genellikle sinsice ilerleyen pulmoner arter sarkomu nun ani ölümlere de yol açabildiğini söyleyerek şu bilgileri verdi:
"Bu hastalık ilerledikçe sağ kalp yetmezliği yapacak ve hasta bize bir gün, aniden bayılma ile gelecekti. Biz o zaman da yine araştırma yapacaktık ve yine bu hastalığı bulacaktık. Ama o dönemde hasta aniden vefat edebilirdi, böyle bir riski var. Akciğer damarı tümörü çok nadir görülüyor. Dünyada da 200'den fazla vaka yok. Bu nedenle bu hastalığın en büyük problemi, doğru tanı konması. Bu da ancak ameliyatla mümkün oluyor. Tanı konulduktan sonra endarterektomi adını verdiğimiz ameliyatla hastaların sağ kalımı artıyor, ameliyattan sonra kemoterapi alıyorlar. Tabii ki hastaların uzun dönem takipleri de çok önemli."
"İKİSİ BİR ARADA ZOR BİR AMELİYAT OLARAK LİTERATÜRE GİRECEK" Kalp Damar Cerrahisi Anabilim Dalı'ndan Prof. Dr. Koray Ak ise "Tümörün hem damarı tutması, hem de kapaktan kaynaklanması nedeniyle tümörü çıkardıktan sonra tabii kalp kapağına bir müdahale yapmak gerekiyordu. Ozaki yöntemi adı verilen bir prosedürle hastanın kendi kalp zarından bir kapak yapma yöntemini seçtik. Biz normalde bu yöntemi, kalp ameliyatı yaptığımız hastalarda, çocukluk dönemi kalp hastalarının cerrahisinde de kullanıyoruz.
Ama aort kapak için uygulanır Ozaki prosedürü. Bu hastamızda 'pulmoner kapak için' Ozaki yöntemini kullandık. Zannediyorum dünya literatüründe de çok nadiren yapılan bir işlem. Ama hem akciğer damarlarında tümör olması ve ona müdahale edilirken eşzamanlı olarak Ozaki ameliyatı, bir ilk. Bu başarıyı dünya literatürüne kazandırmak için de makale haline dönüştürüyoruz. 7-8 saat süren oldukça uzun ve zor bir ameliyat oldu" dedi.
"AZ KALSIN YANLIŞ TEDAVİ GÖRECEKTİM" Ameliyatın ardından birkaç hafta önce taburcu olan ve onkoloji tedavisine yönlendirilen Raşit Batur ise "Bir göğüs ağrısı ile geldim, altından neler çıktıö diyerek yaşadıklarını şöyle özetledi: "Kovid geçirdim 19 Mayıs'ta. Göğüs ağrım devam etti. Sonra zatürre'ye döndü. Zatürrenin sonunda gene göğüs ağrım devam etti. Samsun'daki doktorum Bedrettin (Yıldızeli) Bey ile iletişime geçerek KTEPH (Kronik Tromboembolik Pulmoner Hipertansiyon, akciğer damarlarının tıkanmasına bağlı olarak gelişen akciğer tansiyonu) teşhisi koydu. KTEPH teşhisinden sonra direkt İstanbul'a randevu alıp geldim.
Nefes darlığım, yürüyememe zorluğum da vardı. Zaten Kovid'e bağladık hep. Ben çok şaşırdım, yani bir göğüs ağrısı ile geldik, neler neler çektik. Akciğer damarlarım yüzde 90 tıkalıymış. 'seni acilen ameliyata almamız lazım pıhtı atarsa ölüm tehlikesi var' dediler direkt. Başta kuvvetli bir kan sulandırıcı verip tedaviyi öyle yapacaklardı Samsun'da. Allahtan Bedrettin Hoca ile irtibata geçtiler ve hemen ameliyat edildim. Şimdi kemoterapi ve ışın tedavisine başlayacağız."