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Title: Zdravstvena nega pacienta z marfanovim sindromom po operaciji ascendente aorte Authors: ID Popović, Lidija (Author) ID Saje, Mojca (Mentor) More about this mentor... Files: DIP_Popovic_Lidija_2026.pdf (1,47 MB) MD5: 3E5A14CC121A4C535A2B37A835AB8E24   Language: Slovenian Work type: Bachelor thesis/paper Typology: 2.11 - Undergraduate Thesis Organization: UNM FZV - University of Novo mesto - Faculty of Health Sciences Abstract: Teoretična izhodišča: Marfanov sindrom je avtosomno dominantna bolezen vezivnega tkiva, pri kateri so najnevarnejši zapleti povezani s progresivno dilatacijo in disekcijo ascendentne aorte. Zdravljenje pogosto vključuje profilaktično ali urgentno kirurško zamenjavo aortnega korena/ascendentne aorte (ohranitvene tehnike zaklopke, Bentall), dolgoročni izidi pa so odvisni od vseživljenjskega spremljanja celotne aorte. Ključni del zdravstvene obravnave je pooperativna zdravstvena nega: nadzor hemodinamike (ciljno znižan arterijski tlak), preprečevanje respiratornih zapletov, skrb za kirurško rano in drenaže, učinkovito lajšanje bolečine, varna mobilizacija ter strukturirano izobraževanje pacienta in družine o zdravilih, omejitvah telesne aktivnosti in prepoznavanju opozorilnih znakov. Pomemben je tudi psihološki vidik, saj pacienti – zlasti mlajši – pogosto doživljajo anksioznost in obremenjenost zaradi kronične narave bolezni in možnih reintervencij. Namen diplomske naloge je predstaviti značilnosti Marfanovega sindroma in opredeliti ključne elemente pooperativne zdravstvene nege pacienta po operaciji ascendentne aorte. Poudarek je na hemodinamskem nadzoru, preprečevanju respiratornih in infekcijskih zapletov, varni mobilizaciji, lajšanju bolečin ter izobraževanju pacienta in njegove družine o zdravilih, omejitvah telesnih aktivnosti in prepoznavanju opozorilnih znakov, ki skupaj pomembno prispevajo k dolgoročni varnosti in kakovosti življenja pacientov. Metoda: Uporabljen je bil kvalitativni pristop z deskriptivno metodo dela in sistematičnim pregledom znanstvene in strokovne literature. Vključene so bile baze PubMed, ScienceDirect, SpringerLink, CINAHL in Google Učenjak. Merila vključitve: objave 2015–2025, prost dostop do celotnega besedila v slovenskem ali angleškem jeziku in ključne besede »(po)operativna oskrba«, »zdravstvena nega«, »Marfan(ov) sindrom«, »ascendentna aorta«, »kirurško zdravljenje«. Uporabljeni so bili Boolovi operatorji AND/OR. Iskanje in analiza sta bila izvedena septembra 2025. V končno sintezo je bilo iz skupnega nabora zadetkov vključenih 17 enot literature; proces selekcije je prikazan s PRIZMA diagramom. Rezultati: Analiza izbrane literature kaže, da so najtrdnejši napovedniki varnega izida po operaciji stroga kontrola sistoličnega tlaka in srčne frekvence, dosledno jemanje ß-blokatorja/ARB in redno slikovno spremljanje celotne aorte. Najpogostejši zgodnji zapleti so respiratorni (atelektaze, pljučnica) in krvavitve, pozni pa distalne disekcije/anevrizme, kar zahteva protokolarno spremljanje. Ohranitvene tehnike aortne zaklopke (reimplantacija) dosegajo ugodno dolgoročno funkcijo zaklopke, Bentallova operacija ostaja standard pri določenih indikacijah. Vloga medicinske sestre je ključna pri kontinuiranem nadzoru vitalnih funkcij, interpretaciji subtilnih kliničnih sprememb, aseptični negi rane, varni mobilizaciji, dihalni rehabilitaciji in izobraževanju. Strukturirana zdravstvena vzgoja in psihološka podpora dokazano izboljšujeta adherentnost, zmanjšujeta strah in dvigujeta kakovost življenja. Razprava: Učinkovita pooperativna obravnava pacienta z Marfanovim sindromom po operaciji ascendentne aorte je izrazito multidisciplinarna, pri čemer je medicinska sestra osrednja koordinatorica varnosti in kontinuitete oskrbe. Natančno spremljanje zgodnjih znakov hemodinamske/respiratorne deterioracije, dosledna analgezija in skrb za rano, skupaj z jasnimi protokoli izobraževanja o življenjskem slogu (aerobna, ne izometrična aktivnost), so temelj zmanjševanja ponovnih zapletov. Kakovost življenja je tesno povezana z zgodnjim prepoznavanjem psiholoških potreb in sistematično podporo. Keywords: Marfanov sindrom, ascendentna aorta, kirurško zdravljenje, pooperativna zdravstvena nega. Year of publishing: 2026 PID: 20.500.12556/ReVIS-13161  Publication date in ReVIS: 06.02.2026 Views: 572 Downloads: 14 Metadata:    Cite this work Plain text BibTeX EndNote XML EndNote/Refer RIS ABNT ACM Ref AMA APA Chicago 17th Author-Date Harvard IEEE ISO 690 MLA Vancouver : Copy citation

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Language:	English
Title:	Nursing Care of a Patient with Marfan Syndrome after Ascending Aorta Replacement
Abstract:	Introduction: Marfan syndrome is an autosomal dominant connective tissue disorder in which the most life-threatening complications are related to progressive dilation and dissection of the ascending aorta. Treatment often includes prophylactic or urgent surgical replacement of the aortic root/ascending aorta (valve-sparing techniques, Bentall procedure, etc.), while long-term outcomes depend on lifelong surveillance of the entire aorta. A key element of patient management is postoperative nursing care: haemodynamic monitoring (maintaining a target reduced arterial pressure), prevention of respiratory complications, surgical wound and drain care, effective pain control, safe mobilisation, and structured education of the patient and family regarding medication (β-blocker/ARB), physical activity limitations and recognition of warning signs. The psychological aspect is also important, as patients – particularly younger individuals – often experience anxiety and burden due to the lifelong nature of the disease and the possibility of future re-interventions. Method: A qualitative research approach using a descriptive method and a systematic review of scientific and professional literature was applied. Included databases: PubMed, ScienceDirect, SpringerLink, CINAHL, and Google Scholar. Inclusion criteria: publications 2015–2025, free full-text access in Slovenian or English language, and keywords “(post)operative care”, “nursing care”, “Marfan syndrome”, “ascending aorta”, “surgical management”. Boolean operators AND/OR were used. Literature search and analysis were conducted in September 2025. A total of 17 units of literature were included in the final synthesis from the overall pool of search results; the selection flow is presented with the PRISMA diagram. Results: Analysis of the selected literature indicates that the strongest predictors of safe postoperative outcomes include strict control of systolic blood pressure and heart rate, consistent β-blocker/ARB therapy, and regular imaging follow-up of the entire aorta. The most frequent early complications are respiratory (atelectasis, pneumonia) and bleeding, while late complications include distal dissections/aneurysms, which require protocol-based monitoring. Valve-sparing root repair demonstrates favourable long-term valve function outcomes, while the Bentall procedure remains the standard in specific indications. The nurse plays a key role in continuous monitoring of vital signs, interpretation of subtle clinical changes, aseptic wound care, safe mobilisation, respiratory rehabilitation, and patient education. Structured health education and psychological support have been shown to improve adherence, reduce anxiety, and enhance quality of life. Discussion: Effective postoperative management of a patient with Marfan syndrome after ascending aorta surgery is highly multidisciplinary, with the nurse functioning as the central coordinator of safety and continuity of care. Clinical vigilance for early signs of haemodynamic or respiratory deterioration, consistent analgesia and wound care, along with clear lifestyle education protocols (aerobic, non-isometric activity), are fundamental in reducing recurrent complications. Quality of life is closely linked to early identification of psychological needs and systematic support.
Keywords:	Marfan syndrome, ascending aorta, surgical management, nursing care, postoperative care.

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