The Effect of Pump on Early Postoperative Mortality and Cerebrovascular Accident in Coronary Bypass Surgery Patients

Yıl 2018, Cilt: 21 Sayı: 1, 9 - 15, 01.04.2018

Fatih Aygün Mehmet Özülkü

Öz

Introduction:
This
study investigated the mortality rates during the postoperative early period
(one month) in patients who underwent on- or off-pump coronary artery bypass
grafting (CABG) and explored the effects of cardiopulmonary bypass (CPB) on
early mortality and cerebral accident.

Patients
and Methods: This study comprises a total of 260 subjects that
underwent CABG surgery in our clinic. Patients who underwent CABG were grouped
according to two different surgical techniques: the first group (Group 1)
consisted of patients who underwent CABG using CPB and cross-clamp (on-pump);
the second group (Group 2) consisted of patients who underwent CABG by beating
heart (off-pump) technique. Proximal anastomoses were performed using side
clamps in all cases.

Results: Postoperative
follow-up was conducted on patients until Day 30 for mortality. We encountered
four dead cases and six cerebrovascular accidents.

Conclusion: The rates of cerebral
accidents (2.4% vs. 2.1%) and deaths (1.8% vs. 1%) have the same ratios and are
not statistically significant in on-pump CABG surgeries compared with off-pump
CABG surgeries.

Anahtar Kelimeler

Coronary artery disease, coronary artery bypass, off-pump coronary artery bypass, heart-lung machine, mortality, stroke

Açık Kalp Cerrahisinde, Pompanın Erken Postoperatif Mortalite ve Serebrovasküler Olay Üzerine Etkisi

Öz

Giriş: Bu çalışma, son gelişmelerle pompalı/pompasız koroner arter baypas grafting
(KABGO) uygulanan hastalarda, postoperatif erken dönemde (bir ayda), kardiyopulmoner
baypas (KPB)'ın erken mortalite ve serebral olay üzerine etkileri araştırıldı.

Hastalar ve
Yöntem: Çalışmamız, kliniğimizde koroner arter baypas greftleme
ameliyatı yapılan toplam 260 olguyu içermektedir. KABGO uygulanan hastalar iki
farklı cerrahi tekniğe göre gruplandırıldı. Birinci grup (Grup 1), CPB ve X
klemp (on-pump) kullanılarak KABGO uygulanan hastalardan oluştu. İkinci grup
(Grup 2), atan kalp (off-pump) tekniği ile KABGO uygulanan hastalardan oluştu.
Proksimal anastomozlar tüm olgularda yan klemp kullanılarak yapıldı.

Bulgular: Hastalar postoperatif otuzuncu güne kadar mortalite açısından takip edildi.
Dört ölüm olgusu ve altı serebrovasküler olayla karşı karşıya kaldık.

Sonuç: On-pump KABGO
ameliyatlarında off-pump KABGO ameliyatlarına kıyasla serebral kaza oranları
(%2.4’e karşı %2.1) ve ölüm (%1’e karşı %1.8) benzer oranda görülürken
istatistiksel olarak anlamlı değildir.

Anahtar Kelimeler

Koroner arter hastalığı, koroner arter baypas operasyonu, off pump koroner arter baypas operasyonu, kalp akciğer makinası, mortalite, felç

Kaynakça

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