Kardiyopulmoner Bypass Eşliğinde Kalp Kapak Cerrahisi Uygulanan Hastalarda Perfüzyon Süresinin Postoperatif Sonuçlar Üzerine Etkisi

Year 2023, , 252 - 262, 31.12.2023

Bişar Amaç , Murat Ziya Bağış

https://doi.org/10.58605/bingolsaglik.1380552

Abstract

Kardiyopulmoner bypass (KPB) eşliğinde mekanik mitral kapak veya mekanik aort kapak replasmanı operasyonları yapılmaktadır. KPB eşliğinde kalp kapak replasmanı uygulanmış hastalarda KPB/perfüzyon süresinin kardiyak cerrahi sonrası erken dönem morbidite ve mortalite ile ilişkili olduğu düşünülmektedir. Bu retrospektif çalışmada KPB eşliğinde mekanik kalp kapak replasmanı uygulanmış hastaların KPB/perfüzyon süresinin erken dönem postoperatif sonuçlar üzerine etkisinin değerlendirilmesi amaçlandı.
KPB eşliğinde kalp kapak cerrahisi uygulanmış, toplam 116 hasta retrospektif olarak dahil edildi. Hastaların ortalama perfüzyon süreleri hesaplandı. Ortalama perfüzyon süreleri üzerinden hastalar iki gruba ayrıldı (Ortalama perfüzyon süresinin üstünde perfüzyon süresi olanlar bir grup, ortalama sürenin altında perfüzyon süresi olanlar ikinci grup). Hastaların biyokimyasal, hematolojik ve diğer verileri gruplar arasında karşılaştırıldı.
Daha uzun perfüzyon süresine sahip grubun pacemaker, defibrilasyon ve inotrop ihtiyacı, ES transfüzyonu ve hastanede kalış süresinin daha fazla olduğu, ayrıca ALT, GGT ve pH değerleri de daha yüksekti (p<0.05). Diğer operatif, postoperatif ve erken dönem major komplikasyonlar açısından iki grubun sonuçları benzerdi (p>0.05).
Sonuç olarak daha uzun KPB/perfüzyon süresi, ilişkilendirmede nedensellik anlamına gelmese de, perfüzyon süresinin mümkün olduğunca kısa tutulması veya kabul edilebilir sınırlar içerisinde tutulması gerektiğini düşünmekteyiz.

Keywords

Kardiyopulmoner Bypass, Perfüzyon Süresi, Kalp Kapak Replasmanı, Avr, Mvr.

Ethical Statement

Bu çalışma için; çalışma öncesi, çalışma yapılacak kurumdan (Şanlıurfa Mehmet Akif İnan Eğitim ve Araştırma Hastanesi) ve yerel etik kurulundan (Harran Üniversitesi Klinik Araştırmalar Etik Kurulu) onay alındı (Etik Kurul Tarihi: 28.11.2022 - Onay Numarası: HRÜ/22.23.06). Çalışma Helsinki bildirgesi prensiplerine uygun olarak yapıldı.

The Effect Of Perfusion Time On Postoperative Results In Patients Undergoing Cardiopulmonary Bypass Accompanied Heart Valve Surgery

Abstract

Mechanical mitral valve or mechanical aortic valve replacement operations are performed with cardiopulmonary bypass (CPB). CPB/perfusion time is thought to be associated with early morbidity and mortality after cardiac surgery in patients who underwent CPB-guided heart valve replacement. In this retrospective study, it was aimed to evaluate the effect of CPB/perfusion time on early postoperative outcomes in patients who underwent CPB-guided mechanical heart valve replacement.
A total of 116 patients who underwent CPB-guided heart valve surgery were included retrospectively. The mean perfusion times of the patients were calculated. The patients were divided into two groups based on the mean perfusion times (one group with a perfusion time above the mean perfusion time, the second group with a perfusion time below the mean perfusion time). Biochemical, hematological and other data of the patients were compared between the groups.
The group with longer perfusion time had higher need for pacemaker, defibrillation and inotrope, ES transfusion and hospital stay, and also had higher ALT, GGT and pH values (p<0.05). The results of the two groups were similar in terms of other operative, postoperative and early period major complications (p>0.05).
As a result, although longer CPB/perfusion time does not mean causality in the association, we think that the perfusion time should be kept as short as possible or within acceptable limits.

Keywords

Cardiopulmonary Bypass, Perfusion Time, Heart Valve Replacement, Avr, Mvr.

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