Diyabetik Yaşlı ve İleri Yaş Hasta Gruplarında Atan Kalpte Koroner Arter Cerrahisinin Perioperatif ve Klinik Sonuçları

Year 2016, Volume: 6 Issue: 2, 81 - 86, 19.10.2016

Suleyman Surer İlker Ince Ali Bulut Uğursay Kızıltepe

https://doi.org/10.16899/ctd.41638

Abstract

Giriş: İleri yaş diyabetik hastalarda koroner arter cerrahisine bağlı perioperatif mortalite ve morbidite riski mevcuttur. Çalışmamızda yaşlı (Grup I) ve ileri yaş (Grup II) diyabetik hasta gruplarında atan kalpte koroner arter cerrahisinin risk faktörlerini ve sonuçlarını karşılaştırmayı amaçladık.

Gereç ve Yöntem: Bu çalışma hastanemizde geriye dönük olarak izole atan kalpte koroner cerrahisi yapılan 37 diyabetik hasta yaş gruplarına göre 65 yaş ve üzeri olanlar alındı. Çalışmaya 65 - 75 yaş arasında 25 hasta ve 76 yaş ve üzerinde 12 hasta dahil edildi. Grupların preoperatif ve operatif özellikleri ile ameliyat sonrası sonuçları karşılaştırıldı.

Bulgular: Yaşlı hastalar, ileri yaşlı grubunda olan hastalarla karşılaştırıldığında; ortalama arteryel anastomoz sayısı (p=0.045), vücut kitle indeksi (P=0.001), sigara kullanımı (p=0.027) ve ACE inhibitörü kullanımı (p=0.027) istatistiksel olarak yüksek bulundu. İleri yaşlı grubunda ise ortalama venöz anastomoz sayısı (1.5±0.61 vs 2.25±0.75, p= 0.008) istatistiksel olarak anlamlı bulundu.

Sonuç: Her iki grupta da beklenenden daha uzun yaşam süreleri nedeniyle koroner arter cerrahisi sıklığı artmaktadır. Her iki grupta da atan kalpte koroner arter cerrahisinin daha faydalı bir yöntem olarak önermekteyiz. 

 

Keywords

Yaşlı, ileri yaşlı, diyabetik, atan kalpte koroner arter cerrahisi

Off-Pump Coronary Artery Surgery in Diabetic Elderly and Octogenerian Groups :Perioperative Outcome and Clinical Results

Abstract

-Increased risk for perioperative morbidity and mortality after beating heart coronary artery bypass grafting(CABG) in diabetic octogenarians (Group II) and elderly (Group I) can be in question. We aimed to compare the risk factors and the results of off-pump CABG between diabetic elderly and octogenarian groups .Methods- This study retrospectively enrolled 37 diabetic patients with an age equal to or greater than 65 years who underwent isolated OPCAB at our department . Twenty-five patients were between 65 and 75 years of age while 12 patients had an age equal to or greater than 76 years. Each study group was assessed for preoperative properties, operative characteristics, and postoperative outcomes. Results-Elderly patients had a significantly higher mean number of arterial anastomoses (p=0.045), body mass index (BMI) (P=0.001), number of smoking subjects (p=0.027), and number of subjects using ACE inhibitors (P=0.027) compared to the octogenarians. Octogenarians had a significantly greater mean number of venous grafts (1.5±0.61 vs 2.25±0.75, p= 0.008).Conclusions-People of advanced age have been increasingly operated with CABG operation as persons 80 years old or older live longer than previously expected. Off-pump CABG was a beneficial surgical coronary revascularization method for both elderly and octogenarian patients-

Keywords

Elderly, octogenarians, diabetic, off-pump coronary artery bypass grafting

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