Kalp Cerrahisi Yapılan Hastalarda Erken Dönemde Gelişen Postperikardiyotomi Sendromu ve Atriyal Fibrilasyon Arasındaki İlişki

Year 2016, Volume: 19 Issue: 2, 85 - 90, 01.08.2016

Utkan Sevük , Fırat Ayaz Kaan Köse Ertan Demirdaş Aylin Erkul

Abstract

Giriş:
Postoperatif atriyal fibrilasyon (POAF) ve
postperikardiyotomi sendromu (PPS) kalp cerrahisinin sık görülen komplikasyonları
arasında yer alır. POAF ve PPS uzamış yatış süreleri, yüksek morbidite ve
mortalite oranları ve yüksek sağlık bakım maliyetleri ile ilişkili bulunmuştur.
Her iki komplikasyonun da patogenezinde inflamasyon suçlanmakla birlikte, PPS
ve POAF arasındaki ilişki açıklığa kavuşmamıştır. Bu çalışmanın amacı koroner
baypas yapılan hastalarda, erken dönemde gelişen PPS ve POAF arasındaki
ilişkiyi incelemektir.

Hastalar
ve Yöntem: Kliniğimizde kardiyopulmoner
baypas altında koroner baypas operasyonu yapılmış olan hastaların kayıtları
retrospektif olarak incelendi. Takibinde POAF gelişmiş olan ardışık 60 hasta
çalışmaya dahil edildi. Takiplerinde POAF gelişmeyen koroner baypas cerrahisi
yapılmış ardışık 142 hasta kontrol grubuna dahil edildi.

Bulgular:
POAF gelişen hastalarda, POAF gelişmeyen hastalarla
karşılaştırıldığında erken PPS gelişme sıklığı anlamlı olarak daha yüksek
bulunmuştur (%61.7 vs %45.8, p= 0.04 ). Lojistik regresyon analizinde, POAF
gelişen hastalarda erken PPS gelişme riskinin daha fazla olduğu saptandı (Odds
oranı  1.9, %95 güven aralığı 1.03-3.5,
p= 0.04).

Sonuç: Çalışmamızda, izole koroner baypas
ameliyatı yapılmış ve POAF gelişen hastalarda, erken PPS gelişim riskinin POAF
gelişmeyen hastalarla karşılaştırıldığında daha fazla olduğu saptandı. POAF
gelişen hastalar, erken PPS gelişimi açısından yakından takip edilmelidir.

Keywords

Postperikardiyotomi sendromu, postoperatif atriyal fibrilasyon, koroner baypas

Relationship Between Early Post-Pericardiotomy Syndrome and Atrial Fibrillation After Cardiac Surgery

Abstract

Introduction:
Post-operative atrial fibrillation (POAF) and
post-pericardiotomy syndrome (PPS) are common complications of cardiac surgery.
Both PPS and POAF are associated with increased morbidity, mortality, costs and
length of stay after cardiac surgery. Inflammation is involved in the
pathogenesis of both PPS and POAF; however, the relationship between PPS and
POAF remains unclear. The aim of this study was to examine the relationship
between early PPS and POAF in patients who underwent cardiac surgery.

Patients
and Methods: Records of patients who underwent on-pump
coronary artery bypass graft (CABG) surgery were retrospectively reviewed. A
total of 60 consecutive patients who were diagnosed with POAF were included in
the study, while 142 consecutive patients who were not diagnosed with POAF were
included as controls.

Results:
An early PPS development was significantly higher
in patients with POAF than in patients without POAF (61.7% vs 45.8%, p= 0.04).
Logistic regression analysis demonstrated that patients with POAF had 1.9-times
increased risk for developing early PPS (OR, 1.9; 95% CI, 1.03-3.5; p= 0.04).

Conclusion: This study showed that POAF was
associated with an increased incidence of early PPS in patients who underwent
isolated CABG surgery. Therefore, patients with POAF should be closely
monitored for the occurrence of early PPS.

Keywords

Post-pericardiotomy syndrome, post-operative atrial fibrillation, coronary artery bypass graft surgery

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