Koroner Baypas Cerrahisi Sonrasında Atriyal Fibrilasyon Gelişen Hastalarda Risk Faktörlerinin Değerlendirilmesi

Year 2015, Volume: 18 Issue: 2, 76 - 79, 03.08.2015

Mehmed Yanartaş , Hidayet Demir Hakan Hançer Hasan Erdem Kamil Cantürk Çakalağaoğlu Deniz Çevirme Cengiz Köksal Hasan Sunar Sunar

Abstract

Giriş: Postoperatif atriyal
fibrilasyon (AF) kardiyak operasyonlar sonrasında mortalite ve morbiditeye etki
eden önemli bir faktördür. Bu çalışmada, kliniğimizde yapılan koroner baypas
operasyonları sonrası AF gelişme sıklığının ve risk faktörlerinin araştırılması
amaçlanmıştır.

Hastalar
ve Yöntem: Kliniğimizde Ocak 2011- Nisan
2011 yılları arasında yapılan koroner baypas operasyonlarının kayıtları
retrospektif olarak incelenmiştir. Çalışmaya 211 hasta dahil edilmiştir.
Postoperatif AF gelişen hastalar Grup I, gelişmeyen hastalar ise Grup II olarak
sınıflandırılmıştır. İki grup, diabetes mellitus (DM), hipertansiyon (HT),
sigara kullanımı, kronik obstrüktif akciğer hastalığı (KOAH), distal anastomoz
sayısı ve aort kros klemp süresi (AKK) açısından karşılaştırılmıştır.

Bulgular: Grup I’deki hastaların 33 (%68)’ü erkek, 15 (%32)’i
kadın hasta, Grup II’deki hastaların 119 (%73)’u  erkek, 44 (%27)’ü kadındı. Ortalama yaş Grup
I’de 66.2 ± 10.8 yıl, Grup II’de 60.4 ± 9.3 yıl olarak saptandı (p< 0.05).
Gruplar arasında DM, sigara alışkanlığı, HT ve KOAH açısından anlamlı fark
yoktu. Distal anastomoz sayısı Grup I’de ortalama 5.6 ± 2.1, Grup II’de ise ortalama
3.5 ± 2.4 idi (p< 0.05). AKK süresi I. Grupta ortalama 58.2 ± 29.1 dakika,
II. Grupta ortalama 39.6 ± 18.4 dakika olarak bulundu (p< 0.05). Ortalama
yatış süresi Grup I’de 5.2 ± 2.6 gün, Grup II’de 4.5 ± 3.1 gün olarak
belirlendi. Erken dönem mortalite izlenmedi (Taburculuk sonrası ilk bir ay).
Yaş, AKK ve distal anastomoz sayısı, postoperatif AF gelişimini etkileyen temel
faktörler olarak belirlendi.

Sonuç: Postoperatif AF operasyonel
faktörlerden etkilenebilmektedir. Değiştirilebilen risk faktörlerinin kontrolü
postoperatif AF gelişimini önleyebilir.

Keywords

Atriyal fibrilasyon, koroner baypas cerrahisi, risk faktörleri

Evaluation of Risk Factors for Atrial Fibrillation Occurring After Coronary Bypass Surgery

Abstract

Introduction:
Postoperative atrial fibrillation (AF) is an important determinant of mortality
and morbidity after cardiac surgery. In this study, our aim was to examine the
incidence of and risk factors for AF developing after coronary bypass surgery.

Patients and Methods:
Patients undergoing coronary bypass surgery between January 2011 and April 2011
in our department were examined retrospectively. A total of 211 patients were
included in the study. Patients with postoperative AF comprised Group I, while
those without comprised Group II. The two groups were compared in terms of a
number of potential risk factors for AF including the presence of diabetes
mellitus (DM), hypertension (HT), cigarette smoking, chronic obstructive
pulmonary disease (COPD), number of distal anastomoses, and aortic cross clamp
time (ACC).

Results: There were
33 (68%) were male and 15 (32%) female patients in Group I and 119 (73%) male
and 44 (27%) female patients in Group II, respectively. Mean age was 66.2 ±
10.8 years in Group I and 60.4 ± 9.3 years in Group II (p= 0.001). There were
no significant differences between study groups in terms of the incidence of
DM, smoking, HT or COPD. Number of distal anastomoses were 5.6 ± 2.1 in Group I
and 3.5 ± 2.4 in Group II (p< 0.05). ACC time was 48.2 ± 29.1 and 59.6 ±
18.4 minutes in Groups I and II, respectively (p< 0.05). Mean duration of
hospitalization was 5.2 ± 2.6 days in Group I and 4.5 ± 3.1 days in Group II.
No early mortality occurred during the first month after discharge. Age, ACC,
and number distal anastomoses emerged as determinants of the risk of
postoperative AF.

Conclusion: The risk of postoperative AF is
dependent on certain surgical factors. Control of modifiable risk factors can
assist in the prevention of postoperative AF.

Keywords

Atrial fibrillation, coronary bypass surgery, risk factors

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