KORONER ARTER BYPASS GREFTLEMELİ HASTALARDA GELİŞEN POST PERİKARDİYEKTOMİ SENDROMUNDA KOLŞİSİN KULLANIMI VE CERRAHİ MÜDAHALE ÜZERİNE ETKİSİ

Year 2022, , 190 - 195, 20.04.2022

Ziya Yıldız

https://doi.org/10.18229/kocatepetip.937302

Abstract

AMAÇ: Postperikardiyotomi sendromu (PPS); bütün gelişmelere rağmen kardiyak cerrahi sonrası morbiditenin en sık nedenlerinden biri olmaya devam etmektedir. Koroner arter bypass greftleme sonrası PPS’ e bağlı olarak perikardiyal efüzyon ve dirençli perikarditlerin oluştuğu tespit edilen hastalarımızda kolşisinin oluşan perikardiyal efüzyonları ve enflamasyonu kısa sürede azaltıp tamamen ortadan kaldırmada ve cerrahi müdahaleleri belirgin olarak azalttığı konusunda sanılandan daha etkili olup olmadığını araştırdık.
GEREÇ VE YÖNTEM: Ocak 2015 ile Ocak 2020 tarihleri arasında tamamı koroner arter baypas greftleme operasyonu geçiren PPS gelişen 56 hasta retrospektif olarak çalışmaya dahil edildi. Bu hastalardan 24’ünün tedavisinde kolşisin kullanılırken diğer 32 hastanın tedavisinde kolşisin kullanılmadı. Elde edilen sonuçlar karşılaştırıldı. Hastaların gruplar arasında demografik özellikleri, eşlik eden risk faktörleri, risk analizleri koroner arter baypas greftlemede yapılan anastamoz sayıları, drenaj miktarları ve enflamasyon değerleri karşılaştırıldı. Hastalardaki morbidite ve mortaliye etkili faktör araştırılıp incelendi. Kolşisinin hem tedavi üzerine hem de invaziv girişim sıklığı üzerine olan etkinliği araştırıldı.
BULGULAR: Çalışma grubu ve kontrol grubundaki hastalar karşılaştırılmıştır. Çalışma grubundaki hastaların tedavisinde kullanılan kolşisinin perikardiyal mayiinin rezorbsiyonunda ve perikardiyal mayinin boşaltılması için gerekli olabilecek cerrahi müdahalenin sıklığının azaltılmasında etkili olduğu tespit edilmiştir.
SONUÇ: Kolşisin kullanımı; perikardiyal efüzyon miktarını ve bunun için gerekebilecek cerrahi girişim sıklığını ciddi olarak azaltmıştır. Rutin uygulamada kliniğimizde PPS gelişen hastalarda ilk tercih olarak kullanmaktayız. PPS sonrası gerilemeyen perikardiyal efüzyonların, dirençli perikarditlerin tedavisinde invaziv girişlerden önce kolşisinin akılda tutulması gereken etkin, ucuz ve yan etkileri nadir bir tedavi yöntemi olduğunu düşünüyoruz. Kolşisin PPS gelişen hastaların tedavisinde kliniğimizde halen güvenle ve başarıyla kullanılmaktadır.

Keywords

Kolşisin, Perikardit, Perikardiyektomi

Supporting Institution

yoktur

Project Number

yoktur

USE OF COLCHICINE FOR POST PERICARDIECTOMY SYNDROME IN PATIENTS WITH CORONARY ARTERY BYPASS GRAFT AND ITS EFFECTS ON SURGICAL INTERVENTION

Abstract

OBJECTIVE: Postpericardiotomy syndrome (PPS) continues to be one of the most common causes of morbidity after cardiac surgery despite all developments. We investigated whether colchicine is more effective than expected in reducing and eliminating pericardial effusions and inflammation in a short time and significantly reducing surgical interventions in our patients who have pericardial effusion and resistant pericarditis due to PPS after coronary artery bypass grafting.
MATERIAL AND METHODS: Fifty-six patients with PPS all of whom coronary artery bypass grafting between January 2015 and January 2020 were retrospectively included in the study. While colchicine was used in the treatment of 24 of these patients, colchicine was not used in the treatment of the other 32 patients. The results obtained from the data were compared. Demographic characteristics, accompanying risk factors, risk analysis, number of anastomoses performed in coronary bypass grafting, drainage amaount and inflammation values were compared between the groups. Factors that affect morbidity and mortality in patients were investigated and analyzed. The effectiveness of colchicine on both treatment and frequency of invasive procedures was investigated.
RESULTS: Patients in the study group and control group were compared. It has been determined that colchicine used in the treatment of the patients in the study group was effective in the resorption of pericardial fluid and in reducing the frequency of surgical intervention that may be necessary to drain the pericardial fluid.
CONCLUSIONS: The use of colchicine significantly reduced the amount of pericardial effusion and the frequency of surgical intervention that may be required for this. In our clinic, we use it as the first option in patients with PSS in routine practice. In the treatment of non-regressive pericardial effusions and persistent pericarditis after PPS; we think that colchicine is effective and inexpensive treatment method with rare side effects that should be kept in mind before invasive entries. Colchicine is still used safely and successfully in our clinic for the treatment of patients with PPS.

Keywords

Colchicine, Pericardite, Pericardectomy

Project Number

yoktur

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