YENİ KURULAN MERKEZİMİZİN 4 YILLIK AÇIK KALP AMELİYAT SONUÇLARININ DEĞERLENDİRİLMESİ

Öz

AMAÇ: Ebulfez Elçibey Kalp ve Damar Cerrahisi Merkezi 2012 yılında kurulmuş ve ilk açık kalp ameliyatı 17.7.2012 tarihinde başarı ile gerçekleştirilmiştir. Bu makalede,  4 yılda ameliyat edilen hastaların sonuçlarını retrospektif olarak değerlendirerek literatür ile karşılaştırmayı planladık.

GEREÇ VE YÖNTEM: 17 Temmuz 2012 ve 15.07.2016 tarihleri arasında 1079 hastaya 1092  kalp ameliyatı yapılmıştır. Hastaların verileri, pompa formları, ekokardiyografi bulguları ve hastanenin bilgi kayıt sisteminden toplanmıştır. Hastaların %96’ı konvansiyonel olarak kardiyopulmoner baypas tekniğiyle, %3’ü çalışan kalpte  kardiyopulmoner baypas ile kapak ameliyatları  ve %1’i de  off-pump çarpan kalpte  ameliyat edilmiştir.

BULGULAR: Hastaların 726 (%67,3)’ı erkek, 353 (%32,7)’ü kadın olup yaş ortalaması 61,68+12,75 olarak hesaplanmıştır. Yapılan 1092 ameliyatın; 1048’i konvansiyonel, 44’ü çarpan kalpte  yapılmıştır. Hastaların 74 (%7)’ü reoperasyon hastasıydı. 59 hastaya bioprotez kullanıldı. Hastaların %61’i 60 yaş ve üzerinde, %44’ü 65 yaş ve üzerinde, %34’ü 70 yaş ve üzerinde, %19’u 75 yaş ve üzerinde ve %8’i 80 yaş ve üzerindeydi. Ortalama EuroSCORE  3,9+2,1 olarak hesaplanmıştır. Ortalama ejeksiyon fraksiyonu 43,53+12,15 (15-70) olarak hesaplanmıştır. 770 (%70,5) hastaya sadece koroner baypas, 121 (%11) hastaya sadece kapak, 115 (%10) hastaya koroner baypasa ilaveten konkomitant prosedür uygulandı. Postoperatif  morbidite olarak en sık atriyal fibrilasyon %11 oranında görülmüştür. Erken postoperatif mortalite 70 vaka ile %6,5 olarak hesaplanmıştır.

SONUÇ:  Kalp cerrahi bölümümüz  yeni kurulan bir merkez olmasına rağmen  vakalarını makul bir morbidite ve mortalite ile yapabilecek bir merkez haline gelmiştir.

Anahtar kelimeler :  kardiyak cerrahi işlemler, koroner  cerrahisi

OBJECTIVE: Ebulfez Elcibey Cardiovascular Surgery Clinic of Ankara Training and Education Hospital has been established in 2012 and first open heart operation done on 17 July 2012. In this report we have evaluated our operative results of the  literature.

MATERIAL AND METHODS: Between the dates 17 July 2012 – 15 July 2016, 1092 heart operation to 1079 patients has been done. Data of patients have been recovered from pump forms ,echocardiography reports and hospital records.

In 96% of cases conventional cardiopulmonary bypass technique has been apllied. 3% of patients underwent heart valve operation using cardiopulmonary bypass on beating heart. In 1% of patients off-pump beating heart coronary bypass was done.

RESULTS: 726 (%67,3) of patiens were male and 353 (%32,7) of them were female. Aveage age was 61,68+12,75. 1048 of the 1092 operation were conventional open heart operation and 44 of them were beating heart. There were 74 (% 7) reoperation. In 59 patients bioprosthetic heart valve has been used. 61%  of patiens were above age 60, 44% above age 65, 34% above 70, 19% above 75 and 8% above age 80 years . Median EuroSCORE values have been estimated to be 3,9±2,1.

770 (%70,5) patient had only coronary bypass Most common morbidity was atrial fibrilation with rate of 11%. Early postoperative mortality was 6,5% with 70 patients.

CONCLUSION: Our cardiovascular surgery department although newly established has been succesfully accomplished very complicated cardiac and aortic surgical cases with very low and acceptable mortality and morbidity.

 Key words: Cardiac surgical procedures, coronary surgery.

Anahtar Kelimeler

• KARDİYAK CERRAHİ İŞLEMLER,KALP KAPAK CERRAHİSİ,KORONER

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