Atan kalpte koroner arter bypass cerrahisi sonuçlarımız

Yıl 2004, Cilt: 1 Sayı: 4, 17 - 20, 01.08.2004

Osman Tansel Darçın Alper Sami Kunt Mehmet Salih Aydın Cüneyt Şelli,

Öz

Amaç: Kalp cerrahisinde atan kalpte koroner arter bypass KABC tekniği öncelikle yüksek riskli hastalarda olmak üzere günümüzde yaygın olarak kullanılmaktadır. Bu çalışmada koroner arter hastalığı nedeniyle kliniğimizde Euroscore > 5 olan hastalarda çalışan kalpte KABC tekniği ile ameliyat ettiğimiz olguların sonuçlarını sunmayı amaçladık. Gereç ve Yöntem: Kliniğimizde Nisan 2002-Ocak 2005 tarihleri arasındaki dönemde 86 atan kalpte KABC ameliyatı yapıldı. Tüm olguların yaş ortalaması 61.5 ± 8.9 yıl ve %89.64’ü erkek idi. Preoperatif değerlendirilmelerinde olguların risk faktörleri; sigara içimi 23 olgu %27.90 , diyabet 19 olgu %23.25 , hipertansiyon 34 olgu %40.69 , kronik obstrüktif akciğer hastalığı 6 olgu %6.97 ile sıralanmaktaydı. Bulgular: Olguların sol ventrikül ejeksiyon fraksiyonu % 34.2 ± 9.1 ve Euroscore değerleri 9.7 ± 3.1 bulundu. Ortalama distal anastomoz 1.99 ± 0.6 olarak gerçekleştirildi. Ortalama yoğun bakım kalış süresi 19 ± 5.2 saat , hastane kalış süresi 7.5 ± 1.5 gün idi. Sekiz olguda %9.19 intraaortik balon pompası kullanıldı. Beş olguya %5.74 atan kalpte KABC ve koroner endarterektomi yapıldı. Hastane mortalitesi 3 hastada % 3.4 görüldü. Sonuç: Atan kalpte KABC tekniğinin yüksek riskli hastalarda kabul edilebilir mortalite ve morbiditeyle uygulanabileceği kanaatindeyiz

Anahtar Kelimeler

Atan kalp, koroner arter bypass cerrahisi, Euroscore

Clinical outcome off-pump coronary artery bypass grafting

Öz

Background: In the recent years, off-pump coronary artery bypass OPCAB surgery has become an established surgical technique especially in Euroscore > 5 patients. The purpose of this study is to investigate the results of on the beating heart coronary bypass surgery in patients with Euroscore > 5. Methods: Eighty-six patients operated on the beating heart between April 2002 and January 2005 were included in this study. Mean age of patients 61.5 ± 8.9 years and 89.64% were male. Preoperative patşent risk factor was; smoking 23 patient 27.90% , diabetes mellitus 19 patient 23.25% , hypertansion 34 patient 40,69% and cronic obstruktive lung disease in 6 patient. Results: Mean of left ventricular ejection fraction of all patients was 42 ± 9.1%, Euroscore was 9.7 ± 3.1. The mean number of bypassed grafts was 1.99 ± 0.6. Mean stay at intensive care unit 19 ± 5.2 hour, and at hospital 7.5 ± 1.5 days. İntra-aortic balloon pump was used in eight patients 4.6% . Five patients 5.8% received endarterectomy of at least one coronary artery. Hospital mortality was 3.4% with 3 patients. Conclusions: Off-pump CABG can be performed with low mortality and morbidity in patients with Euroscore>5

Anahtar Kelimeler

Beating heart, Coronary artery bypass, Euroscore

Kaynakça

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