Controlling Bleeding From Proximal and Coronary Ostial Anastomoses By Using Blood Cardioplegia Delivering Antegradely While Performing Bentall Procedure

Öz

Bentall procedure is one of the valved conduit techniques which is used in the treatment of aortic valve diseases accompanied by ascending aortic aneurysm and dissection and it is used commonly around the world. In Bentall procedure, which is a complicated and long surgery, the rate of mortality and morbidity are not only related to the operation itself but also to the complications like major neurological events, myocardial damage and bleeding which take place during the intraoperative and postoperative period. Although the quantity and frequency of bleeding is declined with teflon strips and biological tissue glues, modifications of Bentall procedure are still an important problem. This study was conducted retrospectively with 48 patients in terms of early results of complication of bleeding caused specifically by proximal suture line and coronary ostium anastomosis lines controlled by the method of blood cardioplegia while performing Bentall procedure and supracoronary aort replacement in our clinic.

Anahtar Kelimeler

• Cardiopulmonary bypass; cardioplegic solutions; hemorrhage.

Bentall Prosedürü Sırasında Proksimal ve Koroner Ostiyum Anastomozlarından Oluşabilecek Kanamaların Antegrad Verilen Kan Kardiyoplejisiyle Kontrolü

Öz

Bentall prosedürü, aort kapak hastalıkları ile birlikte seyreden asendan aort anevrizması ve aort diseksiyonlarının tedavisinde uygulanan kapaklı konduit tekniklerinden biri olup tüm dünyada yaygın olarak kullanılmaktadır. Komplike ve uzun bir ameliyat olan Bentall prosedüründe mortalite ve morbidite oranları sadece ameliyatın kendisine değil aynı zamanda intraoperatif ve postoperatif dönemde meydana gelebilecek santral nörolojik olay, miyokardiyal hasar ve kanama gibi komplikasyonlarla da ilişkilidir. Kanama probleminin önlenebilmesi için geliştirilen Bentall prosedürünün modifikasyonları, teflon stripler ve biyolojik doku yapıştırıcıları ile kanama miktarı ve sıklığı azalmış olsa da halen önemli bir sorun olarak gündemdedir. Kliniğimizde Bentall prosedürü ve suprakoroner aort replasmanı uygulanan 48 hastada özellikle proksimal sütür hattından ve koroner ostiyum anastomoz hatlarından meydana gelebilecek cerrahi kanamalar, antegrad verilen kan kardiyoplejisi yöntemi ile erken dönem sonuçları açısından retrospektif olarak incelenmiştir.

Anahtar Kelimeler

• Kardiyopulmoner baypas, kardiyoplejik solüsyonlar, kanama.

Kaynakça

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