BİR ÜNİVERSİTE HASTANESİ KLİNİĞİNDE YAPILAN İLK 200 AÇIK KALP AMELİYATI SONUÇLARI: KIRIKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ, KALP-DAMAR CERRAHİSİ

Yıl 2020, Cilt: 22 Sayı: 3, 348 - 356, 31.12.2020

Yıldırım Gültekin Ali Bolat

https://doi.org/10.24938/kutfd.793704

Cited By: 3

Öz

Amaç: Çalışmanın amacı, kliniğimizde yapılan ilk 200 açık kalp ameliyatının sonuçlarını değerlendirmektir.

Gereç ve Yöntemler: Yapılan 200 kalp ameliyatı hastane kayıt sistemi taranarak geriye dönük olarak incelendi. Hastaların yaş, cinsiyet, komorbiditeleri, ameliyat tipleri, hastane ve yoğun bakımda yatış süreleri, morbidite ve mortalite oranları değerlendirildi.

Bulgular: Hastaların 128’i kadın,72’si erkekti. Yaşları 38-90 yıl arasında olup, ortalama 68±5 yıldı. Komorbit faktörleri olarak, kronik obstrüktif akciğer hastalığı, hipertansiyon, diabetes mellitus, hiperlipidemi, serebro-vasküler hastalık, periferik arter hastalığı ve kronik böbrek yetmezliği ve miyokart enfarktüsü görüldü. 

Toplam 162 koroner arter bypass grefti (KABG) yapıldı. Bunlardan 24 tanesi çalışan kalpte gerçekleştirildi. Eş zamanlı olarak 5 karotis endarterektomi ve 15 koroner endarterektomi yapıldı. Dört KABG ve mitral kapak replasmanı (MVR), 2 KABG ve aort kapak replasmanı (AVR), 6 AVR, 12 MVR, 4 AVR ve MVR, 3 MVR ve tricuspit anuloplasti yapıldı. İki hastaya aort diseksiyonu nedeniyle asenden aort replasmanı ve 3 hastanın asenden aort anevrizmasına supra koroner aort replasmanı yapıldı. İki hastaya kardiyak yaralanma nedeniyle sağ ventrikül tamiri yapıldı.

Düşük kardiyak debi nedeniyle 10 hastaya intra-aortik balon pompası takıldı. Komplikasyon olarak 38 hastada atrial fibrilasyon, 4 hastada akut böbrek yetmezliği, 3 hastada serebrovaskuler olay gelişti. Hastaların 4’ünde postoperatif kanama ve 3’ünde sternal dehisens nedeniyle revizyon yapıldı. Bir hastada mediastinit görüldü. Yoğun bakımda kalış süresi ortalama 2,2±1,7 gün olup, hastanede kalış süresi 7,5±4 gündü. Hastane mortalitesi 8 hastada (%4) görüldü.

Sonuç: Kırıkkale Üniversitesi Tıp Fakültesi Araştırma ve Uygulama Hastanesi kalp ve damar cerrahisi kliniği, açık kalp ameliyatlarının literatüre uygun morbidite ve mortalite oranları ile yapıldığı bir merkez olmuştur.

Anahtar Kelimeler

Kalp cerrahisi, yeni merkez, üniversite hastanesi

Destekleyen Kurum

YOK

Proje Numarası

YOK

Teşekkür

.

Results of the First 200 Open Heart Surgeries Performed in A University Hospital Clinic: Kırıkkale University, Faculty of Medicine, Cardiovascular Surgery

Öz

Objective: The aim of the study is to evaluate the results of the first 200 open heart surgeries performed in our clinic.

Material and Methods: Two hundred heart surgeries performed were analyzed retrospectively by scanning the hospital registry system. Patients' age, gender, comorbidities, types of surgery, hospital stay and intensive care unit stay, morbidity and mortality rates were evaluated.

Results: One hundred and twenty-eight of the patients were women and 72 were men. Their age was between 38-90 years and the mean age was 68±5 years. Comorbid factors included, chronic obstructive pulmonary disease, hypertension, diabetes mellitus, hyperlipidemia, cerebro-vascular disease, peripheral artery disease, chronic renal failure, and myocardial infarction. A total of 162 coronary artery bypass graft (CABG) surgeries were performed and 24 of them were off-pump. Five carotid endarterectomies and 15 coronary endarterectomies were performed simultaneously. Four CABG and mitral valve replacement (MVR), 2 CABG surgery and aortic valve replacement (AVR), 6 AVR, 12 MVR, 4 AVR and MVR, 3 MVR and tricuspid annuloplasty were performed. Ascending aortic replacement was performed in 2 patients due to aortic dissection. A supracoronary aortic replacement was performed to 3 ascending aortic aneurysms. Right ventricle was repaired due to 2 cardiac injuries. Ten intraaortic balloon pumps were inserted due to low cardiac output. Complications were 38 atrial fibrillation, 4 acute renal failure, and 3 cerebro-vascular events. Revision was performed due to 4 postoperative bleeding and 3 sternal dehiscence. Mediastinitis developed in 1 patient. The average length of stay in intensive care unit was 2.2±1.7 days, and the hospital stay was 7.5±4 days. Hospital mortality was seen in 8 (4%).

Conclusion: Kırıkkale University Faculty of Medicine Research and Application Hospital cardiovascular surgery clinic has become a center where open heart surgeries are performed in line with the literature regarding morbidity and mortality rates.

Anahtar Kelimeler

Cardiac surgery, new center, university hospital

Proje Numarası

YOK

Kaynakça

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