Sağ ventrikül dalına ek bypass greftlemenin elektrokardiyografik ve ekokardiyografik parametreler üzerindeki etkisi

Öz

Amaç: Bu çalışma, sağ ventrikül (SV) dallarına ek koroner arter bypass greftleme (KABG) işleminin ekokardiyografik ve elektrokardiyografik parametreler üzerindeki etkisini, özellikle SV fonksiyonu ve elektriksel stabiliteye odaklanarak değerlendirmeyi amaçladı. Gereç ve Yöntemler: Ocak 2017 ile Aralık 2022 tarihleri arasında belirgin sağ koroner arter (SKA) hastalığı nedeniyle KABG uygulanan hastalar retrospektif olarak incelendi. Hastalar dahil edilerek iki gruba ayrıldı: Grup 1 (n = 34), sadece distal RCA dallarına (posterior desendan arter veya posterolateral dal) greft uygulanan hastaları içerirken, Grup 2 (n = 34), hem distal SKA hem de SV dalına greft uygulanan hastaları içeriyordu. Gruplar arasında ameliyat öncesi ve taburculuk dönemindeki ekokardiyografik ve elektrokardiyografik parametreler karşılaştırıldı. Bulgular: Gruplar arasında başlangıçta ekokardiyografik ve elektrokardiyografik parametreler dahil olmak üzere temel özellikler açısından fark bulunmamaktaydı. Taburculuk döneminde, triküspit anüler düzlem sistolik ekskürsiyonu (TAPSE) değeri Grup 1’de Grup 2’ye kıyasla daha düşüktü (11.7 ± 2.7 mm vs. 15.1 ± 2.3 mm; p < 0.001). Diyastolik disfonksiyon oranı Grup 1’de Grup 2’ye göre daha yüksekti (%91.2 vs. %61.8; p < 0.001). Ortalama QT dispersiyonu (54.6 ± 15.4 ms vs. 63.7 ± 18.5 ms; p = 0.031) ve ortalama P dalgası dispersiyonu (22.5 ± 5.3 ms vs. 26.2 ± 8.8 ms; p = 0.048) değerleri Grup 2’de Grup 1’e kıyasla daha düşüktü. Sonuçlar: Belirgin RCA hastalığı olan hastalarda RV dalına ek bypass greftleme, SV fonksiyonlarında iyileşme ve daha olumlu elektrokardiyografik parametrelerle ilişkilendirildi.

Anahtar Kelimeler

• Koroner arter bypass greftleme
• P dalgası dispersiyonu
• sağ ventrikül fonksiyonu
• sağ koroner arter
• ventriküler repolarizasyon
• triküspit anüler düzlem sistolik ekskürsiyonu

The impact of additional right ventricular branch grafting on electrocardiographic and echocardiographic parameters

Öz

Aims: This study aimed to evaluate the impact of additional coronary artery bypass grafting (CABG) to right ventricular (RV) branches on echocardiographic and electrocardiographic parameters, with a focus on RV function and electrical stability. Methods: A retrospective review was conducted on patients who underwent CABG with significant right coronary artery (RCA) disease between January 2017 and December 2022. Patients were included and divided into two groups: Group 1 (n = 34) received grafts only to the distal RCA branches (posterior descending artery or posterolateral branch); Group 2 (n = 34) underwent grafting to both the distal RCA and the RV branch. Preoperative and discharge periods, echocardiographic and electrocardiographic parameters were compared between groups. Results: Both groups had comparable baseline characteristics, including echocardiographic and electrocardiographic parameters. At discharge, tricuspid annular plane systolic excursion (TAPSE) was lower in Group 1 compared to Group 2 (11.7 ± 2.7 mm vs. 15.1 ± 2.3 mm; p < 0.001). The ratio of diastolic dysfunction was higher in Group 1 compared to Group 2 (91.2% vs. 61.8%; p < 0.001). The mean QT dispersion (54.6 ± 15.4 ms vs. 63.7 ± 18.5 ms; p = 0.031) and mean P wave dispersion (22.5 ± 5.3 ms vs. 26.2 ± 8.8 ms; p = 0.048) levels were lower in Group 2 compared to Group 1. Conclusion: Additional bypass grafting of the RV branch in patients with significant RCA disease was associated with improved RV function and more favorable electrocardiographic parameters.

Anahtar Kelimeler

• Coronary artery bypass grafting
• P-wave dispersion
• right ventricular function
• right coronary artery
• ventricular repolarization
• TAPSE
• transannular plane systolic excursion

Kaynakça

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