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Does Blood Parameters Tested Preoperatively Give An Idea About The Complications of Coronary Bypass Surgery?

Yıl 2014, Cilt: 2 Sayı: 3, 93 - 98, 12.07.2016

Ali Ümit Yener Adem Bekler Muhammed Turgut Alper Özkan Hasan Ali Kiraz Hüseyin Toman Ömer Faruk Çiçek Ahmet Ekin Ömer Çokkalender Mustafa Saçar Sedat Özcan Tolga Kurt

Öz

It was aimed to reveal the relationship between the blood parameters examined before coronary artery bypass surgery and morbidity and mortality seen after coronary artery bypass surgery.181 patients who had undergone coronary bypass surgery between February 2013 and June 2014 were included in the study. Preoperative hemogram parameters and complications were recorded.Patients were divided into two groups: NLR≥2.78 (n=60) and NLR< 2.78 (n=121) (NLR: neutrophil to lymphocyte ratio).Univariate analyses revealed an association with mortality and cross clamp time, PLR (platelet to lymphocyte ratio) and NLR. On multivariate analysis, cross clamp time, increased preoperative PLR and NLR was independently associated with in-hospital mortality after coronary bypass surgery.It has been determined that having an idea about morbidity and mortality seen after coronary bypass graft surgery with a basic blood test obtained preoperatively.

Anahtar Kelimeler

Coronary bypass surgery complications blood tests

Kaynakça

  • 1. Cooley DA,Frazier OH. The past 50 years of cardiovascular surgery. Circulation. 2000;102(20 Suppl 4):IV87-93.
  • 2. Antunes PE, de Oliveira JF, Antunes MJ. Risk-prediction for post-operative major morbidity in coronary surgery. Eur J Cardiothorac Surg. 2009;35(5):760-6. discussion 6-7.
  • 3. Christakis GT, Ivanov J, Weisel RD, Birnbaum PL, David TE, Salerno TA. The changing pattern of coronary artery baypass surgery. Circulation 1989;80:I151–161.
  • 4. Pintor PP, Bobbio M, Colangelo S, Veglia F, Marras R, Diena M. Can Euroscore predict direct costs of cardiac surgery?. Eur J Cardiothorac Surg. 2003 Apr;23(4):595-8.
  • 5. De Cocker J, Messaoudi N, Stockman BA, Bossaert LL, Rodrigus IE. Preoperative prediction of intensive care unit stay following cardiac surgery. Eur J Cardiothorac Surg. 2011 Jan;39(1):60-7. doi: 10.1016/j.ejcts.2010.04.015.
  • 6. Virmani R., Burke A.P., Farb A., Kolodgie F.D.Pathology of the vulnerable plaque.J Am Coll Cardiol. 47 2006:C13-C18.
  • 7. Falk E: Pathogenesis of atherosclerosis. J Am Coll Cardiol, 2006; 47: 7-12
  • 8. Davi G, Patrono C: Platelet activation and atherothrombosis. N Engl J Med, 2007; 357: 2482–94
  • 9. Gibson PH, Cuthbertson BH, Croal BL, Rae D, El-Shafei H, Gibson G, et al. Usefulness of neutrophil/lymphocyte ratio as predictor of new-onset atrial fibrillation after coronary artery baypass grafting. Am J Cardiol 2010;105:186-91.
  • 10. Sheridan FM, Cole PG, Ramage D. Leukocyte adhesion to the coronary microvasculature during ischemia and reperfusion in an in vivo canine model. Circulation 1996;93:1784-7.
  • 11. Horne BD, Anderson JL, John JM et al: Which white blood cell subtypes predict increased cardiovascular risk?. J Am Coll Cardiol, 2005; 45: 1638–43.
  • 12. Davi G, Patrono C: Platelet activation and atherothrombosis. N Engl J Med, 2007; 357: 2482–94.
  • 13. Simel DL, DeLong ER, Feussner JR, Weinberg JB, Crawford J. Erythrocyte anisocytosis. Visual inspection of blood films vs automated analysis of red blood cell distribution width.Archives of Internal Medicine.1988;148(4):822–824.
  • 14. Evans TC, Jehle D. The red blood cell distribution width.Journal of Emergency Medicine.1991;9(1):71–74.
  • 15. Zalawadiya SK, Veeranna V, Panaich SS, Afonso L, Ghali JK. Gender and ethnic differences in red cell distribution width and its association with mortality among low risk healthy United State adults.American Journal of Cardiology.2012;109(11):1664–1670.
  • 16. van Kimmenade RRJ, Mohammed AA, Uthamalingam S, Van Der Meer P, Felker GM, Januzzi JL., Jr. Red blood cell distribution width and 1-year mortality in acute heart failure.European Journal of Heart Failure.2010;12(2):129– 136.
  • 17. Al-Najjar Y, Goode KM, Zhang J, Cleland JGF, Clark AL. Red cell distribution width: an inexpensive and powerful prognostic marker in heart failure.European Journal of Heart Failure.2009;11(12):1155–1162.
  • 18. Shahian DM, O'Brien SM, Filardo G, Ferraris VA, Haan CK, Rich JB, Normand SL, DeLong ER,Shewan CM, Dokholyan RS, Peterson ED, Edwards FH, Anderson RP; Society of Thoracic Surgeons Quality Measurement Task Force. The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 1--coronary artery baypass grafting surgery. Ann Thorac Surg. 2009 Jul;88(1 Suppl):S2-22. doi: 10.1016/j.athoracsur.2009.05.053.
  • 19. Nagajothi N, Braverman A. Elevated red cell distribution width in the diagnosis of thrombotic thrombocytopenic purpura in patients presenting with anemia and thrombocytopenia. South Med J. 2007 Mar;100(3):257-9.
  • 20. Fang WC, Helm RE, Krieger KH, Rosengart TK, DuBois WJ, Sason C, Lesser ML, Isom OW, Gold JP. Impact of minimum hematocrit during cardiopulmonary baypass on mortality in patients undergoing coronary artery surgery. Circulation. 1997 Nov 4;96(9 Suppl):II-194-9.
  • 21. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002;105:1135-43.
  • 22. Gurm HS, Bhatt DL, Lincoff AM, Tcheng JE, Kereiakes DJ, Kleiman NS, et al. Impact of preprocedural white blood cell count on long term mortality after percutaneous coronary intervention: insights from the EPIC, EPILOG, and EPISTENT trials. Heart 2003;89:1200-4.
  • 23. Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR, et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005;45:1638-43.
  • 24. Furman MI, Becker RC, Yarzebski J, Savegeau J, Gore JM, Goldberg RJ. Effect of elevated leukocyte count on inhospital mortality following acute myocardial infarction. Am J Cardiol 1996;78:945-8.
  • 25. Kirtane AJ, Bui A, Murphy SA, Barron HV, Gibson CM. Association of peripheral neutrophilia with adverse angiographic outcomes in ST-elevation myocardial infarction. Am J Cardiol 2004;93:532-6.
  • 26. Thomson SP, Gibbons RJ, Smars PA, Suman VJ, Pierre RV, Santrach PJ, et al. Incremental value of the leukocyte differential and the rapid creatine kinase-MB isoenzyme for the early diagnosis of myocardial infarction. Ann Intern Med 1995;122:335-41.
  • 27. Gibson PH, Cuthbertson BH, Croal BL, Rae D, El-Shafei H, Gibson G, et al. Usefulness of neutrophil/lymphocyte ratio as predictor of new-onset atrial fibrillation after coronary artery baypass grafting. Am J Cardiol 2010;105:186-91.
  • 28. Agarwal S. Red cell distribution width, inflammatory markers and cardiorespiratory fitness: results from the National Health and Nutrition Examination Survey.Indian Heart J. 2012 Jul-Aug;64(4):380-7. doi: 10.1016/j.ihj.2012.06.006.
  • 29. Uyarel H, Ergelen M, Cicek G, Kaya MG, Ayhan E, Turkkan C, Yıldırım E, Kırbas V, Onturk ET, Erer HB, Yesilcimen K, Gibson CM. Red cell distribution width as a novel prognostic marker in patients undergoing primary angioplasty for acute myocardial infarction. Coron Artery Dis. 2011 May;22(3):138-44.
  • 30. Grant BJ, Kudalkar DP, Muti P, McCann SE, Trevisan M, Freudenheim JL, Schünemann HJ. Relation between lung function and RBC distribution width in a population-based study. Chest. 2003 Aug;124(2):494-500.
  • 31. Zöller B, Melander O, Svensson P, Engström G. Red cell distribution width and risk for venous thromboembolism: a population-based cohort study. Thromb Res. 2014 Mar;133(3):334-9. doi: 10.1016/j.thromres.2013.12.013.
  • 32. Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. Relation Between Red Blood Cell Distribution Width and Cardiovascular Event Rate in People With Coronary Disease. Circulation. 2008 Jan 15;117(2):163-168.
  • 33. Acar G, Kalkan ME, Avci A, et al. The relation of platelet– lymphocyte ratio and coronary collateral circulation in patients with stable angina pectoris and chronic total occlusion Clin Appl Thromb Hemost. October 18 2013.
  • 34. Zouridakis EG, Garcia-Moll X, Kaski JC. Usefulness of the blood lymphocyte count in predicting recurrent instability and death in patients with unstable angina pectoris. Am J Cardiol. 2000;86(4): 449-451.
  • 35. Ross R. Atherosclerosis: an inflammatory disease. N Engl J Med 1999;340(2):115-126.
  • 36. Sunbul M, Gerin F, Durmus E, Kivrak T, Sari I, Tigen K, et al. Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension. Clin Exp Hypertens. 2014;36(4):217-21. doi: 10.3109/10641963.2013.804547.
  • 37. Azab B, Shah N, Akerman M, McGinn Jr JT. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-STelevation myocardial infarction. J Thromb Thrombolysis 2012;34(3):326-34.
  • 38. Ugur M, Gul M, Bozbay M, Cicek G, Uyarel H, Koroglu B, Uluganyan M, Aslan S, Tusun E, Surgit O, Akkaya E, Eren M. The relationship between platelet to lymphocyte ratio and the clinical outcomes in ST elevation myocardial infarction underwent primary coronary intervention. Blood Coagul Fibrinolysis. 2014 Jun 6

Preoperatif bakılan kan parametreleri koroner baypas komplikasyonları hakkında fikir verir mi?

Yıl 2014, Cilt: 2 Sayı: 3, 93 - 98, 12.07.2016

Ali Ümit Yener Adem Bekler Muhammed Turgut Alper Özkan Hasan Ali Kiraz Hüseyin Toman Ömer Faruk Çiçek Ahmet Ekin Ömer Çokkalender Mustafa Saçar Sedat Özcan Tolga Kurt

Öz

Koroner baypas cerrahisi öncesi kan testlerinde bakılan parametrelerle koroner baypas cer-rahisi sonrası görülen morbidite ve mortalite arasındaki ilişkinin ortaya konulması amaçlandı.Şubat 2013 - Haziran 2014 tarihleri arasında koroner baypas ameliyatı yapılan 181 hasta çalışmaya dahil edildi. Hastalardan alınan preoperatif hemogram değerleri ve komplikasyon-lar kaydedildi.Hastalar NLR≥2.78 ( n=60) ve NLR

Anahtar Kelimeler

Koroner baypas cerrahisi komplikasyonlar kan testleri

Kaynakça

  • 1. Cooley DA,Frazier OH. The past 50 years of cardiovascular surgery. Circulation. 2000;102(20 Suppl 4):IV87-93.
  • 2. Antunes PE, de Oliveira JF, Antunes MJ. Risk-prediction for post-operative major morbidity in coronary surgery. Eur J Cardiothorac Surg. 2009;35(5):760-6. discussion 6-7.
  • 3. Christakis GT, Ivanov J, Weisel RD, Birnbaum PL, David TE, Salerno TA. The changing pattern of coronary artery baypass surgery. Circulation 1989;80:I151–161.
  • 4. Pintor PP, Bobbio M, Colangelo S, Veglia F, Marras R, Diena M. Can Euroscore predict direct costs of cardiac surgery?. Eur J Cardiothorac Surg. 2003 Apr;23(4):595-8.
  • 5. De Cocker J, Messaoudi N, Stockman BA, Bossaert LL, Rodrigus IE. Preoperative prediction of intensive care unit stay following cardiac surgery. Eur J Cardiothorac Surg. 2011 Jan;39(1):60-7. doi: 10.1016/j.ejcts.2010.04.015.
  • 6. Virmani R., Burke A.P., Farb A., Kolodgie F.D.Pathology of the vulnerable plaque.J Am Coll Cardiol. 47 2006:C13-C18.
  • 7. Falk E: Pathogenesis of atherosclerosis. J Am Coll Cardiol, 2006; 47: 7-12
  • 8. Davi G, Patrono C: Platelet activation and atherothrombosis. N Engl J Med, 2007; 357: 2482–94
  • 9. Gibson PH, Cuthbertson BH, Croal BL, Rae D, El-Shafei H, Gibson G, et al. Usefulness of neutrophil/lymphocyte ratio as predictor of new-onset atrial fibrillation after coronary artery baypass grafting. Am J Cardiol 2010;105:186-91.
  • 10. Sheridan FM, Cole PG, Ramage D. Leukocyte adhesion to the coronary microvasculature during ischemia and reperfusion in an in vivo canine model. Circulation 1996;93:1784-7.
  • 11. Horne BD, Anderson JL, John JM et al: Which white blood cell subtypes predict increased cardiovascular risk?. J Am Coll Cardiol, 2005; 45: 1638–43.
  • 12. Davi G, Patrono C: Platelet activation and atherothrombosis. N Engl J Med, 2007; 357: 2482–94.
  • 13. Simel DL, DeLong ER, Feussner JR, Weinberg JB, Crawford J. Erythrocyte anisocytosis. Visual inspection of blood films vs automated analysis of red blood cell distribution width.Archives of Internal Medicine.1988;148(4):822–824.
  • 14. Evans TC, Jehle D. The red blood cell distribution width.Journal of Emergency Medicine.1991;9(1):71–74.
  • 15. Zalawadiya SK, Veeranna V, Panaich SS, Afonso L, Ghali JK. Gender and ethnic differences in red cell distribution width and its association with mortality among low risk healthy United State adults.American Journal of Cardiology.2012;109(11):1664–1670.
  • 16. van Kimmenade RRJ, Mohammed AA, Uthamalingam S, Van Der Meer P, Felker GM, Januzzi JL., Jr. Red blood cell distribution width and 1-year mortality in acute heart failure.European Journal of Heart Failure.2010;12(2):129– 136.
  • 17. Al-Najjar Y, Goode KM, Zhang J, Cleland JGF, Clark AL. Red cell distribution width: an inexpensive and powerful prognostic marker in heart failure.European Journal of Heart Failure.2009;11(12):1155–1162.
  • 18. Shahian DM, O'Brien SM, Filardo G, Ferraris VA, Haan CK, Rich JB, Normand SL, DeLong ER,Shewan CM, Dokholyan RS, Peterson ED, Edwards FH, Anderson RP; Society of Thoracic Surgeons Quality Measurement Task Force. The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 1--coronary artery baypass grafting surgery. Ann Thorac Surg. 2009 Jul;88(1 Suppl):S2-22. doi: 10.1016/j.athoracsur.2009.05.053.
  • 19. Nagajothi N, Braverman A. Elevated red cell distribution width in the diagnosis of thrombotic thrombocytopenic purpura in patients presenting with anemia and thrombocytopenia. South Med J. 2007 Mar;100(3):257-9.
  • 20. Fang WC, Helm RE, Krieger KH, Rosengart TK, DuBois WJ, Sason C, Lesser ML, Isom OW, Gold JP. Impact of minimum hematocrit during cardiopulmonary baypass on mortality in patients undergoing coronary artery surgery. Circulation. 1997 Nov 4;96(9 Suppl):II-194-9.
  • 21. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002;105:1135-43.
  • 22. Gurm HS, Bhatt DL, Lincoff AM, Tcheng JE, Kereiakes DJ, Kleiman NS, et al. Impact of preprocedural white blood cell count on long term mortality after percutaneous coronary intervention: insights from the EPIC, EPILOG, and EPISTENT trials. Heart 2003;89:1200-4.
  • 23. Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR, et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005;45:1638-43.
  • 24. Furman MI, Becker RC, Yarzebski J, Savegeau J, Gore JM, Goldberg RJ. Effect of elevated leukocyte count on inhospital mortality following acute myocardial infarction. Am J Cardiol 1996;78:945-8.
  • 25. Kirtane AJ, Bui A, Murphy SA, Barron HV, Gibson CM. Association of peripheral neutrophilia with adverse angiographic outcomes in ST-elevation myocardial infarction. Am J Cardiol 2004;93:532-6.
  • 26. Thomson SP, Gibbons RJ, Smars PA, Suman VJ, Pierre RV, Santrach PJ, et al. Incremental value of the leukocyte differential and the rapid creatine kinase-MB isoenzyme for the early diagnosis of myocardial infarction. Ann Intern Med 1995;122:335-41.
  • 27. Gibson PH, Cuthbertson BH, Croal BL, Rae D, El-Shafei H, Gibson G, et al. Usefulness of neutrophil/lymphocyte ratio as predictor of new-onset atrial fibrillation after coronary artery baypass grafting. Am J Cardiol 2010;105:186-91.
  • 28. Agarwal S. Red cell distribution width, inflammatory markers and cardiorespiratory fitness: results from the National Health and Nutrition Examination Survey.Indian Heart J. 2012 Jul-Aug;64(4):380-7. doi: 10.1016/j.ihj.2012.06.006.
  • 29. Uyarel H, Ergelen M, Cicek G, Kaya MG, Ayhan E, Turkkan C, Yıldırım E, Kırbas V, Onturk ET, Erer HB, Yesilcimen K, Gibson CM. Red cell distribution width as a novel prognostic marker in patients undergoing primary angioplasty for acute myocardial infarction. Coron Artery Dis. 2011 May;22(3):138-44.
  • 30. Grant BJ, Kudalkar DP, Muti P, McCann SE, Trevisan M, Freudenheim JL, Schünemann HJ. Relation between lung function and RBC distribution width in a population-based study. Chest. 2003 Aug;124(2):494-500.
  • 31. Zöller B, Melander O, Svensson P, Engström G. Red cell distribution width and risk for venous thromboembolism: a population-based cohort study. Thromb Res. 2014 Mar;133(3):334-9. doi: 10.1016/j.thromres.2013.12.013.
  • 32. Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. Relation Between Red Blood Cell Distribution Width and Cardiovascular Event Rate in People With Coronary Disease. Circulation. 2008 Jan 15;117(2):163-168.
  • 33. Acar G, Kalkan ME, Avci A, et al. The relation of platelet– lymphocyte ratio and coronary collateral circulation in patients with stable angina pectoris and chronic total occlusion Clin Appl Thromb Hemost. October 18 2013.
  • 34. Zouridakis EG, Garcia-Moll X, Kaski JC. Usefulness of the blood lymphocyte count in predicting recurrent instability and death in patients with unstable angina pectoris. Am J Cardiol. 2000;86(4): 449-451.
  • 35. Ross R. Atherosclerosis: an inflammatory disease. N Engl J Med 1999;340(2):115-126.
  • 36. Sunbul M, Gerin F, Durmus E, Kivrak T, Sari I, Tigen K, et al. Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension. Clin Exp Hypertens. 2014;36(4):217-21. doi: 10.3109/10641963.2013.804547.
  • 37. Azab B, Shah N, Akerman M, McGinn Jr JT. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-STelevation myocardial infarction. J Thromb Thrombolysis 2012;34(3):326-34.
  • 38. Ugur M, Gul M, Bozbay M, Cicek G, Uyarel H, Koroglu B, Uluganyan M, Aslan S, Tusun E, Surgit O, Akkaya E, Eren M. The relationship between platelet to lymphocyte ratio and the clinical outcomes in ST elevation myocardial infarction underwent primary coronary intervention. Blood Coagul Fibrinolysis. 2014 Jun 6
Toplam 38 adet kaynakça vardır.

Ayrıntılar

Diğer ID JA42FM33JM
Bölüm Makaleler
Yazarlar

Ali Ümit Yener Bu kişi benim

Adem Bekler Bu kişi benim

Muhammed Turgut Alper Özkan Bu kişi benim

Hasan Ali Kiraz Bu kişi benim

Hüseyin Toman Bu kişi benim

Ömer Faruk Çiçek Bu kişi benim

Ahmet Ekin Bu kişi benim

Ömer Çokkalender Bu kişi benim

Mustafa Saçar Bu kişi benim

Sedat Özcan Bu kişi benim

Tolga Kurt Bu kişi benim

Yayımlanma Tarihi 12 Temmuz 2016
Yayımlandığı Sayı Yıl 2014 Cilt: 2 Sayı: 3

Kaynak Göster

APA Yener, A. Ü., Bekler, A., Özkan, M. T. A., Kiraz, H. A., vd. (2016). Preoperatif bakılan kan parametreleri koroner baypas komplikasyonları hakkında fikir verir mi?. Uluslararası Klinik Araştırmalar Dergisi, 2(3), 93-98.
AMA Yener AÜ, Bekler A, Özkan MTA, Kiraz HA, Toman H, Çiçek ÖF, Ekin A, Çokkalender Ö, Saçar M, Özcan S, Kurt T. Preoperatif bakılan kan parametreleri koroner baypas komplikasyonları hakkında fikir verir mi?. IJCR. Temmuz 2016;2(3):93-98.
Chicago Yener, Ali Ümit, Adem Bekler, Muhammed Turgut Alper Özkan, Hasan Ali Kiraz, Hüseyin Toman, Ömer Faruk Çiçek, Ahmet Ekin, Ömer Çokkalender, Mustafa Saçar, Sedat Özcan, ve Tolga Kurt. “Preoperatif bakılan Kan Parametreleri Koroner Baypas Komplikasyonları hakkında Fikir Verir Mi?”. Uluslararası Klinik Araştırmalar Dergisi 2, sy. 3 (Temmuz 2016): 93-98.
EndNote Yener AÜ, Bekler A, Özkan MTA, Kiraz HA, Toman H, Çiçek ÖF, Ekin A, Çokkalender Ö, Saçar M, Özcan S, Kurt T (01 Temmuz 2016) Preoperatif bakılan kan parametreleri koroner baypas komplikasyonları hakkında fikir verir mi?. Uluslararası Klinik Araştırmalar Dergisi 2 3 93–98.
IEEE A. Ü. Yener, “Preoperatif bakılan kan parametreleri koroner baypas komplikasyonları hakkında fikir verir mi?”, IJCR, c. 2, sy. 3, ss. 93–98, 2016.
ISNAD Yener, Ali Ümit vd. “Preoperatif bakılan Kan Parametreleri Koroner Baypas Komplikasyonları hakkında Fikir Verir Mi?”. Uluslararası Klinik Araştırmalar Dergisi 2/3 (Temmuz 2016), 93-98.
JAMA Yener AÜ, Bekler A, Özkan MTA, Kiraz HA, Toman H, Çiçek ÖF, Ekin A, Çokkalender Ö, Saçar M, Özcan S, Kurt T. Preoperatif bakılan kan parametreleri koroner baypas komplikasyonları hakkında fikir verir mi?. IJCR. 2016;2:93–98.
MLA Yener, Ali Ümit vd. “Preoperatif bakılan Kan Parametreleri Koroner Baypas Komplikasyonları hakkında Fikir Verir Mi?”. Uluslararası Klinik Araştırmalar Dergisi, c. 2, sy. 3, 2016, ss. 93-98.
Vancouver Yener AÜ, Bekler A, Özkan MTA, Kiraz HA, Toman H, Çiçek ÖF, Ekin A, Çokkalender Ö, Saçar M, Özcan S, Kurt T. Preoperatif bakılan kan parametreleri koroner baypas komplikasyonları hakkında fikir verir mi?. IJCR. 2016;2(3):93-8.