Açık Kalp Cerrahisinde, Pompanın Erken Postoperatif Mortalite ve Serebrovasküler Olay Üzerine Etkisi

Giriş: Bu çalışma, son gelişmelerle pompalı/pompasız koroner arter baypas grafting (KABGO) uygulanan hastalarda, postoperatif erken dönemde (bir ayda), kardiyopulmoner baypas (KPB)'ın erken mortalite ve serebral olay üzerine etkileri araştırıldı. Hastalar ve Yöntem: Çalışmamız, kliniğimizde koroner arter baypas greftleme ameliyatı yapılan toplam 260 olguyu içermektedir. KABGO uygulanan hastalar iki farklı cerrahi tekniğe göre gruplandırıldı. Birinci grup (Grup 1), CPB ve X klemp (on-pump) kullanılarak KABGO uygulanan hastalardan oluştu. İkinci grup (Grup 2), atan kalp (off-pump) tekniği ile KABGO uygulanan hastalardan oluştu. Proksimal anastomozlar tüm olgularda yan klemp kullanılarak yapıldı. Bulgular: Hastalar postoperatif otuzuncu güne kadar mortalite açısından takip edildi. Dört ölüm olgusu ve altı serebrovasküler olayla karşı karşıya kaldık. Sonuç: On-pump KABGO ameliyatlarında off-pump KABGO ameliyatlarına kıyasla serebral kaza oranları (%2.4’e karşı %2.1) ve ölüm (%1’e karşı %1.8) benzer oranda görülürken istatistiksel olarak anlamlı değildir.

Anahtar Kelimeler:

Koroner arter hastalığı, koroner arter baypas operasyonu, off pump koroner arter baypas operasyonu, kalp akciğer makinası, mortalite, felç

The Effect of Pump on Early Postoperative Mortality and Cerebrovascular Accident in Coronary Bypass Surgery Patients

Introduction: This study investigated the mortality rates during the postoperative early period (one month) in patients who underwent on- or off-pump coronary artery bypass grafting (CABG) and explored the effects of cardiopulmonary bypass (CPB) on early mortality and cerebral accident. Patients and Methods: This study comprises a total of 260 subjects that underwent CABG surgery in our clinic. Patients who underwent CABG were grouped according to two different surgical techniques: the first group (Group 1) consisted of patients who underwent CABG using CPB and cross-clamp (on-pump); the second group (Group 2) consisted of patients who underwent CABG by beating heart (off-pump) technique. Proximal anastomoses were performed using side clamps in all cases. Results: Postoperative follow-up was conducted on patients until Day 30 for mortality. We encountered four dead cases and six cerebrovascular accidents. Conclusion: The rates of cerebral accidents (2.4% vs. 2.1%) and deaths (1.8% vs. 1%) have the same ratios and are not statistically significant in on-pump CABG surgeries compared with off-pump CABG surgeries.

Keywords:

Coronary artery disease, coronary artery bypass, off-pump coronary artery bypass, heart-lung machine, mortality, stroke,

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi