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Koroner arter bypass cerrahisi sonrası erken kardiyak komplikasyonların tanı ve tedavisinde ekokardiyografinin rolü

Amaç: Koroner arter hastalığı tüm dünyada ve ülkemizde ölümün en önemli sebebidir. Koroner arter by-pass cerrahisi uygulanan hastaların risk düzeyi arttıkça postoperatif komplikasyonlarda artmaktadır. Bu çalışmanın amacı; koroner arter by-pass cerrahisi uygulanan hastalarda postoperatif erken dönemde oluşan kardiyak komplikasyonların tanı ve tedavisinde ekokardiyografinin rolünü araştırmaktır. Gereç ve Yöntem: Bu amaçla Haziran 2016 – Haziran 2017 tarihleri arasında kliniğimizde koroner arter by-pass cerrahisi uygulanan 53 hasta postoperatif dönemde 1 (bir) hafta boyunca günlük ekokardiyografik değerlendirme ile takip edildi.Bulgular: Hastalarda en az drenaj 300 cc iken en fazla 1200 cc (ortalama 460 cc) oldu. Perikardiyal efüzyon 1.günde 28 hastada, 2.günde 6 hastada, 3. günde ise sadece 1 hastada tespit edildi. İki hastada postop 0. gün kalbin ön yüzünde ciddi bası oluşturan ve hemodinamiyi etkileyen perikardiyal tamponat vardı. Bu hastalar yeniden operasyona alınarak hemodinamisi stabil hale getirildi.Sonuç: Koroner bypass yapılan hastaların Yoğun Bakım ünitelerindeki takibinde Ekokardiografinin rutin olarak kullanılmasının hastanede kalış süresini, morbiditeyi ve mortaliteyi önemli ölçüde azaltabileceği kanaatindeyiz.

Anahtar Kelimeler:

Ekokardiyografi, Koroner arter cerrahisi

Role of echocardiography in the diagnosis and treatment of early cardiac complications after coronary artery by-pass surgery

Purpose: Coronary artery disease is the leading cause of death all over the world and in our country. As the level of risk increases in the patients undergone Coronary artery bypass surgery, postoperative complications increases too. The aim of this study is to determine the role of echocardiography in the diagnosis and treatment of early postoperative complications in patients undergoing coronary artery bypass surgery. Materials and Methods: 53 patients undergone coronary artery bypass surgery between June 2016 and June 2017 were followed by daily echocardiographic evaluation during the postoperative period for one week.Results: The minimum drainage in patients was 300 cc and the maximum was 1200 cc (average 460 cc). Pericardial effusion was detected in 28 patients on day 1, 6 patients on day 2, and only 1 patient on day 3. Two patients had pericardial tamponade, which caused significant pressure on the anterior surface of the postop and day 0 and affected the hemodynamics. These patients were re-operated. Hemodynamics stabilized.Conclusion: We believe that the routine use of Echocardiography in the follow-up of intensive care units of patients with coronary bypass may significantly reduce the length of hospital stay, morbidity and mortality.

Keywords:

Echocardiography, Coronary artery surgery,

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