Dilek ERER, Erkan IRİZ, Levent OKTAR, Mehmet Emin OZDOGAN, Huseyin BAYRAM, Mustafa Hakan ZOR

On-Pump Cardiopulmonary Bypass Versus Off-Pump Coronary Artery Bypass Grafting Surgery: Renal And Liver Function Tests

Amaç: Kardiyopulmoner bypass sistemik inflamasyonu tetikler. İnflamatuar sistem aktivasyonu ise karaciğer ve böbrek fonksiyonlarında tahribat yapabilir. Biz bu çalışmamızda çalışan kalpte pompasız koroner arter bypass greftleme (KABG) ile pompalı kardiopulmoner bypass (KPB) cerrahi tekniklerinin böbrek ve karaciğer fonksiyonları üzerine olan etkilerini araştırmayı amaçladık. Gereç ve Yöntemler: Koroner arter bypass cerrahisine giden 64 hasta çalışmaya alındı. Hastalar prospektif olarak pompada KPB (n=40) ve çalışan kalpte pompasız KABG (n=24) olmak üzere 2 gruba ayrıldı. Hastaların kan örnekleri preoperatif, postoperatif 24. ve 48. saatlerde kan üre azotu (BUN), kreatinin, aspartate aminotransferase (AST), alanine aminotranferease (ALT) ve AST / ALT oranına bakılması için toplandı. Bulgular: Her 2 grupta preoperatif klinik ve demografik özellikler benzerdi (Tablo 1). Her iki grubun operasyon öncesi BUN, kreatinin, AST, ALT ve AST /ALT oranları arasında istatistiksel olarak anlamlı fark yoktu. Operasyon sonrası 24. saat kreatinin, AST ve AST/ALT oranları, çalışan kalpte pompasız KABG grubunda düşük olup, BUN ve ALT oranları her iki grupta benzer bulundu. Operasyon sonrası 48. saat BUN, kreatinin, AST ve AST/ALT oranları, çaılşan kalpte pompasız KABG grubunda düşük olup ALT düzeyleri her iki grupta benzer bulundu. Sonuç: Çalışmamızda çalışan kalpte pompasız KABG'nin, pompalı KPB'a göre böbrek ve karaciğer fonksiyonu üzerine olan olumsuz etkilerinin daha az olduğunu saptadık.

Pompada Kardiyopulmoner Bypass ve Pompasız Koroner Arter Bypass Greftleme Cerrahi Tekniklerinin Karşılaştırılması: Böbrek ve Karaciğer Fonksiyon Testleri

Objective: Cardiopulmonary bypass (CPB) triggers systemic inflammation. Inflammatory system activation may cause deteoriation in liver and renal functions. In our study we aimed to search the effect of on-pump CPB and beating heart off-pump coronary artery bypass grafting (CABG) surgery techniques on renal and liver functions. Methods: Sixty four patients who underwent coronary artery surgery were included in the study and were divided into two groups: on-pump CPB group (40) and beating heart off-pump CABG group (24), prospectively. The blood samples were collected for preoperative and postoperative levels of blood urea nitrogen (BUN), creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and AST to ALT ratio at 24th and 48th hours. Results: Clinical and demographic features were similar in both groups. There were no statistically significant difference in levels of preoperative BUN, creatinine, AST, ALT, AST to ALT ratio. The postoperative 24th hour plasma levels of creatinine, AST and AST/ALT were lower in beating heart off-pump CABG group but BUN and ALT levels were similar among the two groups. The postoperative 48th hour plasma levels of BUN, creatinine, AST and AST/ALT were lower in beating heart off-pump CABG group but levels of ALT were similar in both groups. Conclusion: Based on our findings we conclude that beating heart off-pump CABG has lower negative effect on liver and renal function than on-pump CPB. Abstract of this manuscript was presented in 7th Congress of Update in Cardiology and Cardiovascular Surgery in association with TCT Mediterranean as a poster.

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