Veysel BAŞAR, Emre KUBAT, Ferit CİCEKCİOGLU, Mehmed YANARTAŞ, Hasan SUNAR

Eş zamanlı karotis endarterektomi ve koroner arter baypas greftleme operasyonu yapılan hastalarda otolog perikard alternatif bir karotis yama materyali olabilir.

Amaç: Dakron, politetrafloroetilen, büyük safen damarı ve sığır perikardı yaygın olarak yama malzemeleri olarak kullanılır. Ancak karotis endarterektomi cerrahisinde yama materyali olarak otolog perikardiyal ile ilgili bir çalışma bulunmamaktadır. Eş zamanlı karotis endarterektomi ve koroner arter baypas greft cerrahisi uygulanan hastalarda otolog perikardiyal yama kullanımının sonuçlarını değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmaya Ocak 2016 ile Şubat 2020 arasında yama anjiyoplasti ve koroner arter baypas greftleme cerrahisi ile birlikte karotis endarterektomi uygulanan 30 hasta dahil edildi. Karotis endarterektomi sırasında 13 hastada otolog perikard ve 17 hastada dakron yama ile patchplasti yapıldı. Bulgular: Gruplar arasında reoperasyon, arter tıkanıklığı, restenoz, operasyon süresi ve nörolojik olaylar açısından istatistiksel fark bulunmadı. Postoperatif takipte otolog perikard kullanılanlarda karotis cerrahisi uygulanan bölgeden drenaj miktarının Dacron yama uygulananlara göre daha az olduğu belirlendi. (p=0,001) Sonuç: Karotis arter yaması olarak otolog perikardın kullanımının karotid arter ve koroner bypass cerrahisi uygulanan hastalarda güvenli, uygulanabilir ve etkili bir yöntem olduğu sonucuna vardık.

Anahtar Kelimeler:

Perikard, karotis darlığı, endarterektomi, dakron, koroner arter baypas greftleme

Autologous pericardium may be an alternative carotid patch material in patient with undergoing simultaneous carotid endarterectomy and coronary artery bypass grafting

Backround: Dacron, polytetrafluoroethylene, great saphenous vein, and bovine pericardium are the commonly used as patch materials. However, there is no study about autologous pericardial as a patch material in carotid endarterectomy surgery. We aimed to assess the results of the use of autologous pericardial patch in patients undergoing concomitant carotid endarterectomy and coronary artery by-pass graft surgery. Materials and Methods:: The study involved 30 patients who underwent concomitant carotid endarterectomy with patch angioplasty and coronary artery bypass grafting surgery from January 2016 to February 2020. Patchplasty is performed with autologous pericardium for 13 patients and dacron patch for 17 patients during carotid endarterectomy. Results: No statistical difference was found between the groups in terms of reoperation, arterial occlusion, restenosis, operation time, and neurological events. In the postoperative follow-up, it was determined that the amount of drainage from the area on which the carotid surgery was applied was less in the those in whom autologous pericardium was used compared to those in whom Dacron patch was used. (p=0.001) Conclusion: We concluded that the use of autologous pericardium as a carotid artery patch is a safe, feasible, and effective method in patients undergoing combined carotid artery and coronary bypass surgery.

Keywords:

Pericardium, carotid stenosis, endarterectomy, dacron, coronary artery bypass grafting,

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