Hayrettin TEKÜMİT, Duygu DURMAZ, Kamil BERKİ

10727

Orta Derecede Kronik İskemik Mitral Yetersizliği Tedavisinde İzole Koroner Arter Bypass Grefti Yeterli mi?

Amaç İskemik mitral yetmezliğine yaklaşım, kalp- damar cerrahisinin gri alanlarından biri olmaya devam etmektedir. İskemik mitral yetmezliği, mitral kapağının kendi patolojisinden kaynaklanmak yerine bir sol ventrikül hastalığı olması nedeniyle, nasıl bir yaklaşımda bulunulacağı hala tartışılmaktadır: Girişimde bulunmak mı, dokunmamak mı? Bu çalışmamızda, preoperatif dönemde IMY olan ve izole CABG uyguladığımız hastalarda post operatif dönem İMY setrini inceledik. Gereç ve Yöntemler Çalışmamıza 2+/ 3+ İMY olup izole CABG uyguladığımız 30 hasta dahil edildi. Preoperatif ve postoperatif İMY dereceleri, EF, LV çapları ve volümleri mukayese edildi.BulgularPostoperatif dönemde EF ve İMY derecelerinde anlamlı ölçüde azalma olduğu buna karşılık sol ventrikül çap ve volümlerinde anlamlı farklılık olmadığı görüldü. Sonuç 2+/ 3+ İMY olan koroner arter hastalarına yapılacak izole CABG girişiminin seçilmiş hasta grubunda İMY üzerinde iyileştirici etkisi olduğuna inanıyoruz.
Anahtar Kelimeler:

Mitral yetmezlik, Koroner arter hastalığı, Transtorasik ekokardiyografik, Ejeksiyon fraksiyonu

Is Isolated Coronary Artery Bypass Grafting Sufficient to Treat Moderate Chronic Ischemic Mitral Regurgitation?

Objective Approach to ischemic mitral regurgitation is one of the most challenging areas of cardiovascular surgery. Since it is primarily due to left ventricular disturbances rather than mitral valve pathologies itself, interventional approach to IMR has always been controversial: To touch or no- touch. In this study, we aimed to research prognosis of IMR in patients underwent isolated coronary artery bypass surgery that had IMR preoperatively. Materials and Methods Thirty patients suffering from coronary artery disease and 2+/ 3+ IMR who underwent isolated- CABG were included to the study. Postoperative IMR degrees were compared to preoperative values in respect to left ventricular diameters/ volumes and ejection fraction. Results Postoperative 12th. mount transthoracic echocardiographic measures revealed Postoperative12 th. mount TTE findings; LVEF and IMR degrees were significantly decreased. On the other hand, LVEDD, LVESD, and left atrial diameter did not changed statistically. Conclusion We thought that isolated CABG has a decreasing effect on IMR degree and it’s safe and effective intervention in selected patients having CAD and concomitant 2+/ 3+ IMR preoperatively.
Keywords:

Mitral regurgitation, Coronary artery disease, Transthoracic echocardiographic, Ejection fraction,

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Hipokrat Tıp Dergisi-Cover
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2021
  • Yayıncı: Bandırma Onyedi Eylül Üniversitesi
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