Atan Kalpte Koroner Baypas Cerrahisinde Papaverin ve Verapamilin LMA Grefti Akm Üzerine Olan Etkilerinin ncelenmesi
Amaç: Koroner arter cerrahisinde kullanlan en önemli greft olan sol internal mamariyan arter (LMA)'nn hazrlanmas nda ve sonrasnda karfllafllan en önemli sorun LMA spazmdr. Bu çalflmada, atan kalpte koroner baypas (OPCAB) hastalarnda kulland¤mz iki vazodilatör ajann LMA akm üzerine olan etkilerini de¤erlendirdik. Materyal ve Metod: OPCAB yaplan 40 hasta çalflmaya alnd. Hastalarn yafl ortalamas 61.50 ± 11.76 yl idi. Hastalar uygulanan vazodilatör ajana göre iki gruba ayrld (papaverin ve verapamil gruplar). Kan akm ölçümleri esnas nda diyabetes mellitus (DM) varl¤, tansiyon arteriyel (TA) ve aktive edilmifl phtlaflma zaman (ACT) de¤erleri ölçülerek kaydedildi. Bulgular: Topikal ilaç uygulamasndan önce ve LMA anastomoz edilmeden hemen önce yaplan ölçümlerde gruplar arasnda erkek hastalarda kadn hastalara göre (verapamil için p=0.037, papaverin için p=0.042) ve TA yüksek olan hastalarda TA de¤eri düflük olan hastalara göre (verapamil için ilaç uygulama öncesi p=0.001, ilaç uygulama sonras p=0.046, papaverin için ilaç uygulama öncesi p=0.012, ilaç uygulama sonras p=0.021) istatistiksel olarak anlaml farkllk gözlendi (p
Anahtar Kelimeler:
Koroner arter baypas cerrahisi, atan kalpte baypas, vazospazm, vazodilatasyon, papaverin, verapamil
The Search of the Effects of Verapamil and Papaverin on LIMA Graft Flow in Beating Heart Coronary Bypass Surgery
The Search of the Effects of Verapamil and Papaverin on LIMA Graft Flow in Beating Heart Coronary Bypass Surgery Purpose: The most important problem encountered during the preparation phase of LIMA as being the most important graft which is used in coronary surgery and the same problem after this phase is vasospasm of LIMA. In this study, we evaluated the effects of two vasodilator drugs on LIMA flow which are used on patients in beating heart coronary artery bypass surgery. Material and Method: 40 patients were investigated who were undergone beating heart coronary artery bypass surgery. Their average age was 61.50± 11.76. The patients were divided in two groups according to applied vasodilator drugs (papaverin and verapamil groups). The existence of DM, TA and ACT values were recorded during blood flows measurement. The findings: Statistical difference was determined in male patients when compared to female patients (for verapamil p=0.037, for papaverin p=0.042) and in patients with high TA when compared to patients with low TA in the measurements done just before topical drug application and LIMA anastomoses (for verapamil, before drug application p=0.001, after drug application p=0.046, for papaverin before drug application p=0.012, after drug application p=0.021). In both groups, statistically important LIMA blood flow rises were seen after topical drug injection. However papaverin was superior to verapamil when ratio of their ability of increasing blood flow was taken into account (p=0.045). Conclusion: We concluded that short-timed warm bathing process with papaverin increased LIMA blood flow in comparison with the same process done with verapamil; besides, we saw that to keep TA high raises LIMA flow regardless of what kind of vasodilator drugs are used. We claim that, to use papaverin instead of verapamil as topical drug and to keep TA high peroperatively will be beneficial to LIMA flow just after LIMA greft was harvested in patients undergone beating heart coronary artery bypass surgery.
Keywords:
Coronary artery bypass, beating heartcoronary bypass, vasospasm, vasodilation, papaverine, verapamile,
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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
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