İhsan ALUR, Mohammad ALŞALALDEH, Fırat DURNA, Bilgin EMRECAN

Can systemic hypothermia induced during cardiopulmonary bypass protect the brain of patients undergoing carotid endarterectomy?

Karotis arter stenozu (KAS) bulunan koroner arter hastalarında (KAH) öncelikle hangi hastalığın tedavi edileceği ve cerrahi girişimin ne zaman olması gerektiği konusu tartışmalıdır. Koroner baypas cerrahisi uygulanacak hastalarda karotis arter hastalığı varsa serebrovasküler olay gelişme riski yüksek kabul edilir. Karotis arter cerrahisi yapılacak hastalarda ciddi koroner lezyonlar varsa işlem sırasında miyokard enfarktüsü gelişme riski fazladır. Bu nedenlerle bu iki hastalık aynı operasyonda tedavi edilmektedir. Bu hastalarda hangi cerrahi stratejinin uygulanacağı mortalite ve morbiditeyi azaltmada esastır. Biz 3 olguda hafif sistemik hipotermi ve kardiyopulmoner baypas altında karotis endarterektomi (KEA) + koroner arter baypas (CABG) uyguladık. Herhangi bir nörolojik komplikasyonla karşılaşmadık

Karotis endarterektomi yapılan hastalarda kardiyopulmoner baypas ile oluşturulan sistemik hipotermi serebral korumaya yardımcı olabilir mi?

In the cases of coronary artery disease (CAD) concomitant with carotid artery stenosis (CAS), what to manage first is still a controversial subject. Patients with CAS who will undergo coronary artery bypass grafting are considered to be under a high risk of cerebrovascular accidents. On the other hand, patients with CAD who will undergo surgery for CAS are under a high risk of having myocardial infarction during the procedure especially when they have serious coronary artery lesions. That is why it is better to treat both diseases in the same surgery. In such surgeries the cornerstone is to find the best strategy that can reduce both morbidity and mortality. Carotid endareterctomy (CEA) and coronary artery bypass grafting (CABG) were performed in the same session on 3 cases of CAD and CAS who were operated under systemic hypothermia and cardiopulmonary bypass. There were no neurological complications

Kaynakça

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