Ali Şefik KÖPRÜLÜ, Levent ACAR, Hakan GERÇEKOĞLU, Tufan ŞENER, Osman Eren KARPUZOĞLU

Advantages of an inverted J-shaped partial sternotomy in off-pump revascularization of the left anterior descending coronary artery

Amaç: Bu çalışmada sol ön inen (LAD) koroner arterin cerrahi revaskülarizasyonunu gerektiren olgularda atan kalpte tam uzunlukta medyan sternotomi (FLMS) insizyonu ile ters J kısmi sternotomi (IJPS) insizyonunun klinik sonuçları karşılaştırıldı. Çalışma planı: Ocak 2008 - Ocak 2011 tarihleri arasında LAD koroner arterin atan kalpte cerrahi revaskülarizasyonu yapılan 119 hastanın (79 erkek, 40 kadın; ort. yaş 61.6±10.7 yıl) verileri retrospektif olarak incelendi. Hastalar retrospektif ve nonrandomize olarak IJPS veya FLMS gruplarına ayrıldı. Ters J kısmi sternotomi grubunda 46 hasta (23 erkek, 23 kadın) ve FLMS grubunda 73 hasta (56 erkek, 17 kadın) vardı. Her iki grubun ameliyat öncesi, ameliyat sırası ve erken dönem ameliyat sonrası verileri retrospektif olarak birbirleriyle karşılaştırıldı. Bulgular: Her iki grubun demografik özellikleri benzer idi. Her iki grupta da mortalite, erken greft yetmezliği ve miyokard infarktüsü gözlenmedi. Ters J kısmi sternotomi grubunda FLMSye dönme gerekliliği olmadı. Ters J kısmi sternotomi grubunda mekanik ventilasyon süresi daha kısa idi (429.45±267.3 dakikaya kıyasla 209.67±109.7 dakika, p0.05). Ameliyat süreleri açısından iki grup arasında farklılık saptanmadı. Ameliyat sonrası kanama miktarları (FLMS ve IJPS grubunda sırasıyla 418±72 mLye kıyasla 453±87 mL, p

Atan kalpte sol ön inen koroner arterin revaskülarizasyonunda ters J kısmi sternotominin avantajları

Background: In this study, we compared the clinical outcomes of two different surgical approach, full length median sternotomy (FLMS) versus inverted J shaped partial sternotomy (IJPS), in the off-pump revascularization of the left anterior descending (LAD) coronary artery. Methods: Between January 2008 and January 2011, the data from 119 patients (79 males, 40 females; mean age 61.6±10.7 years) who were operated for off-pump surgical revascularization of the LAD 1-vessel LAD coronary artery were retrospectively analyzed. The patients were divided into two groups as retrospective and non-randomized, including IJPS and FLMS. There were 46 patients (23 males, 23 females) in the IJPS group and 73 patients (56 males, 17 females) in the FLMS group. Preoperative, perioperative and early postoperative data of both groups were compared retrospectively. Results: Demographic characteristics were similar for both groups. There was no mortality, early graft insufficiency or myocardial infarction in either group. There was no need for conversion to FLMS in the IJPS group. The duration of mechanical ventilation was shorter in the IJPS group (209.67±109.7 min versus 429.45±267.3 min, p0.05). There was no difference in operation time between the groups. The postoperative amount of bleeding (453±87 ml in the FLMS group versus 418±72 ml in the IJPS, p

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