Hüdai ÇATALYÜREK, Belgin BERBER, Ömür ÖZMEN, Erdem SİLİSTRELİ, Eyüp HAZAN, Ünal AÇIKEL, Nuray AY, Öztekin OTO

Desmopressin ve düşük doz aprotininin aspirin etkisi altında uygulanan koroner bypass cerrahisinde postoperatif drenaj üzerine etkileri

Bu prospektif çalışmada koroner bypass ameliyatından önceki bir hafta içinde aspirin kullanmış olan 60 olgu yaş, cinsiyet ve vücut ağırlığı yönünden randomize olarak sayıca eşit 3 gruba ayrıldı. Grup I'deki olgulara 0.3?g/kg dozda desmopressin, grup II'ye mini doz (2.000.000 Ü) aprotinin verildi. Grup III ise kontrol grubu olarak kaldı. Postoperatif drenajlar ilk 6 saatlik zaman diliminde gruplarda sırasıyla 392.75±181.99, 594.0±229.32 ve 572.0±363.89 ml, ilk 24 saatte ise 694.25±219.99, 950.50±301.64 ve 994.24±310.92 ml idi. Her iki zaman diliminde de desmopressin uygulanan gruptaki drenaj, aprotinin ve kontrol grubuna göre ve kan transfüzyonu ihtiyacı da kontrol grubuna göre daha azdı (p

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1. Kirklin JW, Barret-Boyes BG. Atrial septal defect and partial anomalous pulmonary venous connection. Cardiac Surgery, New York, 1986: 463.
2. Navia JL, Cosgrove DM. Minimally Invasive Mitral Valve Operations. Ann Thorac Surg 1996; 62: 1542-4.
3. Cosgrove DM, Sabik JF. Minimally Invasive Approach for Aortic Valve Operations. Ann Thorac Surg 1996; 62: 596-7.
4. Rosengart TK, Stark JF. Repair of Atrial Septal Defect through a right thoracotomy. Ann Thorac Surg 1993; 5: 1138-40.
5. Lancaster LL, Mavroudis C, Rees AH. Surgical Approach to Atrial Septal Defect in Female Right thoracotomy versus sternotomy. The American Surgeon 1990; 218-221.
6. Schwartz DS, Ribakove GH, Grossi EA. Minimally invasive mitral valve replacement: Port-Access technique, feasibility, and myocardial functional preservation. J Thorac Cardiovasc Surg 1997; 113: 1022-31.
7. Grinda JM, Folliguet TA, Dervanian P. Right Anterolateral Thoracotomy for Repair of Atrial Septal Defect. Ann Thorac Surg 1996; 62: 175-8.
8. Benetti FJ, Rizzardi JL, Pire L. Mitral Valve Replacement Under Video Assistance Through a Minithoracotomy. Ann Thorac Surg 1997; 63: 1150-2.
9. Cohn LH, Adams DH, CouperGS. Minimally invasive cardiac valve surgery improves patientn satisfaciton while reducing costs of cardiac valve replacement and repair. Ann-Surg 1994 Oct; 226 (4): 42-6.
10. Bichell DP, Balaguer JM, Aranki SF. Axiiloaxillary cardiopulmonary bypass: a practical alternative to femorofemoral bypass. Ann Thorac Surg 1997 Sep; 64(3): 702-5.
11. Vander Salm TJ. Prevention of lower extremity schemia during cardiopulmonary bypass via femoral cannulation. Ann Thorac Surg 1997 Jan; 63(1): 251-2.
12. Murray KD, Pasque MK. Routine sternal closure using six overlapping Figure-of-8 wires. Ann Thorac Surg 1997; 64: 1852-4.
13. Esteban A, Alia I, Gordo F. Extubatio outcome after spontaneous breathing trials with T-tube or pressure support ventilation. Am J Respir Crif Care Med. 1997, Vol 156. pp. 549- 465.
14. Dimarco Af, Romaniuk JR, Kowalski KE. Efficacy of Combined Inspiratory intercostal and expiratory muscles pacing to maintain artificial ventilation. Am J Respir Crit Care Med 1997; Vol. 156. pp. 122-126.
15. Kluytmans JAJW, Mouton JW, lizerman EPF.Nasal Carriage of staphylococcus aureus as an Major Risk Factor for wound Infections after Cardiac Surgery. The Journal of Infections Diseases 1995; 171: 216-9.
16. Salzer GM, Klingler P, Klingler A. Pain Treatment after thoracotomy: Is it a special Problem? Ann Thorac Surg 1997; 63: 1411-4.
17. Tribble CG, Killenger WA, Harman PK et al. Anterolateral thoracotomy as an alternative to repaet median sternotomy for replacement of mitral valve. Ann Thorac Surg 1987; 43:380-2.
18. Uppal R, Wolfe WG, Lowe JE. Right thoracotomy for reoparative right coronary bypass procedures. Ann Thorac Surg 1994; 57:123-5.
19. Braxton JH, Higgins RS, Schwann TA. Reoperative mitral valve surgery via right thoracotomy: decreased blood loss andimproved hemodynamics J Heart Valve Dis. 1996 Mar; 5(2): 169-73.