Denyan MANSUROĞLU, Füsun GÜZELMERİÇ, Kaan KIRALİ, Murat Bülent RABUŞ, Cevat YAKUT, Mustafa GÜLER, Hasan Basri ERDOĞAN

Sol torakotomi ile kombine koroner arter bypass ve sol pnomonektomi

Aynı seansta koroner arter bypass ve pnomonektomi ameliyatlarının yapılması yüksek mortalite ile seyretmekte ve hastaların yoğun bakımda kalış süresi uzamaktadır. Koroner arter bypassın kardiyopulmoner bypassta yapılması mortalite ve morbiditeyi arttırmaktadır. Kardiyopulmoner bypassın yan etkilerinden kaçınmak için, son yıllarda pompa kullanılmadan yapılan bypass girişimleri oldukça popüler olmuştur. Yetmiş yaşındaki erkek hastaya sol torakotomi yoluyla aynı seansta önce sol pnömonektomi, ardından off-pump yöntemi ile sol ön inen koroner arter ve diagonal artere, proksimal anastomozu desandan aortaya yapılan safen "Y" greft ile koroner bypass uygulandık. Hasta birinci ayında normal fizik aktivitesini sürdürmektedir.

Combined coronary artery bypass grafting and left pneumonectomy using left thoracotomy

Coronary arterial bypass procedures concommitant with pneumonectomy have with high mortality rate and prolonged intensive care stay. In particular, on-pump coronary arterial bypass grafting has a high mortaity and morbidity. To avoid the side effects of cardiopulmonary bypass, off-pump procedures are favored over on-pump coronary arterial bypass grafting. We performed a left pneumonectomy via left thoracotomy, then proceed to off-pump coronary arterial bypass grafting to the left anterior descending artery and first diagonal artery using a saphenous “Y” graft with its proximal anastomosis on the descending aorta to a 70 years old male patient. In his first month postoperatively, patient has a normal physical activity.

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