Pompalı ile çalışan kalpte yapılan koroner baypas cerrahisi sonrasında akut böbrek hasarı gelişiminin karşılaştırılması
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Date
2012-04-30
Authors
Sevingil, Tolunay
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Çalışan kalpte koroner baypas tekniğiyle pompalı koroner baypas tekniğinin postoperatif akut böbrek hasarı gelişimine etkisini karşılaştırdık. Kliniğimizde elektif koroner baypas yapılmak üzere 40 olgu, eşit iki gruba ayrılarak çalışmaya alındı. Birinci gruba çalışan kalpte koroner baypas (grup 1), ikinci gruba pompalı koroner baypas (grup 2) uygulandı. Preoperatif ve postoperatif en yüksek serum kreatinin değerleri alındı. İki grup arasında preoperatif ve intraoperatif değerler operasyon süresi (p=0.001) ve distal anastomoz sayıları (p=0.02) hariç benzerdi. Postoperatif akut böbrek hasarı gelişimi açısından iki grup arasında istatistiksel fark bulunmadı. İki grupta da sadece evre 1 akut böbrek hasarı gelişti (grup 1’de %10, grup 2’de %25) (p=0.204). Akut böbrek hasarı gelişen 7 hastanın 2’sinde sol ana koroner arter lezyonu saptandı. Grup 2’de yoğunbakımda kalış süresi 2.40±0.25 gün, grup 1’de 1.45±0.15 gün olarak bulundu (p=0.006). Postoperatif akut böbrek hasarı gelişimi açısından çalışan kalpte ve pompalı koroner baypas tekniklerinin birbirlerine üstünlük sağlamadığı, sol ana koroner arter lezyonunun akut böbrek hasarı gelişiminde önemli bir etken olduğu görüldü.
The aim of this study is to compare the effect of off-pump CABG technique obtained by eliminating cardiopulmonary bypass and conventional techniques of on-pump CABG surgery on development of acute renal injury postoperatively. Forty patients for elective coronary artery bypass operation were involved in the study and divided into two groups equally. First group underwent to off-pump and the second group underwent to on-pump CABG surgery. The peak serum creatinine values of the patients were taken preoperatively and postoperatively. All preoperative and intraoperative values except operation time (p=0.001) and number of distal anostomosis (p=0.02) were found to be identical for both. No statistical difference were observed between two groups in respect to development of acute renal injury postoperatively. In both groups, only grade 1 acute renal injury was developed (10% in group 1 and 25% in group 2) (p=0.204). Left main coronary artery lesion was found in 2 of 7 patients developing acute renal injury. Patients in group 2 is observed to stay longer in ICU (2.40±0.25 days), compared to group 1 (1.45±0.15 days) (p=0.006). This study showed that, there was no significant difference between off-pump and on-pump CABG surgery tecniques in development of acute renal injury postoperatively. It was shown that left main coronary artery lesion was found to be an important factor causing acute renal injury.
The aim of this study is to compare the effect of off-pump CABG technique obtained by eliminating cardiopulmonary bypass and conventional techniques of on-pump CABG surgery on development of acute renal injury postoperatively. Forty patients for elective coronary artery bypass operation were involved in the study and divided into two groups equally. First group underwent to off-pump and the second group underwent to on-pump CABG surgery. The peak serum creatinine values of the patients were taken preoperatively and postoperatively. All preoperative and intraoperative values except operation time (p=0.001) and number of distal anostomosis (p=0.02) were found to be identical for both. No statistical difference were observed between two groups in respect to development of acute renal injury postoperatively. In both groups, only grade 1 acute renal injury was developed (10% in group 1 and 25% in group 2) (p=0.204). Left main coronary artery lesion was found in 2 of 7 patients developing acute renal injury. Patients in group 2 is observed to stay longer in ICU (2.40±0.25 days), compared to group 1 (1.45±0.15 days) (p=0.006). This study showed that, there was no significant difference between off-pump and on-pump CABG surgery tecniques in development of acute renal injury postoperatively. It was shown that left main coronary artery lesion was found to be an important factor causing acute renal injury.
Description
Keywords
Pompalı koroner baypas, Çalışan kalpte koroner baypas, Akut böbrek hasarı, Kreatinin, Sol ana koroner arter, On-pump CABG, Off-pump CABG, Acute renal injury, Creatinine, Left main coronary artery
Citation
Sevingil, T. vd. (2012). "Pompalı ile çalışan kalpte yapılan koroner baypas cerrahisi sonrasında akut böbrek hasarı gelişiminin karşılaştırılması". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 38(3), 167-172.