Çalışan kalpte yapılan koroner bypass cerrahisi sırasında kardiyopulmoner bypassa dönüşümün mortalite ve morbidite üzerine etkisi
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Date
2013-07-29
Authors
Önder, Tolga
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Çalışmamızda planlı off-pump koroner arter bypass cerrahisi sırasında acil kardiopulmoner bypassa konversiyonun sonuçlarını değerlendirdik ve konversiyon hastalarının sonuçlarını kardiyopulmoner bypass eşliğinde yapılan koroner bypass ile retrospektif olarak karşılaştırdık. Kliniğimizde Ocak 2004-Ocak 2010 tarihleri arasında 1257 izole çalışan kalpte koroner bypass, 494 izole konvansiyonel koroner bypass uygulandı. 66 hastada (%5.4) acil kardiyopulmoner bypassa konversiyon gereksinimi oldu. Kardiyopulmoner bypassa konversiyon olan hastalar, konvansiyonel cerrahi ile karşılaştırıldığında mortalitenin (p=0.003), intraaortik balon pompa kullanımının (p=0.007), ventilasyon süresinin (p=0.020), kardiopulmoner bypass süresinin (p=0.002), operasyon süresinin (p=0.001), inotrop ihtiyacının (p<0.001), aritmi insidansının (p<0.001), hastanede kalış süresinin (p<0.001), göğüs tüpü drenajınını (p=0.023) önemli derecede yüksek olduğu görüldü. Off-pump koroner bypass cerrahisi esnasında acil kardiyopulmoner bypassa konversiyon olması yüksek mortalite ve morbidite ile sonuçlanır. Off-pump koroner bypass cerrahisi ile konvansiyonel cerrahiyi karşılaştıran çalışmalarda konversiyon hastaları off pump grubuna dahil edilmelidir.
The purpose of this study was to evaluate outcomes of emergency conversion to cardiopulmonary bypass during planned off-pump coronary artery bypass grafting and compare patients outcomes for acutely converted OPCAB with CABG-CPB in retrospective. From January 2004 through January 2010, 1257 consecutive isolated off pump coronary artery bypass operations and 494 isolated convantionel coronary artery bypass operations were performed at our Medical Faculty. Sixty six (5.4%) patients required emergency conversion to cardiopulmonary bypass. Those converted to cardiopulmonary bypass had significantly higher rates of mortality (p=0.003), intraaortic balloon pumping (p=0.007), ventilation time (p=0.02), CPB time (p=0.002), operation time (p=0.001), need for inotrop (p<0.001), incidance of arrhythmia (p<0.001), hospital stay (p<0.001), chest tube drainage (p=0.023) compared to convantionel CABG. Emergency conversion to cardiopulmo nary bypass during attempted off-pump coronary bypass surgery results in significantly higher morbidity and mortality. Studies comparing off-pump coronary bypass surgery with conventional coronary artery surgery should include converted patients in the off-pump group
The purpose of this study was to evaluate outcomes of emergency conversion to cardiopulmonary bypass during planned off-pump coronary artery bypass grafting and compare patients outcomes for acutely converted OPCAB with CABG-CPB in retrospective. From January 2004 through January 2010, 1257 consecutive isolated off pump coronary artery bypass operations and 494 isolated convantionel coronary artery bypass operations were performed at our Medical Faculty. Sixty six (5.4%) patients required emergency conversion to cardiopulmonary bypass. Those converted to cardiopulmonary bypass had significantly higher rates of mortality (p=0.003), intraaortic balloon pumping (p=0.007), ventilation time (p=0.02), CPB time (p=0.002), operation time (p=0.001), need for inotrop (p<0.001), incidance of arrhythmia (p<0.001), hospital stay (p<0.001), chest tube drainage (p=0.023) compared to convantionel CABG. Emergency conversion to cardiopulmo nary bypass during attempted off-pump coronary bypass surgery results in significantly higher morbidity and mortality. Studies comparing off-pump coronary bypass surgery with conventional coronary artery surgery should include converted patients in the off-pump group
Description
Keywords
Koroner bypass, Morbidite, Off-pump koroner bypass, Konversiyon, Mortalite, CABG, Morbidity, Mortality, Conversion, OPCAB
Citation
Önder, T. vd. (2013). "Çalışan kalpte yapılan koroner bypass cerrahisi sırasında kardiyopulmoner bypassa dönüşümün mortalite ve morbidite üzerine etkisi". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 39(2), 111-117.