Koroner bypass reoperasyonları sonuçlarımız ve risk faktörlerinin değerlendirilmesi
Küçük Resim Yok
Tarih
2000
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızın amacı, reoperasyon koroner bypass (CABG) uygulanan olguların preoperatif, peroperatif bulguları ile postoperatif erken ve orta dönem izlem sonuçlarına göre mortalite ve morbiditeye etki eden faktörleri araştırmaktır. Materyal ve Metod: 1994 ile 1999 arasında Ege Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Anabilim Dalı'nda ılımlı hipotermik kardiyopulmoner bypass altında CABG reoperasyonu uygulanan 40 olgunun preoperatif, operatif, postoperatif erken ve orta dönem izlem verileri retrospektif olarak değerlendirilmiştir. Olguların taburcu olmasını takiben ilk 6 aylık dönemde poliklinikte, sonrasında ise yılda bir kez poliklinik kontrolü ve telefon görüşmeleri ile takipleri yapılmıştır. Bulgular: Peroperatif iki, postoperatif bir olarak toplam mortalite 3 (%7.5) olgudur. 12'si kardiyak kökenli, toplam 16 olguda postoperatif komplikasyonlar gelişmiştir. Yaşayan 37 olgunun 31 $\pm$ 19.36 aylık izlem süresinde fonksiyonel kapasitelerindeki iyileşme tamdır. Olgularda reoperasyon öncesi var olan risk faktörlerinden obezite, kronik obstrüktif akciğer hastalığı (KOAH), kadın cinsiyet ve ileri yaşın morbiditeyi; diyabet, hipertansiyon, hiperlipidemi, < %50 ejeksiyon fraksiyonu (LVEF), geçirilmiş miyokard infarktüsünün (MI) hem mortalite hem morbiditeyi arttırdığı saptanmıştır. Sonuç: Koroner reoperasyonlarımızın peroperatif mortalite ve morbidite oranları düşük olduğu gibi postoperatif semptomlarda sağlanan iyileşme ve sürvi oranları tatmin edicidir. Hiperlipidemi, hipertansiyon, diyabet, obezite, kadın cinsiyet, KOAH, ileri yaş, geçirilmiş MI ve düşük LVEF reoperasyonların riskini arttıran faktörler olarak ortaya çıkmaktadır.
Background: Purposes of this study were to evaluate the performance of our coronary reoperations and to determine the risk factors affecting mortality and morbidity according to preoperative, perioperative, and postoperative early and mid-term follow-up results. Methods:A retrospective analysis of preoperative, perioperative, and postoperative early and mid-term follow-up data of 40 patients who underwent reoperative coronary artery bypass grafting via moderately hypothemic cardiopulmonary bypass in the Cardiovascular Surgery Department of Ege University between 1994 and 1999, was performed. Follow-up data after the discharge of these patients were obtained via monthly periodical examinations in first 6 months, and after then via telephone interviews. Results: As two occured in perioperative, and one in postoperative periods overall mortality was 3 (7.5%) patients. Cardiac problems were observed in 12 of overall 16 complicated patients. The improvement in functional capacity of surviving 37 patients was perfect in 31 $\pm$ 19.36 months of follow-up. Preoperative factors associated with increased in-hospital mortality and morbidity were diabetes, hypertension, hypercholesterolemia, ejection fraction (LVEF) of < %50, and previous myocardial infarction (MI). Besides these factors, obesity, chronic obstructive pulmonary disease (COPD), female sex, and older age were also associated with increased morbidity. Conclusions: The mortality and morbidity rates of our coronary reoperations were low as well as postoperative symptomatic improvement and survival rates were satisfactory. Hypercholesterolemia, hypertension, diabetes, obesity, female sex, COPD, older age, previous MI, and low LVEF were appeared as significant risk factors in coronary reoperations.
Background: Purposes of this study were to evaluate the performance of our coronary reoperations and to determine the risk factors affecting mortality and morbidity according to preoperative, perioperative, and postoperative early and mid-term follow-up results. Methods:A retrospective analysis of preoperative, perioperative, and postoperative early and mid-term follow-up data of 40 patients who underwent reoperative coronary artery bypass grafting via moderately hypothemic cardiopulmonary bypass in the Cardiovascular Surgery Department of Ege University between 1994 and 1999, was performed. Follow-up data after the discharge of these patients were obtained via monthly periodical examinations in first 6 months, and after then via telephone interviews. Results: As two occured in perioperative, and one in postoperative periods overall mortality was 3 (7.5%) patients. Cardiac problems were observed in 12 of overall 16 complicated patients. The improvement in functional capacity of surviving 37 patients was perfect in 31 $\pm$ 19.36 months of follow-up. Preoperative factors associated with increased in-hospital mortality and morbidity were diabetes, hypertension, hypercholesterolemia, ejection fraction (LVEF) of < %50, and previous myocardial infarction (MI). Besides these factors, obesity, chronic obstructive pulmonary disease (COPD), female sex, and older age were also associated with increased morbidity. Conclusions: The mortality and morbidity rates of our coronary reoperations were low as well as postoperative symptomatic improvement and survival rates were satisfactory. Hypercholesterolemia, hypertension, diabetes, obesity, female sex, COPD, older age, previous MI, and low LVEF were appeared as significant risk factors in coronary reoperations.
Açıklama
Anahtar Kelimeler
Cerrahi, Kalp ve Kalp Damar Sistemi
Kaynak
Türk Göğüs Kalp Damar Cerrahisi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
8
Sayı
3
