You are here

Home » Content

70 Yaş Üzeri Hastalarda On-Pump, Off-Pump Koroner Revaskülarizasyon

Off-Pump and On-Pump Coronary Revascularisation in Over 70 Years Old Patients

Journal Name:

  • Cerrahpaşa Tıp Dergisi

Publication Year:

  • 2006

Key Words:

Keywords (Original Language):

Author Name
Abstract (2. Language): 
Though perioperative outcome of beating heart surgery have been considered better than conventional methods, late results are still controversial especially in elderly patients. In this clinical trial we have compared early and late results of 71 aged cases operated either by beating or conventional methods. Preoperative risk factors of both groups were comparable except chronic obstructive pulmonary disease. In perioperative parameters, conventional group had statistically significantly longer intensive care and hospital stay days. During late follow-up period mortality rates were comparable but functional capacity of conventional group were better. Perioperative merits and late outcomes of both techniques should be evaluated for decision of operative technique.
Bookmark/Search this post with
Abstract (Original Language): 
Atan kalp yönteminin hastane morbiditesi üzerinde açık yararı ortaya konulmuşsa da geç dönem sonuçları özellikle yüksek riskli gruplarda halen tartışılmaktadır. Bu klinik çalışmada atan kalp veya konvansiyonel yöntemle opere edilen, ileri yaş grubundaki 71 hastanın, erken ve uzun dönem sonuçlarını karşılaştırdık. Preoperatif risk faktörleri açısından kronik obstrüktif akciğer hastalığı hariç her iki grupta fark yoktu. Hastane ve yoğun bakım kalış süreleri konvansiyonel grupta uzun bulundu. Takip süresince ise sürvi farkı yokken konvansiyonel yöntemle opere edilen hastaların fonksiyonel kapasiteleri daha iyiydi. Yaşlı hasta grubunda perioperatif morbidite ve mortalite atan kalp tekniği ile daha iyi gibi görünse de geç dönem fonksiyonel kapasite açısından konvansiyonel yöntem daha iyi gözükmektedir. Erken dönem yüksek peroperatif komplikasyon oranı ile orta-uzun dönem dezavantajları iyi değerlendirilmelidir.
FULL TEXT (PDF): 
PDF icon arastirmax-70-yas-uzeri-hastalarda-pump-pump-koroner-revaskularizasyon.pdf
  • 4
131 - 136
  • Turkish

REFERENCES

References: 

1. Boyd WD, Desai ND, Del Rizzo DF, et al. Off-pump
surgery decreases postoperative complications and
resource utilization in the elderly. Ann Thorac Surg
1999; 68:1490-1493.
2. Ivanov J, Weisel RD, David TE, Naylor CD. Fifteenyear
trends in risk severity and operative mortality
in elderly patients undergoing coronary artery bypass
graft surgery. Circulation. 1998; 97: 673-680.
3. Parsonnet V, Dean D, Bernstein AD. A method of uniform
stratification of risk for evaluating the results of
surgery in acquired adult heart disease. Circulation.
1989; 79: I3-12. Erratum in: Circulation 1990; 82: 1078.
4. Lancey RA, Soller BR,Vander Salm TJ. Off-pump versus
on-pump coronary artery bypass surgery: a casematched
comparison of clinical outcomes and costs.
Heart Surg Forum 2000; 3: 277-281.
5. Puskas JD, Wright CE, Ronson RS, et al. Off-pump
multivessel coronary bypass via sternotomy is safe
and effective. Ann Thorac Surg 1998; 66: 1068-1072.
6. Allen KB, Matheny RG, Robison RJ, et al.Minimally
invasive versus conventional reoperative coronary
artery bypass. Ann Thorac Surg 1997; 64: 616-622.
7. Koh TW, Carr-White GS, DeSouza AC ve ark. Intraoperative
cardiac troponin T release and lactate metabolism
during coronary artery surgery: comparison
of beating heart with conventional coronary artery
surgery with cardiopulmonary bypass. Heart 1999;
81: 495-500.
8. Khan NE, De Souza A, Mister R et al. A randomized
comparison of off-pump and on-pump multivessel
coronary-artery bypass surgery. N Engl J Med 2004;
350: 21-28.
9. Ascione R, Lloyd CT, Underwood MJ, et al. On-pump
versus off-pump coronary revascularization: evalution
of renal function. Ann Thorac Surg 1999; 68: 493-498.
10. Van Dijk D, Nierich AP, Jansen EW, et al. Octopus
Study Group. Early outcome after off-pump versus
on-pump coronary bypass surgery: result from a randomized
study. Circulation 2001; 104: 1761-1766.
11. BhaskerRao B, VanHimbergen D, Edmonds HL Jr, et
al. Evidence for improved cerebral function after minimally
invasive bypass surgery. J Card Surg 1998;
13: 27-31.
12. Brown WR, Moody DM, Challa VR, et al. Longer duration
of cardiopulmonary bypass is associated with
greater numbers of cerebral microemboli. Stroke
2000; 31: 707-713.
13. Abu-Omar Y, Balacumaraswami L, Pigott DW, et al.
Solid and gaseous cerebral microembolization during
off-pump, on-pump, and open cardiac surgery procedures.
J Thorac Cardiovasc Surg 2004; 127: 1759-
1765.
14. Arom KV, Flavin TF, Emery RW, et al. Safety and efficacy
of off-pump coronary artery bypass grafting.
Ann Thorac Surg 2000; 69: 704-10.
15. Angelini GD, Taylor FC, Reeves BC, Ascione R. Early
and midterm outcome after off-pump and on-pump
surgery in Beating Heart Against Cardioplegic Arrest
Studies (BHACAS 1 and 2): a pooled analysis of two
randomised controlled trials. Lancet 2002; 359: 1194-
1199.
16. Haissaguerre M, Jais P, Shah DC, et al. Spontaneous
initiation of atrial fibrillation by ectopic beats originating
in the pulmonary veins. N Engl J Med 1998;
339: 659-666.
17. Rathore SS, Berger AK,Weinfurt KP, et al. Acute myocardial
infarction complicated by atrial fibrillation
in the elderly: prevalence and outcomes. Circulation
2000; 101: 969-974.
18. Kolvekar S, D’Souza A, Akhtar P , et al. Role of atrial
ischaemia in development of atrial fibrillation following
coronary artery bypass surgery. Eur J Cardiothorac
Surg 1997; 11: 70-75.
19. Kilo J, Baumer H, Czerny M, et al. Target vessel revascularization
without cardiopulmonary bypass in
elderly high-risk patients. Ann Thorac Surg 2001; 71:
537-542.
20. Jones EL, Weintraub WS. The importance of completeness
of revascularization during long-term followup
after coronary artery operations. J Thorac Cardiovasc
Surg 1996; 112: 227-237.
21. Bell MR, Bailey KR, Reeder GS, et al. Percutaneous
transluminal angioplasty in patients with multivessel
coronary disease: how important is complete revascularization
for cardiac event-free survival? J Am
Coll Cardiol 1990; 16: 553-562.
22. Tu JV, Jaglal SB, Naylor CD. Multicenter validation
of a risk index for mortality, intensive care unit stay,
and overall hospital length of stay after cardiac surgery.
Steering Committee of the Provincial Adult Cardiac
Care Network of Ontario.Circulation 1995; 91:
677-684.
23. Mullany CJ, Mock MB, Brooks MM, et al. Effect of
age in the Bypass Angioplasty Revascularization Investigation
(BARI) randomized trial.Ann Thorac Surg
1999; 67: 396-403.
24. Kannel WB, Larson M. Long-term epidemiologic prediction
of coronary disease. The Framingham experience.
Cardiology 1993; 82: 137-152.
B. KETENCİ ve ark.
136

Thank you for copying data from http://www.arastirmax.com