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Koroner Arter Bypass Reoperasyonlarında Sağ internal Torasik Arter Kullanımı

The Use of Right Internal Thoracic Artery in Coronary Artery Bypass Reoperations

Journal Name:

  • Fırat Tıp Dergisi

Publication Year:

  • 2010

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
Objective: Internal thoracic artery (ITA) is the graft of choice in coronary artery bypass (CABG operations) due to its advantages in survival, ischemia recurrence and need for reintervention. In this study, we retrospectively analyzed our CABG reoperations with right ITA (RITA). Materials and Methods: Only the patients who had RITA graft in coronary revascularizations were enrolled in this study (n=12). Eleven patients (91.6%) were female and one male (8.4%). The average age of the patients was 57.4±5.9 (ranged, 48-66). The average duration of first and second CABG was 5.1±1.4 years (ranged, 1-6). Eight patients were operated off-pump. The mean duration of postoperative follow up was 5.0±1.9 years (ranged, 1.2-7.3) (total of 59.6 patient/years). Results: There was no in-hospital death. The average durations of intensive care and hospital stays were 1.3±0.5 days (ranged, 1-2) and 6.2±1.5 days (ranged, 5-9). The mean NYHA functional capacity of the patients in the follow-up was 1.3±0.5 (ranged, Class 1-2). The difference was statistically significant (p=0.045). There was only one long term mortality during the follow-up. Conclusion: ITA grafts should be preferred in the era of increasing CABG reoperations. Considering that the left ITA is used frequently in the initial operations, RITA should be the first graft of choice in the reoperations. The use of this graft does not cause increased mortality or morbidity
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Abstract (Original Language): 
Amaç: internal torasik arter (İTA); sağ kalım, iskemi rekürensi ve yeni koroner girişim ihtiyacı açısından belirgin üstünlüğü nedeniyle koroner arter bypass (KABG) ameliyatlarında sıklıkla kullanılmaktadır. Bu çalışmada sağ İTA (RİTA) grefti kullanılarak yapılan KABG reoperasyonları geriye dönük olarak analiz ettik. Gereç ve Yöntemler: Bu çalışmaya koroner reoperasyonlarda RİTA grefti kullanılan hastalar dâhil edilmiştir (n=12). Hastaların kadın (%91.6) ve biri erkek idi (%8.4). Hastaların ortalama yaşı 57.4±5.9 (48-66 arasında) idi. İlk KABG ameliyatı ile reoperasyon arasındaki ortalama süre 5.1±1.4 yıl (1-6 yıl arasında) idi. Hastaların 8'i atan kalpte ameliyat edildi. Hastalar ortalama olarak 5.0±1.9 yıl (1.2-7.3 yıl arasında) takip edildi (toplam 59.6 hasta/yıl). Bulgular: Hiçbir hastada mortalite görülmedi. Ameliyat sonrası hastaların yoğun bakım ve hastane kalış süreleri sırasıyla ortalama 1.3±0.5 (1-2 gün arası) ve 6.2±1.5 (5-9 gün arası) oldu. Taburculuk sonrası kontrollerinde hastaların ortalama NYHA kapasiteleri 1.3±0.5 (Class 1-2 arasında) idi. Preoperatif dönemle karşılaştırıldığında aradaki fark anlamlı kabul edildi (p=0.045). Hastaların ameliyat sonrası takiplerinde tek bir hastada geç mortalite oldu. Sonuç: Sonuç olarak, KABG reoperasyonlarının arttığı bu dönemde hastaların sağ kalımına olumlu etkisi olan İTA grefti tercih edilmelidir. Günü¬ müzde ilk ameliyatlarda LİTA greftinin büyük bir oranda kullanıldığı düşünülürse, reoperasyonlarda ilk tercih RİTA grefti olmaktadır. Bu greftin kullanılması ameliyat döneminde ek bir mortalite veya morbidite getirmemektedir.
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  • 2
70-73
  • Turkish

REFERENCES

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