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KRONİK BÖBREK YETMEZLİKLİ HASTALARDA GÜNCEL AÇIK KALP CERRAHİSİ UYGULAMALARI

CURRENT OPEN CARDIAC SURGERY APPLICATIONS IN PATIENTS WITH CHRONIC RENAL FAILURE

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2002

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
"Widespreadlyperforming cardiac operations and their successfull results, caused to think these operations in the patients with high risk and comorbidities, or for treated patients. Main reason of death in chronic renal failure patients were cardiovasculary diseases and death rate due to coronary artery disease was between 30% and 53%. Renal failure can also cause valvular calcification, asymetric septal hypertrophy and conduction disorders and dialysis procedures increase the rate of infective endocarditis. Parallel with developments in dialysis technology, survival rate of the patients with chronic renal failure increased and as a result patient number admitted to cardiovasculary surgery clinics were increased. Main risk factors in these patients are limited tolerance to cardiopulmonary bypass, insufficient excretion of anesthetic drugs, hemorrhagy due to coagulation disorder and tendency to infection. If possible bypass operations of these patients must be performed with beating heart procedure and if not, with acceptable mortality and morbidity, classical cardiopulmonary bypass can be performed and so symptoms are improved, quality of life is increased and there is a change for renal transplantation so, survival increases significantly
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Abstract (Original Language): 
Kalp ameliyatlarının yaygın olarak başarılı sonuçlarla yapılabilmesi daha yüksek risk grubunu oluşturan, birlikte başka sistemlere ait hastalığı olan, ya da tedavi edilmiş olan hastalarda da bu ameliyatların yapılmasını gündeme getirmiştir. Kronik böbrek yetmezlikli hastalarda ölümün ana nedeni kardiyovasküler hastalıklar olup koroner arter hastalığına bağlı ölüm oranının %30-53 arasında değiştiği saptanmıştır. Böbrek yetmezliği aynı zamanda valvüler kalsifikasyon, asimetrik septal hipertrofi ve iletim bozukluklarına sebep olabilmekte, diyaliz işlemleri ise enfektif endokardit insidansını arttırmaktadır. Diyaliz teknolojisindeki gelişmelere paralel olarak da kardiyovasküler cerrahi kliniklerine başvuran böbrek yetmezlikli hasta sayısı giderek artmaktadır. Bu hastalarda kardiyopulmoner bypassa toleransın kısıtlılığı, anestezik ilaçların atılımındaki yetersizlik, koagülasyon bozukluğuna bağlı kanama ve enfeksiyona eğilim başlıca risk faktörlerini oluşturmaktadır. Bu hastalarda mümkünse koroner bypass operasyonlarının çalışan kalpte (beating heart prosedürüne göre) yapılmasının uygun olacağı ve buna uygun olmayan hastalarda da klasik kardiyopulmoner bypass yönteminin kullanılarak kabul edilebilir morbidite ve mortalite ile uygulanan bu cerrahi işlemle hastalarda kardiyak semptomlarda düzelme, yaşam kalitesinde artma temin edilirken, renal transplantasyon şansı elde edilebilmekte böylece yaşam süreleri önemli ölçüde artabilmektedir.
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  • 3
135-139
  • Turkish

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