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Çalışan Kalpte Koroner Baypas İle Eş Zamanlı ve Aşamalı Karotis Endarterektominin Erken Dönem Sonuçları

Early Results of Combined and Staged Carotid Endarterectomy with Beating Heart Coronary Artery Bypass Surgery

Journal Name:

  • Uludağ Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2007

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
In patients with concomitant carotid and coronary artery disease, no consensus has been established in terms of the surgical approach. Though succesful results have been reported for combined surgery, studies that showed an increase in mortality and morbidity have also been reported. In this study, we aimed to compare the results of cases with concomitant carotis endarterectomy and coronary artery bypass with cases who had staged carotis endarterectomy with coronary bypass surgery in beating heart. In our clinic, a total of 45 cases (15 woman, 30 male) that had combined carotis endarterectomy with coronary artery bypass and staged carotis endarterectomy with coronary bypass surgery in beating heart between 2000-2006 were retrospectively evaluated. The cases were examined in two groups: group 1 had combined carotis endarderectomy and coronary artery bypass and group 2 had staged carotid endarderectomy and coronary bypass surgery in beating heart. There were no significant differences between two groups in terms of preoperative demographic charactheristics. The mean age of the cases in group 1 and group 2 was 65.7±4.7and 66.1±4.3, respectively. In group 1 and 2 the female to male ratios were 7/15 and 8/15, respectively. In group 1 in one case died due to low cardiac output. There was no mortality in group 2. In group 1, one case had temporary stroke. In group 2, one case had a transient ischemic attack. No significant difference was found between the groups in terms of mortality and morbidity. Since results of cases with concomitant carotid endarterectomy and coronary artery bypass and cases who had staged carotis endarterectomy with coronary bypass surgery in beating heart are similar, we assume that combined surgery may be safely used in cases with critical carotid artery stenosis with coronary artery disease.
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Abstract (Original Language): 
Karotis arter hastalığı ile birlikte koroner arter hastalığı olan hastalarda cerrahi yaklaşım açısından fikir birliği sağlanamamıştır. Kombine cerrahi girişimle başarılı sonuçlar bildirilmekle birlikte mortalite ve morbidite riskini artığını gösteren yayınlarda bildirilmiştir. Bu çalış- mada aynı dönem içinde aşamalı karotis endarterektomi ile çalışan kalpte koroner baypasla birlikte karotis endarterektomi uygulanan olguların sonuclarını karşılaştırmayı amaçladık. Kliniğimizde 2000-2006 tarihleri arasında aşamalı ve çalışan kalpte koroner arter bypass (OPCABG) ile birlikte karotis endarterektomi (CEA) uygulanan 15 bayan, 30 erkek 45 olgu retrospektif olarak incelendi. Olgular Grup1(G1); CEA+OPCABG(eşzamanlı) (22), Grup2(G2); CEA sonra CABG(aşamalı) (23) olmak üzere 2 grupta incelendi. Preoperatif demografik özellikler açısından gruplar arasında anlamlı fark yoktu Hastaların yaş ortalaması G1 de 65.7±4.7 G2 de 66.1±4.3 idi.G1 de Kadın(K)/Erkek(E): 7/15, G2 de K/E: 8/15. Postoperatif G1 de 1 olguda düşük kalp debisi nedeniyle mortalite gelişti, G 2 de mortalite yoktu. Grup 1 de 1 olguda geçici stroke görüldü. Grup 2 de 1 olguda transiskemik atak görüldü. Gruplar arasında mortalite ve morbidite açısından istatiksel olarak anlamlı fark bulunmadı. OPCAB ile birlikte CEA sonuçlarının aşamalı uygulama sonuclarına benzer olmasıyla kritik karotis stenozu ve koroner arter hastalığı olan hastalarda kombine girişimin güvenle uygulanabileceği düşünmekteyiz.
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  • 3
135-139
  • Turkish

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