İskemik Kardiyomiyopatide Cerrahi Revaskülarizasyon Tekniklerinin Sonuçları

Makalenin İngilizce İsmi: 
Early and Late Outcomes of Surgical Revascularization Procedures in Ischemic Cardiomyopathy
Makale İçerik Bilgileri
Makale Dili: 
Türkçe
Anahtar Kelimeler: 
Kardiyomyopati
koroner arter bypass
off-pump.
Key Words: 
Cardiomyopathies
coronary artery bypass
off-pump.
İngilizce Özet: 

Management of patients with ischemic cardiomyopathy is rather complicated and also has a poor prognosis. Recently,
substantial success rates have also been reported with off-pump technique in these high risk patients. Nevertheless, owing to
the great advances that were achieved in traditional myocardial preservation and cardiopulmonary bypass techniques in the
most recent years; a dilemma still remains regarding superiority of these techniques to each other in patients with ischemic
cardiomyopathy. Thus, we have compared early and late results of these two techniques in this study. Study group included
25 operated patients who have an left ventricle ejection fraction of less than 30 % and left ventricular dilatation between 2001
and 2005. Groups 1 and 2 included patients that were operated with "off pump" and "cardiopulmonary bypass" techniques,
respectively. Hospital mortality was 4% with 1 patient dying in Group 2. Durations of intensive care unit and hospital stays were
shorter in Group 1. Two patients (1 from each group) died in the late postoperative period. Although midterm comparisons of
both functional and angina classifications revealed better results in Group 2 patients, statistical significance wasn't present. Early
and late outcomes of surgical revascularization procedures were satisfactory with both techniques in patients with ischemic
cardiomyopathy. In this study, short term results seemed better in "off pump" patients, while late morbidity rate was lower for
"cardiopulmonary bypass" group.

Yazar Bilgileri
1. Yazar
Yazar Adı: 
Bülend KETENCİ
Yazar Ünvanı: 
Doktor
Yazar E-posta: 
2. Yazar
Yazar Adı: 
Batuhan Özay
3. Yazar
Yazar Adı: 
Mehmet GÜNEY
4. Yazar
Yazar Adı: 
Serdar ÇİMEN
5. Yazar
Yazar Adı: 
Vedat ÖZKUL
6. Yazar
Yazar Adı: 
Rafet GÜNAY
7. Yazar
Yazar Adı: 
Alper GÖRÜR
8. Yazar
Yazar Adı: 
Gökçen ORHAN
9. Yazar
Yazar Adı: 
Murat DEMİRTAŞ
Makale Künye Bilgisi
Makalenin Yayımlandığı Dergi: 
Cerrahpaşa Tıp Dergisi
Makale Yayın Yılı: 
2006
Cilt/Sayı: 
37
Sayı: 
3
Sayfa Aralığı: 
88 - 91
Referanslar: 

1 Warner CD, Weintraub WS, Craver JM, et al. Effect
of cardiac surgery patient characteristics on patient
outcomes from 1981 through 1995. Circulation
1997; 96: 1575-1579.
2 Hartz AJ, Manley JC, Walker JA, et al. Trends during
25 years of coronary artery bypass operation at St.
Luke's Medical Center in Milwaukee, Wisconsin.
Ann Thorac Surg 2000; 69: 829-833. .
3 Nashef SA, Rogues F, Michel P, et al. European
system for cardiac operative risk evaluation (Euro-
SCORE). Eur J Cardiothorac Surg 1999; 16: 9-13.
4 Tugtekin SM, Gulielmos V, Cichon R, et al. Offpump
surgery for anterior vessels in patients with
severe dysfunction of the left ventricle. Ann Thorac
Surg 2000; 70: 1034-1036.
5 Ery›lmaz S, Çorapc›o¤lu T, Eren NT, et al. Off-pump
coronary artery bypass surgery in the left ventricular
dysfunction. Eur J Cardiothorac Surg 2002; 21: 36-40.
6 Yau TM, Fedak PW ,Weisel RD , et al. Predictors of
operative risk for coronary bypass operations in
patients with left ventricular dysfunction. J Thorac
Cardiovasc Surg 1999;118: 1006-1013. .
7 Moshkovitz Y, Sternik L, Paz Y, et al. Primary coronary
artery bypass grafting without cardiopulmonary
bypass in impaired left ventricular function. Ann
Thorac Surg 1997; 63(Suppl 6): 44-47. .
8 Veenhuyzen GD, Singh SN, McAreavey D, et al.
Prior coronary artery bypass surgery and risk of death
among patients with ischemic left ventricular dysfunction.
Circulation 2001;104: 1489-1493.
9 Wos S, Bachowski R, Ceglarek W, et al. Coronary
artery bypass grafting without cardiopulmonary
bypass; initial experience of 50 cases. Eur J Cardiothorac
Surg 1998;14(Suppl 1): 38-42. .
10 Meharwal ZS,Trehan N. Off-Pump coronary artery
bypass grafting in patients with left ventricular dysfunction.
Heart Surgery Forum 2002; 5: 41-45.
11 Nemec P, Bedanova H, Necas J, et al. Coronary
artery bypass grafting in patients with left ventricular
ejection fraction of 30% or less. Bratisl Lek Listy
2001;102: 15-21.
12 Peric MS, Huskic R, Gradinac S, et al. The internal
thoracic artery in myocardial revascularization in
patients with severely depressed left ventricular
function. Srp Arh Celok Lek. 2001;129: 119-23.
13 Luciani GB, Faggian G, Razzolini R, et al. Severe
ischemic left ventricular failure: coronary operation
or heart transplantation? AnnThorac Surg 1993;
55: 719-723.
14 Louie HW, Laks H, Milgalter E, et al. Ischemic
cardiomyopathy: Criteria for coronory revascularization
and cardiac transplantation. Circulation 1991;
84 (Suppl 5): III290-295.
15 Pasquet A, Williams MJ, Secknus MA, et al. Correlation
of preoperative myocardial function, perfusion,
and metabolism with postoperative function at rest
and stress after bypass surgery in severe left ventricular
dysfunction. Am J Cardiol 1999; 84: 58-64. .
16 Schinkel AF, Poldermans D, Rizzello V, et al. Why
do patients with ischemic cardiomyopathy and a
substantial amount of viable myocardium not always
recover in function after revascularization? J Thorac
Cardiovasc Surg 2004;127: 385-390.

Türkiye’nin ilk İşletme Fakültesi olan İstanbul Üniversitesi İşletme Fakültesi bir ilke daha imza atmaya hazırlanıyor. Arastirmax.com "1. Liselerarası İşletme ve Ekonomi Proje Yarışması"nın sponsorlarından biri olmaktan gurur duymakta.