Outcomes of open heart surgery

Orhan BOZOĞLAN, Erdinç EROĞLU, Alptekin YASİM, Atalay METE, Bülent MEŞE, Serdal ELVEREN, İbrahim YILDIRIMDEMİR, Murat ARI

Özet

Amaç: İlk kez Şubat 2006 yılında başlanılan açık kalp cerrahisi sonuçlarını sunmayı amaçladık. Gereç ve Yöntemler: Şubat 2006 ile Nisan 2012 tarihleri arasında aynı ilde iki merkezde toplam 1238 açık kalp ameliyatı gerçekleştirildi. Ortalama yaş 58,31±14,45 idi. Yetmiş birhasta acil şartlarda (%5,7) operasyona alındı. Koroner arter hastalığı tanısıyla 940 hasta (%72,2) koroner arter bypass cer- rahisi uygulandı. On bir hastaya koroner arter bypass cerrahisi ile birlikte karotis arter endarterektomisi yapıldı. 220 hastada(%17,7) kalp kapağına müdahale edildi. Toplam 20 hastaya aort cerrahisi yapıldı. Yedi hastaya asendan aort replasmanı, 1hastaya desandan aort replasmanı, 1 hastaya asendan aort replasmanı ile birlikte koroner arter bypass cerrahisi, 12 hastayabentall ve cabrol prosedürü uygulandı. Yedi hasta miksoma tanısı ile opere edildi. Toplam 52 hastaya (%4,2) konjenital kalp ameliyatı yapıldı. Bulgular: Kardiyopulmoner bypass altında CABG yapılan hastalarda ortalama kross klemp zamanı 68,41±28,71dakika ve perfüzyon zamanı 96,58±35,99 dakika olarak bulundu. Distal anostomoz sayısı ortalama 2,94±0,9 (1-6) idi. Yüz iki hastada (%10,8) CABG koroner arter endarterektomisi yapıldı. CABG ilave olarak 11 hastada sol ventrikül anevrizmasına müdahale edildi. Altmış iki hastaya (%5) düşük kalp debisi nedeniyle intraaortik balon pompası takıldı. Hastane mortalitesi %4,2 idi. Yoğun bakımda kalma süreleri ortalama 2,3±0,6 gün, hastanede kalış süreleri ortalama 6,2±2,4 gündü. Sonuç: Şubat 2006 tarihinden itibaren açık kalp cerrahisi yapılan her iki merkezde artan bir ivme ve başarı ile açık kalp cerrahisi devam etmektedir.

Abstract

Objective: We aimed to represent outcomes of open heart surgeries which began first in April 2006.Material and Methods: One thousand two hundred thirtyeight open heart surgery procedures were performed in twohospitals between February 2006 and April 2012. Mean agewas 58.31±14.45. Seventy-one patients underwent emergencysurgery. Nine hundred and forty patients underwent coronaryartery bypass grafting (CABG) surgery with the diagnosis ofcoronary artery disease. Coronary artery bypass grafting surgery with carotid artery endarterectomy was performed in 11patients. Two hundred and twenty patients (17.7%) were perated on for heart valve surgery. Aortic surgery was performedin 20 patients. Ascending aorta replacement surgery was performed in 7 patients, descending aorta replacement surgerywas performed in 1 patient, ascending aorta replacement surgery and CABG surgery were performed in 1 patient, Bentalland Cabrol surgery procedure was performed in 12 patients.Seven patients were operated on with the diagnosis of myxoma. Congenital heart surgery operation was performed in 52patients (4.2%).Results: Mean cross clamping time was 68.41±28.71 minutes and mean perfusion time was 96.58±35.99 minutes in patients who had CABG surgery or cardiopulmonary bypass. Mean distal anastomosis number was 2.94±0.9 (1-6). Coronary artery endarterectomy was performed in 102 patients (10.8%). Left ventricule aneurysm was operated on in 11 patients who had CABG surgery. Intraaortic balloon pump was inserted in 62 patients (5%) for low cardiac output. Hospital mortality rate was 4.2%. Mean intensive care unit hospitalization time was 2.3±0.6 days, mean hospitalization time was 6.2±2.4 days. Conclusion: Open heart surgery has continued in 2 centers with accelerating success since February 2006, when surgeries began to be performed.