Purpose: Coronary artery disease incidence under 40 years age is increasing parallel with atherosclerotic disease at the present day while it’s seen frequently over 40. We compared the preoperative risk factors and e...Purpose: Coronary artery disease incidence under 40 years age is increasing parallel with atherosclerotic disease at the present day while it’s seen frequently over 40. We compared the preoperative risk factors and early postoperative results of patients under 40 years age with those over 80 years age executed coronary artery bypass surgery in our clinic in this retrospective study. Patients and method: 128 patients (106 patients under 40 years age (Group 1) and 22 patients aged over 80 (Group 2)) executed coronary artery bypass surgery between January 2004 and June 2012 in our clinic are included in this study. Result: Mean age was 45.2 ± 17.2. Smoking, diabetes mellitus and high low density lipoprotein levels were the predisposing risk factors in Group 1 while hypertension and chronic obstructive pulmonary disease are predominated in the other. All patients are taken to surgical procedure under elective conditions. Aortic cross clamp duration were 37.02 ± 16.2 and 38.9 ± 13.5 minutes respectively;total cardiopulmonary bypass interval was 67.1 ± 26.3 minutes. Utilization of left internal mammarian artery was significantly higher (p = 0.01) in group 1 when compared in terms of graft management. Necessity of positive inotropic support (p = 0.033) and intraaortic balloon pump demand (p = 0.315) are found higher in Group 2. Atrial fibrillation, neurologic complications, delirium, wound infection, and postoperative revision demand are found significantly low (p = 0.136) in Group 1. There was no mortality in both groups. Discussion: Postoperative complications are seen more often in the elder group, while there was no significant difference in terms of mortality in both groups. Coronary revascularisation is safely practical in both young and elder patients with well early postoperative results and acceptable hospital mortality.展开更多
Introduction: In this study we explicated early results of patients (the patients in whom levosimendan was used) who underwent coronary artery bypass graft surgery with ejection fraction 35% or less. We compared this ...Introduction: In this study we explicated early results of patients (the patients in whom levosimendan was used) who underwent coronary artery bypass graft surgery with ejection fraction 35% or less. We compared this group with the patients in whom levo-simendan was not used. Material and Methods: 97 patients who have 35% ejection fraction or less taken to isolated coronary artery bypass surgery between January 2009 and December 2011 in our clinic are chosen for this study retrospectively. We compared the patients in whom levosimendan was used with the patients in whom levosimendan was not used. Levo- simendan (Simdax, Abbott) has been used according to surgeon’s decision in patients. Results: The mean age of group 1 was 62.3 ± 7.6, and the mean age of group 2 was 59.3 ± 10.5 (p > 0.05). It was detected that the average ejection fraction was less in group 1 (p 0.05). It was found that need for blood transfusion were less in group 1 than group 2 (p 0.05). Conclusion: We consider levosimendan reduces need for blood transfusion in coronary artery bypass graft surgery. This results may change with increasing number of patients so we consider that multicenter larger study is needed.展开更多
In this report, we present the case of a patient who presented with a pellet in his myocardium and was managed with cardiac tamponade due to shotgun injury. A 49-year-old man presented to the emergency department due ...In this report, we present the case of a patient who presented with a pellet in his myocardium and was managed with cardiac tamponade due to shotgun injury. A 49-year-old man presented to the emergency department due to a close-range shotgun pellet injury. The patient was operatedemergently because arterial pressure was progressively decreasing and cardiac tamponade was detected echocardiographically. Three pellet entrance hole were detected on left ventricule posterior wall in surgical exploration after the cardiac tamponade relieved. No further intervention was considered because bleeding discontinued. We conclude that in shotgun pellet cardiac injuries, if the pellets are located in the myocardium, the operational decision and surgical procedure to be undertaken depends on the clinical situation of the patient and the echocardiographic signs.展开更多
Introduction: In this study we examined the early results of coronary artery bypass surgery in our female patients and compared them with those of our male patients. Material and Methods: One thousand and ninety four ...Introduction: In this study we examined the early results of coronary artery bypass surgery in our female patients and compared them with those of our male patients. Material and Methods: One thousand and ninety four patients who underwent coronary artery bypass surgery between January 2009 and December 2011 inour clinic were included into this study. Three hundred and thirteen female patients (group 1) were compared to 781 male patients (group 2). Results: The mean age of group 1 was 61.4 ± 9.6, and the mean age of group 2 was 58.1 ± 9.6 (p < 0.001). The ratio of diabetes mellitus and hypertension in group 1 was higher than that of group 2 (p < 0.001). There were no significant difference between two groups when compared regarding the need for inotropics after weaning from cardiopulmonary bypass, cross clamp and total cardiopulmonary bypass periods (p > 0.05). It was found that the amount of drainage was higher in group 1 than group 2 (p < 0.001). There was no significant difference between two groups when compared in terms of mortality, re-operation (because of bleeding), postoperative atrial fibrillation, need for intraaortic balloon pump, usage of levosimendan, cerebrovascular accident, chronic renal failure, discharging intervals and period in intensive care unit. It was found that sternal wound infection was higher in group 1 than group 2 (p < 0.05). Conclusion: We consider that female gender does not put an additional risk to increase mortality and morbidity in coronary artery bypass surgery.展开更多
文摘Purpose: Coronary artery disease incidence under 40 years age is increasing parallel with atherosclerotic disease at the present day while it’s seen frequently over 40. We compared the preoperative risk factors and early postoperative results of patients under 40 years age with those over 80 years age executed coronary artery bypass surgery in our clinic in this retrospective study. Patients and method: 128 patients (106 patients under 40 years age (Group 1) and 22 patients aged over 80 (Group 2)) executed coronary artery bypass surgery between January 2004 and June 2012 in our clinic are included in this study. Result: Mean age was 45.2 ± 17.2. Smoking, diabetes mellitus and high low density lipoprotein levels were the predisposing risk factors in Group 1 while hypertension and chronic obstructive pulmonary disease are predominated in the other. All patients are taken to surgical procedure under elective conditions. Aortic cross clamp duration were 37.02 ± 16.2 and 38.9 ± 13.5 minutes respectively;total cardiopulmonary bypass interval was 67.1 ± 26.3 minutes. Utilization of left internal mammarian artery was significantly higher (p = 0.01) in group 1 when compared in terms of graft management. Necessity of positive inotropic support (p = 0.033) and intraaortic balloon pump demand (p = 0.315) are found higher in Group 2. Atrial fibrillation, neurologic complications, delirium, wound infection, and postoperative revision demand are found significantly low (p = 0.136) in Group 1. There was no mortality in both groups. Discussion: Postoperative complications are seen more often in the elder group, while there was no significant difference in terms of mortality in both groups. Coronary revascularisation is safely practical in both young and elder patients with well early postoperative results and acceptable hospital mortality.
文摘Introduction: In this study we explicated early results of patients (the patients in whom levosimendan was used) who underwent coronary artery bypass graft surgery with ejection fraction 35% or less. We compared this group with the patients in whom levo-simendan was not used. Material and Methods: 97 patients who have 35% ejection fraction or less taken to isolated coronary artery bypass surgery between January 2009 and December 2011 in our clinic are chosen for this study retrospectively. We compared the patients in whom levosimendan was used with the patients in whom levosimendan was not used. Levo- simendan (Simdax, Abbott) has been used according to surgeon’s decision in patients. Results: The mean age of group 1 was 62.3 ± 7.6, and the mean age of group 2 was 59.3 ± 10.5 (p > 0.05). It was detected that the average ejection fraction was less in group 1 (p 0.05). It was found that need for blood transfusion were less in group 1 than group 2 (p 0.05). Conclusion: We consider levosimendan reduces need for blood transfusion in coronary artery bypass graft surgery. This results may change with increasing number of patients so we consider that multicenter larger study is needed.
文摘In this report, we present the case of a patient who presented with a pellet in his myocardium and was managed with cardiac tamponade due to shotgun injury. A 49-year-old man presented to the emergency department due to a close-range shotgun pellet injury. The patient was operatedemergently because arterial pressure was progressively decreasing and cardiac tamponade was detected echocardiographically. Three pellet entrance hole were detected on left ventricule posterior wall in surgical exploration after the cardiac tamponade relieved. No further intervention was considered because bleeding discontinued. We conclude that in shotgun pellet cardiac injuries, if the pellets are located in the myocardium, the operational decision and surgical procedure to be undertaken depends on the clinical situation of the patient and the echocardiographic signs.
文摘Introduction: In this study we examined the early results of coronary artery bypass surgery in our female patients and compared them with those of our male patients. Material and Methods: One thousand and ninety four patients who underwent coronary artery bypass surgery between January 2009 and December 2011 inour clinic were included into this study. Three hundred and thirteen female patients (group 1) were compared to 781 male patients (group 2). Results: The mean age of group 1 was 61.4 ± 9.6, and the mean age of group 2 was 58.1 ± 9.6 (p < 0.001). The ratio of diabetes mellitus and hypertension in group 1 was higher than that of group 2 (p < 0.001). There were no significant difference between two groups when compared regarding the need for inotropics after weaning from cardiopulmonary bypass, cross clamp and total cardiopulmonary bypass periods (p > 0.05). It was found that the amount of drainage was higher in group 1 than group 2 (p < 0.001). There was no significant difference between two groups when compared in terms of mortality, re-operation (because of bleeding), postoperative atrial fibrillation, need for intraaortic balloon pump, usage of levosimendan, cerebrovascular accident, chronic renal failure, discharging intervals and period in intensive care unit. It was found that sternal wound infection was higher in group 1 than group 2 (p < 0.05). Conclusion: We consider that female gender does not put an additional risk to increase mortality and morbidity in coronary artery bypass surgery.
