ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Koroner Bypass Cerrahisi ile Birlikte Kalp Kapaklarına Yönelik Girişimlerin Morbidite ve Mortalite Üzerine Etkisi
Barbaros KINOĞLU, Bülent POLAT, Atıf AKÇEVİN, Mehmet Salih BİLAL, Tayyar SARIOĞLU, Cihat BAKAY, Rüstem OLGA, Aydın AYTAÇ
İ.Ü. Kardiyoloji Enstitüsü, Kalp ve Damar Cerrahisi Anabilim Dalı, Haseki
In the University of Istanbul, Institute of Cardiology, 90 patients who underwent combined valve and coronery artery bypass operations between November 1986 and February 1993 are retrospectively reviewed. Mean age at operation was 60.3 years (range, 40 to 75 years). 72 patients (80%) were in New York Hart Association functional class III or IV and 41 patients had myocardial infarction previously. All of the patients underwent coronary artery bypass operation. 52 patients underwent additional mitral valve operations (47 MVR, 5 mitral plasty). Aortic valve replacement was performed in 30 patients (28 isolated AVR, 1 supracoronary graft interposition, 1 Bentall operation). 6 patients underwent double valve (mitral and aortik valves), 1 patient, triple valve (aortic, mitral, tricuspid valves) surgery and 1 patient had pulmonary valvotomy. 4 of the patients who received MVR andcoroneray surgery, had also left ventricular aneurysm repair at the same session. 8 patients were lost at early post operative period (within first 30 days). Overall hospital mortality was 8.9%. Deaths were ocurred as a results of low cardiac output in most of the cases, and all of these cases were preoperatively NYHA class III-IV patients. Early mortality in coronary bypass and mitral valve intreventions was 9.6%, where as in coronary bypass and aortic valve cases it was 6.6%. The postoperative mean follow up periods aailable for 72 patients were 42 months (range, 5 months to 7 years). There were 6 late deaths (8.2%). Of the remaining patients, 94% were in NYHA class I functional capacity in their postoperative lives. The results of this study, like lots of others in the literature have proven us that coronary bypass operations to gether with valvuler operations can be done with low early mortality rate and satisfactory late term results. The most important factors that effects the postoperative early and ate mortality are preoperative functional capacity, left ventricular functions and myocardial protection techniques used in the operations.
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