Off-Pump ve On-Pump Koroner Arter Bypas Tekniklerinin QT Dispersiyonu Üzerine Olan Etkilerinin Karşılaştırılması
Abstract
Amaç Koroner arter bypas greftleme sonrası ventriküler eksra atımdan süreğen olmayan venrtiküler takikardi, süreğen venrtiküler takikardi ve ventriküler fibrilasyon gibi takiaritmilere değişen aritmik tablolar görülebilir. Bu çalışmada atan kalpte ve on pump Koroner arter bypas greftlemenin QT dispersiyonu üzerine olan etkilerini araştırmayı amaçladık.Materyal ve Metot: Çalışmaya 64 koroner arter bypas greftleme adayı olan hasta alındı. Bu hastalar on-pump koroner arter bypas greftleme grubu (n= 40) ve atan kalpte koroner arter bypas greftleme grubu (n= 24) olarak iki gruba ayrıldı. Elektrokardiyografi ve ekokardiyografi, cerrahiden önce ve 1 ay sonrasında uygulandı.Bulgular: Her iki grubunun bazal karekteristik özelliklerine bakıldığında, gruplar arasında istatistiksel açıdan fark saptanmadı. Her iki koroner arter bypas greftleme tekniğinin kendi içerisinde operasyon öncesi ve sonrasında anlamlı değişiklik mevcuttu. Operasyon sonrası atan kalpte koroner arter bypas greftleme ve pompada koroner arter bypas greftleme gruplarının minimum QT, maksimum QT, QT dispersiyonu, minimum QTc, maksimum QTc ve QTc dispersiyonu açısından karşılaştırıldığında aralarında istatiksel açıdan anlamlı fark yoktu.Sonuç: Bizim çalışmamızda her iki koroner arter bypas greftleme tekniğinin de QT dispersiyonu üzerine düzeltici etkisi olduğu gözlenmiştir. Fakat iki tekniğin birbirlerine üstünlüğü olmadığı görülmüştür.
References
- Fitz Gibbon GM, Leach AJ, Keon WJ, Burton JR, Kafka HP. Coronary bypass graft fate. Angiographic study of 1,179 vein grafts early, one year, and five years after operation. J Thorac Cardiovasc Surg 1986;91(5):773-8.
- Angelini GD, Taylor FC, Reeves BC, Ascione R. Early and midterm outcome after off-pump and on-pump surgery in Beating Heart Against Cardioplegic Arrest Studies (BHACAS 1 and 2): a pooled analysis of two randomized controlled trials. Lancet 2002;359(9313):1194-9.
- Bull DA, Neumayer LA, Stringham JC, Meldrum P, Affleck DG, Karwande SV. Coronary artery bypass grafting with cardiopulmonary bypass versus off-pump cardiopulmonary bypass grafting: does eliminating the pump reduce morbidity and cost? Ann Thorac Surg 2001;71(1):170-3.
- Darwazah AK, Abu Sham'a RA, Hussein E, Hawari MH, Ismail H. Myocardial revascularization in patients with low ejection fraction < or =35%: effect of pump technique on early morbidity and mortality. J Card Surg 2006;21(1):22-7.
- Yokoyama T, Baumgartner FJ, Gheissari A, Capouya ER, Panagiotides GP, Declusin RJ. Off-pump versus on-pump coronary bypass in high-risk subgroups. Ann Thorac Surg 2000;70(5):1546-50.
- Kerendi F, Puskas JD, Craver JM, Cooper WA, Jones EL, Lattouf OM, et al. Emergency coronary artery bypass grafting can be performed safely without cardiopulmonary bypass in selected patients. Ann Thorac Surg 2005;79(3):801-6.
- Beckermann J, Van Camp J, Shuling L, Wahl SK, Collins A, Herzog CA. On-pump versus off-pump coronary surgery outcomes in patients requiring dialysis: perspectives from a single center and the United States experience. Journal of thoracic and cardiovascular surgery 2006; 131(6):1261-1266.
- Diegeler A, Hirsch R, Schneider F, Schilling L-O, Falk V, Rauch T, et al.. Neuromonitoring and neurocognitive outcome in off-pump versus conventional coronary bypass operation. The Annals of thoracic surgery 2000; 69(4):1162-1166.
- Bucerius J, Gummert JF, Walther T, Schmitt DV, Doll N, Falk V, et al. On-pump versus off-pump coronary artery bypass grafting: impact on postoperative renal failure requiring renal replacement therapy. The Annals of thoracic surgery 2004; 77(4):1250-1256.
- Puskas J, Williams W, Duke P, Staples J, Glas K, Marshall J, et al. Off-pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury, transfusion requirements, and length of stay: a prospective randomized comparison of two hundred
- unselected patients undergoing off-pump versus conventional coronary artery bypass grafting. The Journal of Thoracic and Cardiovascular Surgery 2003;125(4):797808.
- Mack M, Bachand D, Acuff T, Edgerton J, Prince S, Dewey T, et al. Improved outcomes in coronary artery bypass grafting with beating-heart techniques. The Journal of Thoracic and Cardiovascular Surgery 2002; 124(3):598607.
- Welch PJ, Page RL, Hamdan MH. Management of ventricular arrhythmias. J Am Coll Cardiol 1999;34:621–30.
- -
- O’Rourke RA. Role of myocardial revascularization in sudden cardiac death. Circulation 1992;85 Suppl I:I112–7.
- Rubin DA, Nieminski KE, Monteferrante JC. Ventricular arrhythmias after coronary artery bypass surgery: incidence, risk factors, and long-term prognosis. J Am Coll Cardiol 1985;6:307–10.
- Costeas XF, Schoenfeld MH. Usefulness of electrophysiologic studies for new-onset sustained ventricular tachyarrhythmias shortly after coronary artery bypass grafting. Am J Cardiol 1993;72:1291–4.
- -
- Day CP, Mc Comb JM, Campbell R. QTd: An indication of arrhythmia risk in patients with long QT intervals. Br Heart J 1990; 53:342-44
- -
- Higham P, Furniss S, Campbell R. QT dispersion and components of the QT interval in ischemia and infarction. Br Heart J 1995; 73:32-36
- Fu GS, Meissner A, Simon R. Repolarization dispersion and sudden cardiac death in patients with impaired left ventricular function. Eur Heart J 1997; 18: 281-89
- Yi G, Crook R, Guo XH, Staunton A, Camm AJ, Malik M. Exercise-induced changes in the QT interval duration and dispersion in patients with sudden cardiac death after myocardial infarction. Int J Cardiol 1996; 63: 271-79.
- Stierle U, Giannitsis E, Sheikhzadeh A, Krüger D, Schmücker G, Mitusch R, et al. Relation between QT dispersion and the extent of myocardial ischemia in patients with three-vessel coronary artery disease. Am J Cardiol 1998; 81: 564-68
- Roukema G, Singh JP, Meijs M, Carvalho C, Hart G. Effect of exercise-induced ischemia on QT interval dispersion. Am Heart J 1998; 135: 88-92
- Naka M, Shiotani I, Koretrune Y, Imai K, Akamatsu Y, Hishida E, et al. Occurrence of sustained increase in QT dispersion following exercise in patients with residual myocardial ischemia after healing of anterior wall myocardial infarction. Am J Cardiol, 1997; 80: 1528-31
- Musha H, Kunishima T, Awaya T, Iwasaki T, Nagashima J, Nakamura T, et al. Influence of exercise on QT dispersion in ischemic heart disease, Jpn Heart J 1997; 38:219-26
- Tarabey R, Sukenik D, Molnar J, Somberg JC. Effect of intracoronary balloon inflation at percutaneous transluminal coronary angioplasty on QT dispersion. Am Heart J 1998;135: 519-22
- Sporton SD, Taggart P, Sutton PM, Walker JM, Hardman SM. Acute ischemia: a dynamic influence on QT dispersion. Lancet 1997; 349: 306-09
- Sá MPBO, Ferraz PE, Escobar RR, Martins WN, Lustosa PC, Nunes Ede O, et al. Off-pump versus on-pump coronary artery bypass surgery: meta-analysis and meta-regression of 13,524 patients from randomized trials. Rev Bras Cir Cardiovasc 2012;27(4):631-41.
- Gerritsen W, Van Boven W, Driessen A, Haas F, Aarts L. Off-pump versus on-pump coronary artery bypass grafting: oxidative stress and renal function. European journal of cardiothoracic surgery 2001; 20(5):923-929.
- -
- Rukosujew A, Klotz S, Reitz C, Gogarten W, Welp H, Scheld HH. Patients and complication with off-pump vs on-pump cardiac surgery? a single surgeon experience. İnteractive Cardiovascular and Thoracic Surgery 2007; 6(6):768-771.
- Wu C, Camacho FT, Culliford AT, Gold JP, Wechsler AS, Higgins RS, et al. A Comparison of Long-Term Mortality for Off-Pump and On-Pump Coronary Artery Bypass Graft Surgery. Circ Cardiovasc Qual Outcomes 2012; 5(1): 76–84.
- Elming H, Holm E, Jun L, Torp-Pedersen C, Køber L, Kircshoff M, et al. The prognostic value of the QT interval and QT interval dispersion in all-cause and cardiac mortality and morbidity in a population of Danish citizens. Eur Heart J 1998;19:1391.
- Padmanabhan S, Silvet H, Amin J, Pai RG. Prognostic value of QT interval and QT dispersion in patients with left ventricular systolic dysfunction: results from a cohort of 2265 patients with an ejection fraction of 40%. Am Heart J 2003;145:132 -8.
- Pye M, Quinn AC, Cobbe SM. QT interval dispersion: a non-invasive marker of susceptibility to arrhythmia in patients with sustained ventricular arrhythmias? Br Heart J 1994;71:511 - 4.
- Yunus A, Gillis AM, Duff HJ, Wyse DG, Mitchell LB. Increased precordial QTc dispersion predicts ventricular fibrillation during acute myocardial infarction. Am J Cardiol 1996;78:706-8.
- Barr CS, Naas A, Freeman M, Lang CC, Struthers AD. QT dispersion and sudden unexpected death in chronic heart failure. Lancet 1994;343:327 -9.
- Trusz-Gluza M, Swiderska E, Wozniak-Skowerska I, Szydlo K. Influence of antiarrhythmic agents on the QT interval dispersion in coronary artery disease. PACE, 1997; 20: 1506.
- Steinberg JS, Gaur A, Sciacca R, Tan E. New-onset sustained ventricular tachycardia after cardiac surgery. Circulation 1999;99:903–8.
- Ascione R, Reeves BC, Santo K, Khan N, Angelini GD. Predictors of new malignant ventricular arrhythmias after coronary surgery: a case-control study.. J Am Coll Cardiol. 2004;43:1630–8.
Year 2015,
Volume: 5 Issue: 4, 187 - 192, 17.12.2015
Abstract
References
- Fitz Gibbon GM, Leach AJ, Keon WJ, Burton JR, Kafka HP. Coronary bypass graft fate. Angiographic study of 1,179 vein grafts early, one year, and five years after operation. J Thorac Cardiovasc Surg 1986;91(5):773-8.
- Angelini GD, Taylor FC, Reeves BC, Ascione R. Early and midterm outcome after off-pump and on-pump surgery in Beating Heart Against Cardioplegic Arrest Studies (BHACAS 1 and 2): a pooled analysis of two randomized controlled trials. Lancet 2002;359(9313):1194-9.
- Bull DA, Neumayer LA, Stringham JC, Meldrum P, Affleck DG, Karwande SV. Coronary artery bypass grafting with cardiopulmonary bypass versus off-pump cardiopulmonary bypass grafting: does eliminating the pump reduce morbidity and cost? Ann Thorac Surg 2001;71(1):170-3.
- Darwazah AK, Abu Sham'a RA, Hussein E, Hawari MH, Ismail H. Myocardial revascularization in patients with low ejection fraction < or =35%: effect of pump technique on early morbidity and mortality. J Card Surg 2006;21(1):22-7.
- Yokoyama T, Baumgartner FJ, Gheissari A, Capouya ER, Panagiotides GP, Declusin RJ. Off-pump versus on-pump coronary bypass in high-risk subgroups. Ann Thorac Surg 2000;70(5):1546-50.
- Kerendi F, Puskas JD, Craver JM, Cooper WA, Jones EL, Lattouf OM, et al. Emergency coronary artery bypass grafting can be performed safely without cardiopulmonary bypass in selected patients. Ann Thorac Surg 2005;79(3):801-6.
- Beckermann J, Van Camp J, Shuling L, Wahl SK, Collins A, Herzog CA. On-pump versus off-pump coronary surgery outcomes in patients requiring dialysis: perspectives from a single center and the United States experience. Journal of thoracic and cardiovascular surgery 2006; 131(6):1261-1266.
- Diegeler A, Hirsch R, Schneider F, Schilling L-O, Falk V, Rauch T, et al.. Neuromonitoring and neurocognitive outcome in off-pump versus conventional coronary bypass operation. The Annals of thoracic surgery 2000; 69(4):1162-1166.
- Bucerius J, Gummert JF, Walther T, Schmitt DV, Doll N, Falk V, et al. On-pump versus off-pump coronary artery bypass grafting: impact on postoperative renal failure requiring renal replacement therapy. The Annals of thoracic surgery 2004; 77(4):1250-1256.
- Puskas J, Williams W, Duke P, Staples J, Glas K, Marshall J, et al. Off-pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury, transfusion requirements, and length of stay: a prospective randomized comparison of two hundred
- unselected patients undergoing off-pump versus conventional coronary artery bypass grafting. The Journal of Thoracic and Cardiovascular Surgery 2003;125(4):797808.
- Mack M, Bachand D, Acuff T, Edgerton J, Prince S, Dewey T, et al. Improved outcomes in coronary artery bypass grafting with beating-heart techniques. The Journal of Thoracic and Cardiovascular Surgery 2002; 124(3):598607.
- Welch PJ, Page RL, Hamdan MH. Management of ventricular arrhythmias. J Am Coll Cardiol 1999;34:621–30.
- -
- O’Rourke RA. Role of myocardial revascularization in sudden cardiac death. Circulation 1992;85 Suppl I:I112–7.
- Rubin DA, Nieminski KE, Monteferrante JC. Ventricular arrhythmias after coronary artery bypass surgery: incidence, risk factors, and long-term prognosis. J Am Coll Cardiol 1985;6:307–10.
- Costeas XF, Schoenfeld MH. Usefulness of electrophysiologic studies for new-onset sustained ventricular tachyarrhythmias shortly after coronary artery bypass grafting. Am J Cardiol 1993;72:1291–4.
- -
- Day CP, Mc Comb JM, Campbell R. QTd: An indication of arrhythmia risk in patients with long QT intervals. Br Heart J 1990; 53:342-44
- -
- Higham P, Furniss S, Campbell R. QT dispersion and components of the QT interval in ischemia and infarction. Br Heart J 1995; 73:32-36
- Fu GS, Meissner A, Simon R. Repolarization dispersion and sudden cardiac death in patients with impaired left ventricular function. Eur Heart J 1997; 18: 281-89
- Yi G, Crook R, Guo XH, Staunton A, Camm AJ, Malik M. Exercise-induced changes in the QT interval duration and dispersion in patients with sudden cardiac death after myocardial infarction. Int J Cardiol 1996; 63: 271-79.
- Stierle U, Giannitsis E, Sheikhzadeh A, Krüger D, Schmücker G, Mitusch R, et al. Relation between QT dispersion and the extent of myocardial ischemia in patients with three-vessel coronary artery disease. Am J Cardiol 1998; 81: 564-68
- Roukema G, Singh JP, Meijs M, Carvalho C, Hart G. Effect of exercise-induced ischemia on QT interval dispersion. Am Heart J 1998; 135: 88-92
- Naka M, Shiotani I, Koretrune Y, Imai K, Akamatsu Y, Hishida E, et al. Occurrence of sustained increase in QT dispersion following exercise in patients with residual myocardial ischemia after healing of anterior wall myocardial infarction. Am J Cardiol, 1997; 80: 1528-31
- Musha H, Kunishima T, Awaya T, Iwasaki T, Nagashima J, Nakamura T, et al. Influence of exercise on QT dispersion in ischemic heart disease, Jpn Heart J 1997; 38:219-26
- Tarabey R, Sukenik D, Molnar J, Somberg JC. Effect of intracoronary balloon inflation at percutaneous transluminal coronary angioplasty on QT dispersion. Am Heart J 1998;135: 519-22
- Sporton SD, Taggart P, Sutton PM, Walker JM, Hardman SM. Acute ischemia: a dynamic influence on QT dispersion. Lancet 1997; 349: 306-09
- Sá MPBO, Ferraz PE, Escobar RR, Martins WN, Lustosa PC, Nunes Ede O, et al. Off-pump versus on-pump coronary artery bypass surgery: meta-analysis and meta-regression of 13,524 patients from randomized trials. Rev Bras Cir Cardiovasc 2012;27(4):631-41.
- Gerritsen W, Van Boven W, Driessen A, Haas F, Aarts L. Off-pump versus on-pump coronary artery bypass grafting: oxidative stress and renal function. European journal of cardiothoracic surgery 2001; 20(5):923-929.
- -
- Rukosujew A, Klotz S, Reitz C, Gogarten W, Welp H, Scheld HH. Patients and complication with off-pump vs on-pump cardiac surgery? a single surgeon experience. İnteractive Cardiovascular and Thoracic Surgery 2007; 6(6):768-771.
- Wu C, Camacho FT, Culliford AT, Gold JP, Wechsler AS, Higgins RS, et al. A Comparison of Long-Term Mortality for Off-Pump and On-Pump Coronary Artery Bypass Graft Surgery. Circ Cardiovasc Qual Outcomes 2012; 5(1): 76–84.
- Elming H, Holm E, Jun L, Torp-Pedersen C, Køber L, Kircshoff M, et al. The prognostic value of the QT interval and QT interval dispersion in all-cause and cardiac mortality and morbidity in a population of Danish citizens. Eur Heart J 1998;19:1391.
- Padmanabhan S, Silvet H, Amin J, Pai RG. Prognostic value of QT interval and QT dispersion in patients with left ventricular systolic dysfunction: results from a cohort of 2265 patients with an ejection fraction of 40%. Am Heart J 2003;145:132 -8.
- Pye M, Quinn AC, Cobbe SM. QT interval dispersion: a non-invasive marker of susceptibility to arrhythmia in patients with sustained ventricular arrhythmias? Br Heart J 1994;71:511 - 4.
- Yunus A, Gillis AM, Duff HJ, Wyse DG, Mitchell LB. Increased precordial QTc dispersion predicts ventricular fibrillation during acute myocardial infarction. Am J Cardiol 1996;78:706-8.
- Barr CS, Naas A, Freeman M, Lang CC, Struthers AD. QT dispersion and sudden unexpected death in chronic heart failure. Lancet 1994;343:327 -9.
- Trusz-Gluza M, Swiderska E, Wozniak-Skowerska I, Szydlo K. Influence of antiarrhythmic agents on the QT interval dispersion in coronary artery disease. PACE, 1997; 20: 1506.
- Steinberg JS, Gaur A, Sciacca R, Tan E. New-onset sustained ventricular tachycardia after cardiac surgery. Circulation 1999;99:903–8.
- Ascione R, Reeves BC, Santo K, Khan N, Angelini GD. Predictors of new malignant ventricular arrhythmias after coronary surgery: a case-control study.. J Am Coll Cardiol. 2004;43:1630–8.
There are 42 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | December 17, 2015 |
| Submission Date | December 17, 2015 |
| Published in Issue | Year 2015 Volume: 5 Issue: 4 |
The published articles in SMJ are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.