KORONER ARTER CERRAHİSİ ÖNCESİNDE ASETİLSALİSİK ASİT KULLANAN HASTALARLA KULLANMAYANLARIN POSTOPERATİF DÖNEMDE MEDİYASTİNAL DRENAJ VE FARKLI DEĞİŞKENLERİNİN KARŞILAŞTIRILMASI
Öz
Bu çalışmanın amacı; koroner arter bypass greftleme operasyonuna kadar günde 100 mg enterik kaplı ASA tablet kullanan hastalarla, kullanmayan hastaların postoperatif dönemde mediyastinal drenaj, kan ve kan ürünleri transfüzyon miktarları ve mortalite gibi postoperatif değişkenlerinin irdelenip anlamlı fark olup olmadığının saptanmasıdır. Kliniğimizde Ocak 2011-Aralık 2011 tarihleri arasında koroner arter bypass greftleme cerrahisi uygulanan 61 koroner arter hastası retrospektif olarak incelendi.Çalışmaya dahil edilen 61 hastanın 49’u %80.3 kardiyopulmoner bypass cihazı kullanılarak, 12’si %19.7 ise atan kalpte ameliyat edilmiştir. Kardiyopulmoner bypass cihazı kullanılarak ve atan kalpte ameliyat edilen her iki farklı grupta da ASA’nın istatistiksel olarak anlamlı bir kanamaya neden olmadığı, ayrıca mediyastinal re-eksplorasyon, inotropik kullanımı, kan transfüzyonları, intraortik balon kullanımı ve mortalite gibi değişkenlerde ASA kullanmayan gruba göre yine istatistiksel olarak anlamlı bir fark bulunmadığını da saptadık. ASA’nın koroner arter bypass greftleme cerrahisi öncesinde kesilmesi gerekmemektedir. Kaldıki 2011 ACCF/AHA kılavuzunda da preoperatif ASA kullanımı klas I olarak gösterilmiş olup çalışmamızda elde olunan bulgularımız kılavuzdaki bilgilerle uyum göstermektedir
Anahtar Kelimeler
Asetil salisilik asit koroner arter bypass greftleme cerrahisi mediyastinal drenaj mortalite
Kaynakça
- 1) Antithrombotic Trialists’ Collaboration. Collaborative meta analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 324:71– 86.
- 2) Levine GN, Ali MN, Schafer AI. Antithrombotic therapy in patients with acute coronary syndromes. Arch Intern Med 2001; 161:937– 48.
- 3) Dacey LJ, Munoz JJ, Johnson ER, et al. Effect of preoperative aspirin use on mortality in coronary artery bypass grafting patients. Ann Thorac Surg 2000; 70:1986–90.
- 4) Mangano DT, Multicenter Study of Perioperative Ischemia Research Group. Aspirin and mortality from coronary bypass surgery. N Engl J Med 2002; 347:1309 –17.
- 5) Ferraris VA, Ferraris SP, Joseph O, Wehner P, Mentzer RM Jr. Aspirin and postoperative bleeding after coronary artery bypass grafting. Ann Surg 2002; 235:820 –7.
- 6) Ferraris VA, Ferraris SP, Moliterno DJ. The Society of Thoracic Surgeons practice guideline series: aspirin and other antiplatelet agents during operative coronary revascularization (executive summary). Ann Thorac Surg. 2005 Apr; 79:1454-61.
- 7) Srinivasan AK, Grayson AD, Pullan DM, Fabri BM, Dihmis WC.Effect of preoperative aspirin use in off-pump coronary artery bypass operations. Ann Thorac Surg 2003; 76:41–5.
- 8) Bybee KA, Powell BD, Valeti U, Rosales AG, Kopecky SL, Mullany C, Wright RS. Preoperative aspirin therapy is associated with improved postoperative outcomes in patients undergoing coronary artery bypass grafting. Circulation 2005; 112 (Suppl.9)1286-92.
- 9) Tuman KJ, McCarthy RJ, O’Connor CJ, McCarthy WE, Ivankovich AD. Aspirin does not increase allogeneic blood transfusion in reoperative coronary artery surgery. Anesth Analg 1996; 83:1178–84.
- 10) Kallis P, Tooze JA, Talbot S, Cowans D, Bevan DH, Treasure T. Pre-operative aspirin decreases platelet aggregation and increases post-operative blood loss—a prospective, randomised, placebo controlled, double-blind clinical trial in 100 patients with chronic stable angina. Eur J Cardiothorac Surg 1994; 8:404–9.
- 11) Sethi GK, Copeland JG, Goldman S, Moritz T, Zadina K, Henderson WG. Implications of preoperative administration of aspirin in patients undergoing coronary artery bypass grafting. Department of Veterans Affairs Cooperative Study on Antiplatelet Therapy. J Am Coll Cardiol 1990; 15: 15–20.
- 12) Hillis LD, Smith PK, Anderson JL, Bittl JA, 2011 ACCF/AHA guideline for coronary artery bypass graft surgery: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg. 2012; 143: 4-34.
COMPARISON OF PATIENTS WITH AND WITHOUT PREOPERATIVE SALICYLATE USE IN TERMS OF POSTOPERATIVE MEDIASTINAL DRAINAGE AND DIFFERENT CHANGES
Öz
The aim of study is to compare preoperative groups with and without 100mg enteric coated ASA in aspects of mediastinal drainage, blood transfusion amounts and mortality rates. We evaluated 61 patients who were operated in our clinic between January 2011-December 2011. Among them, 49 patients 80,3% were operated on cardiopulmonary bypass and 12 patients 19.7% were operated off pump. We found no statistically significant difference in postoperative term on bleeding, revision requirement, inotropic support need, blood transfusion amounts, intraaortic balon pump need and mortality rate. We revealed that it is not obligatory to stop ASA before operation date. In 2011 ACCF/AHA guideline, preoperative ASA usage has class 1 indication and our results are compatible with that
Anahtar Kelimeler
Asetylsalicylic acid coronary artery bypass surgery mediastinal drainage mortality rate
Kaynakça
- 1) Antithrombotic Trialists’ Collaboration. Collaborative meta analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 324:71– 86.
- 2) Levine GN, Ali MN, Schafer AI. Antithrombotic therapy in patients with acute coronary syndromes. Arch Intern Med 2001; 161:937– 48.
- 3) Dacey LJ, Munoz JJ, Johnson ER, et al. Effect of preoperative aspirin use on mortality in coronary artery bypass grafting patients. Ann Thorac Surg 2000; 70:1986–90.
- 4) Mangano DT, Multicenter Study of Perioperative Ischemia Research Group. Aspirin and mortality from coronary bypass surgery. N Engl J Med 2002; 347:1309 –17.
- 5) Ferraris VA, Ferraris SP, Joseph O, Wehner P, Mentzer RM Jr. Aspirin and postoperative bleeding after coronary artery bypass grafting. Ann Surg 2002; 235:820 –7.
- 6) Ferraris VA, Ferraris SP, Moliterno DJ. The Society of Thoracic Surgeons practice guideline series: aspirin and other antiplatelet agents during operative coronary revascularization (executive summary). Ann Thorac Surg. 2005 Apr; 79:1454-61.
- 7) Srinivasan AK, Grayson AD, Pullan DM, Fabri BM, Dihmis WC.Effect of preoperative aspirin use in off-pump coronary artery bypass operations. Ann Thorac Surg 2003; 76:41–5.
- 8) Bybee KA, Powell BD, Valeti U, Rosales AG, Kopecky SL, Mullany C, Wright RS. Preoperative aspirin therapy is associated with improved postoperative outcomes in patients undergoing coronary artery bypass grafting. Circulation 2005; 112 (Suppl.9)1286-92.
- 9) Tuman KJ, McCarthy RJ, O’Connor CJ, McCarthy WE, Ivankovich AD. Aspirin does not increase allogeneic blood transfusion in reoperative coronary artery surgery. Anesth Analg 1996; 83:1178–84.
- 10) Kallis P, Tooze JA, Talbot S, Cowans D, Bevan DH, Treasure T. Pre-operative aspirin decreases platelet aggregation and increases post-operative blood loss—a prospective, randomised, placebo controlled, double-blind clinical trial in 100 patients with chronic stable angina. Eur J Cardiothorac Surg 1994; 8:404–9.
- 11) Sethi GK, Copeland JG, Goldman S, Moritz T, Zadina K, Henderson WG. Implications of preoperative administration of aspirin in patients undergoing coronary artery bypass grafting. Department of Veterans Affairs Cooperative Study on Antiplatelet Therapy. J Am Coll Cardiol 1990; 15: 15–20.
- 12) Hillis LD, Smith PK, Anderson JL, Bittl JA, 2011 ACCF/AHA guideline for coronary artery bypass graft surgery: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg. 2012; 143: 4-34.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Research Article |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Aralık 2013 |
| Yayımlandığı Sayı | Yıl 2013 Cilt: 17 Sayı: 4 |