Intraoperative Left Mamarian Artery Flow Measurement in Elderly Patients

Abstract

ÖzetAmaç: Batı toplumlarında yaşlı nüfus giderek artmakta olup ,bununla bağlan-tılı olarak koroner bypass cerrahisine refere edilen yaşlı nüfusta artmaktadır.Koroner bypass cerrahisinde bu hasta grubunda LİMA kullanımının daha iyi erken dönem patensi sağlamakta ve hayatta kalımı artırmaktadır.Bu çalışma-da LİMA\\\'nın kan akımı 75 yaş üstü hasta grubunda diğer tüm komponentlerden bağımsız olarak ölçülerek diğer yaş grublarıyla karşılaştırması yapıla-rak bu grublarla anlamlı fark olup olmadığı ortaya çıkarılmaya çalışıldı. Gereç üstü ≥75 yaştır. Lima kan akımını daha detaylı karşılaştırabilmek için hastalar ayrıca alt gruplara da ayrıldı: atletik aktivitelerle uğraşanlar, diyabetikler, non-diyabetikler, ve erkek-kadın gibi. Bulgular:Gruplara ait LİMA kan akımla-rı şu şekilde ölçüldü: Grup I: 83.7 ± 12.4 ml / dk, Grup II: 79.5 ± 13.4 ml / dk ve Grup III: 78.6 ± 10.6 ml / dk (P≤0.76) Tartışma: LIMA kan akım hızı diğer tüm değişkenlerden bağımsız olarak değerlendirildi. LIMA kan akış hızı açısından değerlendirildiğinde, yaşlı hastalar ve diğer hasta grupları arasında istatistiksel olarak anlamlı bir fark yoktu. Anahtar KelimelerKan Akım Hızı; Mammarian Arter; Koroner Arter Bypass; Geriyatrik Hasta Abstract Aim: The elderly are a continuously growing subgroup in Western society. Therefore, increasing numbers of elderly patients are being referred for coronary artery bypass grafting (CABG) surgery. The left internal mammary artery (LIMA) grafting technique performed during CABG surgery has been shown to result in better early patency and improved survival rate. In the present study, the LIMA blood flow was measured independently from other components in a group of patients above 75 years of age. Additionally, we examined if there was significant difference between the LIMA blood flow rate of this and other age groups. Material and Method: Between March 2010 and November 2013, primary CABG was performed in 84 consecutive patients. Patients were divided into three groups as follows: Group I, 60≤ years; Group II, 60-75 years; Group III, ≥75 years. For the comparison of LIMA blood flow rates, the patients were further divided into subgroups as those who were actively engaged in athletic activities, diabetics, non-diabetics, males, and females. Results: The LIMA blood flow rate measured in the three groups had the following values: Group I, 83.7 ± 12.4 mL/min; Group II, 79.5 ± 13.4 mL/min; Group III, 78.6 ± 10.6 mL/min (P≤0.76). Mean blood flow was 84.6 ± 14.8 mL/ min in males, 76.8 ± 9.4 mL/min (P≤0.05) in females, 76.4 ± 12.4 mL/min in diabetics, 86.6 ± 12.8 mL/min (P≤0.05) in non-diabetics, 88.6 ± 14.2 mL/min in patients actively engaged in athletic activities, and 78.3 ± 11.3 mL/min (P≤0.05) in patients who were not engaged in athletic activities. Discussion: There was no statistically significant difference between the LIMA blood flow rates of elderly patients and that of other patient groups. Therefore, arterial grafting could be widely used in elderly patients.

Female Gender is not a Risk Factor for Early Mortality after Coronary Artery Bypass Grafting

“…[26] Their early patency rates are also much superior to venous grafts reducing the incidence of postoperative MI, and its use was found to decrease the 30-day mortality (HR 0.480). [27] In spite of these advantages, LIMA is under-utilized in women compared to men. Saphenous vein can be of poor quality in women leading to early graft occlusion.…”