Sol ventrikül fonksiyonları bozulmuş, ejeksiyon fraksiyonu %40’ın altında olan, koroner arter by-pass greft operasyonu yapılacak hastalara verilen levosimendan tedavisinin, kardiyoprotektif etkinliğinin postoperatif olarak değerlendirilmesi

ÖZBAYBURT, Merih; Gültekin, Yıldırım; Gemalmaz, Hüseyin

doi:10.32322/jhsm.798470

Cited by 2 publications

(1 citation statement)

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“…In our study, the mean cannulation time was determined as 50±9 minutes. Since an exposure similar to median sternotomy can be obtained, total ECD and CC times are not very different from each other (17). In the study, the mean duration of ECD was 95±11 minutes, and the mean duration of CC was 61±9 minutes.…”

Section: Discussionmentioning

confidence: 67%

Our results of cardiac surgery performed with a right infra axillary mini thoracotomy

Gemalmaz

Gültekin

2021

Journal of Health Sciences and Medicine

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The aim of the study is to share the technique and results of heart surgery performed with right infra-axillary mini thoracotomy. Materyal and Method: Between March 2013 and July 2014, 16 heart operations were performed with right infra-axillary mini thoracotomy incision. Patient data were analyzed retrospectively. These are 6 mitral valve replacement (MVR), 3 aortic valve replacement (AVR), 2 AVR+MVR, 2 atrial septal defect (ASD) repair, 1 myxoma excision. One of them is AVR+tricuspid ring annuloplasty operation and MVR performed due to reoperation. Radiofrequency (RF) ablation was also applied to 1 patient who underwent MVR due to atrial fibrillation. In these operations, thoracotomy was performed through the right anterior infra-axillary line. A parabolic incision of 6-8 cm was made at the 3rd intercostal space (ICA) for aortic valve interventions and at the 4th ICA level for other valve interventions. No special surgical instruments were used in the operations except standard surgical instruments. All cannulation procedures were carried out through the existing thoracotomy incision. Results: No mortality or morbidity was observed as a result of the operations. The mean extracorporeal circulation (ECC) time was 95±11 minutes, and the mean cross clamp (CC) time was 61±9 minutes. There was an average of 380±35 cc drainage. Extubation time was 7±2.3 hours on average. All patients were taken to the service after 1±0.5 day of intensive care treatment. They were discharged from the hospital in an average of 6±1.5 days. Incision site infection was not observed in any patient. No patients were revised due to bleeding. One patient who was ablated for atrial fibrillation (AF) developed postoperative AF again. He was discharged with medical treatment and speed control. Conclusion:In this study, we think that heart surgeries with right infra-axillary mini thoracotomy incision may be a good alternative to standard sternotomy and other minimally invasive methods in heart surgery. With standard surgical instruments and cannulation through a single incision, not only the mitral valve but also the aortic valve, tricuspid valve and other cardiac pathologies can be easily intervened. However, very good results are obtained in patients cosmetically.

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Section: Discussionmentioning

confidence: 67%

Our results of cardiac surgery performed with a right infra axillary mini thoracotomy

Gemalmaz

Gültekin

2021

Journal of Health Sciences and Medicine

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Bi̇r Üni̇versi̇te Hastanesi̇ Kli̇ni̇ği̇nde Yapilan İlk 200 Açik Kalp Ameli̇yati Sonuçlari: Kirikkale Üni̇versi̇tesi̇, Tip Fakültesi̇, Kalp-Damar Cerrahi̇si̇

Gültekin

Bolat

2020

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

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Amaç: Çalışmanın amacı, kliniğimizde yapılan ilk 200 açık kalp ameliyatının sonuçlarını değerlendirmektir. Gereç ve Yöntemler: Yapılan 200 kalp ameliyatı hastane kayıt sistemi taranarak geriye dönük olarak incelendi. Hastaların yaş, cinsiyet, komorbiditeleri, ameliyat tipleri, hastane ve yoğun bakımda yatış süreleri, morbidite ve mortalite oranları değerlendirildi. Bulgular: Hastaların 128'i kadın,72'si erkekti. Yaşları 38-90 yıl arasında olup, ortalama 68±5 yıldı. Komorbit faktörleri olarak, kronik obstrüktif akciğer hastalığı, hipertansiyon, diabetes mellitus, hiperlipidemi, serebro-vasküler hastalık, periferik arter hastalığı ve kronik böbrek yetmezliği ve miyokart enfarktüsü görüldü. Toplam 162 koroner arter bypass grefti (KABG) yapıldı. Bunlardan 24 tanesi çalışan kalpte gerçekleştirildi. Eş zamanlı olarak 5 karotis endarterektomi ve 15 koroner endarterektomi yapıldı. Dört KABG ve mitral kapak replasmanı (MVR), 2 KABG ve aort kapak replasmanı (AVR), 6 AVR, 12 MVR, 4 AVR ve MVR, 3 MVR ve tricuspit anuloplasti yapıldı. İki hastaya aort diseksiyonu nedeniyle asenden aort replasmanı ve 3 hastanın asenden aort anevrizmasına supra koroner aort replasmanı yapıldı. İki hastaya kardiyak yaralanma nedeniyle sağ ventrikül tamiri yapıldı. Düşük kardiyak debi nedeniyle 10 hastaya intra-aortik balon pompası takıldı. Komplikasyon olarak 38 hastada atrial fibrilasyon, 4 hastada akut böbrek yetmezliği, 3 hastada serebrovaskuler olay gelişti. Hastaların 4'ünde postoperatif kanama ve 3'ünde sternal dehisens nedeniyle revizyon yapıldı. Bir hastada mediastinit görüldü. Yoğun bakımda kalış süresi ortalama 2,2±1,7 gün olup, hastanede kalış süresi 7,5±4 gündü. Hastane mortalitesi 8 hastada (%4) görüldü. Sonuç: Kırıkkale Üniversitesi Tıp Fakültesi Araştırma ve Uygulama Hastanesi kalp ve damar cerrahisi kliniği, açık kalp ameliyatlarının literatüre uygun morbidite ve mortalite oranları ile yapıldığı bir merkez olmuştur. Objective:The aim of the study is to evaluate the results of the first 200 open heart surgeries performed in our clinic. Material and Methods: Two hundred heart surgeries performed were analyzed retrospectively by scanning the hospital registry system. Patients' age, gender, comorbidities, types of surgery, hospital stay and intensive care unit stay, morbidity and mortality rates were evaluated. Results: One hundred and twenty-eight of the patients were women and 72 were men. Their age was between 38-90 years and the mean age was 68±5 years. Comorbid factors included, chronic obstructive pulmonary disease, hypertension, diabetes mellitus, hyperlipidemia, cerebro-vascular disease, peripheral artery disease, chronic renal failure, and myocardial infarction. A total of 162 coronary artery bypass graft (CABG) surgeries were performed and 24 of them were off-pump. Five carotid endarterectomies and 15 coronary endarterectomies were performed simultaneously. Four CABG and mitral valve replacement (MVR), 2 CABG surgery and aortic valve replacement (AVR), 6 AVR, 12 MVR, 4 AVR and MVR, 3 MVR and tricuspid annuloplasty were perf...

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Sol ventrikül fonksiyonları bozulmuş, ejeksiyon fraksiyonu %40’ın altında olan, koroner arter by-pass greft operasyonu yapılacak hastalara verilen levosimendan tedavisinin, kardiyoprotektif etkinliğinin postoperatif olarak değerlendirilmesi

Cited by 2 publications

References 20 publications

Our results of cardiac surgery performed with a right infra axillary mini thoracotomy

Our results of cardiac surgery performed with a right infra axillary mini thoracotomy

Bi̇r Üni̇versi̇te Hastanesi̇ Kli̇ni̇ği̇nde Yapilan İlk 200 Açik Kalp Ameli̇yati Sonuçlari: Kirikkale Üni̇versi̇tesi̇, Tip Fakültesi̇, Kalp-Damar Cerrahi̇si̇

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