Yıl: 2015 Cilt: 23 Sayı: 1 Sayfa Aralığı: 26 - 31 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery

Öz:
Amaç: Bu çalışmada kardiyak cerrahide miyokardiyal koruma açısındanintermittant antegrad kardiyopleji ile antegrad/retrograd süreklikardiyopleji karşılaştırıldı.Ça­lış­ma­pla­nı:­ Ekim 2010 - Ocak 2011 tarihleri arasında kliniğimizdekardiyak cerrahi ameliyatı uygulanan 106 hasta çalışmaya alındı.Hastalar, intermittant antegrad kardiyopleji uygulananlar (grup1; 18 kadın, 14 erkek) ve antegrad/retrograd sürekli kardiyoplejiuygulananlar (grup 2; 16 kadın, 58 erkek) olmak üzere iki grubaayrıldı ve ameliyat sonrası elde edilen sonuçlar karşılaştırıldı. İşlemsürecinde troponin-I, kreatin kinaz-miyokard bandı (CK-MB) düzeyleri,kardiyopulmoner baypas (KPB) ve kros klemp süreleri, kardiyoplejitoplam miktarları ve potasyum kullanımı değerlendirildi.Bul gu lar: Bulgularımıza göre, ortalama troponin-I ve CK-MBdeğerleri grup 1de grup 2den daha yüksekti. Ancak bu farklılıkistatistiksel olarak anlamlı değildi. Grup 1de troponin-I ve CK-MBdeğerleri kros-klemp ve KPB süresi ile korele iken, grup 2detroponin-I ve CK-MB değerleri kros-klemp ve KPB süresi ile koreledeğildi.So­nuç:­ Troponin-I, CK-MB düzeyleri ile KPB ve kros-klempzamanları arasında anterograd/retrograd sürekli kardiyoplejiuygulanan grupta korelasyon bulunmadı. Buna göre, antegrad/retrograd sürekli kardiyopleji ile efektif miyokardiyal korumasağlandığında, troponin-I ve CK-MB değerleri etkilenmedi vemiyokardiyal koruma daha iyiydi. Anterograd/retrograd süreklikardiyopleji daha iyi miyokardiyal koruma sağlasa da anterogradkardiyopleji sırasında aort basıncı istenen düzeylerde tutulabilmesiiçin monitörize edilmeli ve retrograd kardiyopleji sırasında daretrograd kanül doğru yerde tutulmalıdır.Anah­tar­söz­cük­ler: Kardiyopleji, koroner baypas cerrahi, miyokardiyalyaralanma, miyokardiyal koruma.
Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi Cerrahi

Kardiyak cerrahide miyokardiyal koruma açısından intermittant antegrad kardiyopleji ile antegrad/retrograd sürekli kardiyoplejinin karşılaştırılması

Öz:
Background:­ This study aims to compare intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms ofmyocardial protection in cardiac surgery.Methods: Hundred six patients who underwent cardiac surgery in ourclinic between October 2010 and January 2011 were included in the study.Patients were divided into two groups as patients who received intermittentantegrade cardioplegia (group 1; 18 females, 14 males) and who receivedantegrade/retrograde continuous cardioplegia (group 2; 16 females,58 males), and postoperative results were compared. Troponin-I, creatinekinase-myocardial band (CK-MB) levels, durations of cardiopulmonarybypass (CPB) and cross-clamping, total amounts of cardioplegia, andpotassium utilization during the process were evaluated.Results:­ According to our results, mean troponin-I and CK-MB levelswere higher in group 1 than group 2. However, this difference wasnot statistically significant. While troponin-I and CK-MB values werecorrelated to durations of cross-clamping and CPB in group 1, troponin-Iand CK-MB values were not correlated to durations of cross-clampingand CPB in group 2.Conclusion:­ No correlation was detected between troponin I, CK-MBlevels, and durations of CPB and cross-clamping in the group whichreceived anterograde/retrograde continuous cardioplegia. Therefore,troponin-I and CK-MB levels were not affected and myocardialprotection was better once effective myocardial protection wasobtained by antegrade/retrograde continuous cardioplegia. Althoughantegrade/retrograde continuous cardioplegia provides better myocardialprotection, aortic pressure must be monitored to be kept between desiredlevels during antegrade cardioplegia, and the retrograde cannula must bekept in the appropriate place during retrograde cardioplegia.
Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Alex J, Ansari J, Guerrero R, Yogarathnam J, Cale AR, Griffin SC, et al. Comparison of the immediate post- operative outcome of two different myocardial protection strategies: antegrade-retrograde cold St Thomas blood cardioplegia versus intermittent cross-clamp fibrillation. Interact Cardiovasc Thorac Surg 2003;2:584-8.
  • 2. Cohen G, Borger MA, Weisel RD, Rao V. Intraoperative myocardial protection: current trends and future perspectives. Ann Thorac Surg 1999;68:1995-2001.
  • 3. Tan TE, Ahmed S, Paterson HS. Intermittent tepid blood cardioplegia improves clinical outcome. Asian Cardiovasc Thorac Ann 2003;11:116-21.
  • 4. Ascione R, Suleiman SM, Angelini GD. Retrograde hot-shot cardioplegia in patients with left ventricular hypertrophy undergoing aortic valve replacement. Ann Thorac Surg 2008;85:454-8.
  • 5. Lotto AA, Ascione R, Caputo M, Bryan AJ, Angelini GD, Suleiman MS. Myocardial protection with intermittent cold blood during aortic valve operation:antegrade versus retrograde delivery. Ann Thorac Surg 2003;76:1227-33.
  • 6. Minatoya K, Okabayashi H, Shimada I, Tanabe A, Nishina T, Nandate K, et al. Intermittent antegrade warm blood cardioplegia for CABG: extended interval of cardioplegia. Ann Thorac Surg 2000;69:74-6.
  • 7. Pelletier LC, Carrier M, Leclerc Y, Cartier R, Wesolowska E, Solymoss BC. Intermittent antegrade warm versus cold blood cardioplegia: a prospective, randomized study. Ann Thorac Surg 1994;58:41-8.
  • 8. Landymore RW, Marble AE, Fris J. Effect of intermittent delivery of warm blood cardioplegia on myocardial recovery. Ann Thorac Surg 1994;57:1267-72.
  • 9. Shirai T, Rao V, Weisel RD, Ikonomidis JS, Hayashida N, Ivanov J, et al. Antegrade and retrograde cardioplegia: alternate or simultaneous? J Thorac Cardiovasc Surg 1996;112:787-96.
  • 10. Abah U, Garfjeld Roberts P, Ishaq M, De Silva R. Is cold or warm blood cardioplegia superior for myocardial protection? Interact Cardiovasc Thorac Surg 2012;14:848-55.
  • 11. Yilik L, Ozsoyler I, Yakut N, Emrecan B, Yasa H, Calli AO, et al. Passive infusion: a simple delivery method for retrograde cardioplegia. Tex Heart Inst J 2004;31:392-7.
  • 12. Young JN, Choy IO. Aortic root pressure monitoring during antegrade cardioplegia administration. Ann Thorac Surg 1996;62:1213-4.
  • 13. Manasse E, Barbone A, Gallotti R. How to determine the correct placement of the retrograde cardioplegia catheter. Interact Cardiovasc Thorac Surg 2002;1:28-9.
APA aksun m, Girgin S, AKSUN S, KESTELLİ M, Bozok Ş, YUREKLI I, KUYUCU D, ŞENCAN A, GÜRBÜZ A, karahan n (2015). Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery. , 26 - 31.
Chicago aksun murat,Girgin Senem,AKSUN SALİHA,KESTELLİ Mert,Bozok Şahin,YUREKLI ISMAIL,KUYUCU Derya,ŞENCAN Atilla,GÜRBÜZ ALİ,karahan nagihan Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery. (2015): 26 - 31.
MLA aksun murat,Girgin Senem,AKSUN SALİHA,KESTELLİ Mert,Bozok Şahin,YUREKLI ISMAIL,KUYUCU Derya,ŞENCAN Atilla,GÜRBÜZ ALİ,karahan nagihan Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery. , 2015, ss.26 - 31.
AMA aksun m,Girgin S,AKSUN S,KESTELLİ M,Bozok Ş,YUREKLI I,KUYUCU D,ŞENCAN A,GÜRBÜZ A,karahan n Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery. . 2015; 26 - 31.
Vancouver aksun m,Girgin S,AKSUN S,KESTELLİ M,Bozok Ş,YUREKLI I,KUYUCU D,ŞENCAN A,GÜRBÜZ A,karahan n Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery. . 2015; 26 - 31.
IEEE aksun m,Girgin S,AKSUN S,KESTELLİ M,Bozok Ş,YUREKLI I,KUYUCU D,ŞENCAN A,GÜRBÜZ A,karahan n "Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery." , ss.26 - 31, 2015.
ISNAD aksun, murat vd. "Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery". (2015), 26-31.
APA aksun m, Girgin S, AKSUN S, KESTELLİ M, Bozok Ş, YUREKLI I, KUYUCU D, ŞENCAN A, GÜRBÜZ A, karahan n (2015). Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 23(1), 26 - 31.
Chicago aksun murat,Girgin Senem,AKSUN SALİHA,KESTELLİ Mert,Bozok Şahin,YUREKLI ISMAIL,KUYUCU Derya,ŞENCAN Atilla,GÜRBÜZ ALİ,karahan nagihan Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery. Türk Göğüs Kalp Damar Cerrahisi Dergisi 23, no.1 (2015): 26 - 31.
MLA aksun murat,Girgin Senem,AKSUN SALİHA,KESTELLİ Mert,Bozok Şahin,YUREKLI ISMAIL,KUYUCU Derya,ŞENCAN Atilla,GÜRBÜZ ALİ,karahan nagihan Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery. Türk Göğüs Kalp Damar Cerrahisi Dergisi, vol.23, no.1, 2015, ss.26 - 31.
AMA aksun m,Girgin S,AKSUN S,KESTELLİ M,Bozok Ş,YUREKLI I,KUYUCU D,ŞENCAN A,GÜRBÜZ A,karahan n Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2015; 23(1): 26 - 31.
Vancouver aksun m,Girgin S,AKSUN S,KESTELLİ M,Bozok Ş,YUREKLI I,KUYUCU D,ŞENCAN A,GÜRBÜZ A,karahan n Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2015; 23(1): 26 - 31.
IEEE aksun m,Girgin S,AKSUN S,KESTELLİ M,Bozok Ş,YUREKLI I,KUYUCU D,ŞENCAN A,GÜRBÜZ A,karahan n "Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery." Türk Göğüs Kalp Damar Cerrahisi Dergisi, 23, ss.26 - 31, 2015.
ISNAD aksun, murat vd. "Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery". Türk Göğüs Kalp Damar Cerrahisi Dergisi 23/1 (2015), 26-31.