Mitral kapak cerrahisi uygulanan hastalarda kardiyopulmoner bypass süresinin post-operatif renal fonksiyonlar üzerine etkilerinin araştırılması
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Date
2020
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Tekirdağ Namık Kemal Üniversitesi
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info:eu-repo/semantics/openAccess
Abstract
Amaç: Kardiyak cerrahi sonrası gelişen akut böbrek hasarı mortalite ve morbidite oranları ile sonuçlanmaktadır. Çalışmanın amacı kardiyopulmoner bypass süresinin böbrek fonksiyonları üzerine etkisinin araştırılmasıdır. Gereç ve Yöntemler: Enstitüler Kalp ve Damar Cerrahisi Kliniği'nde 2010-2019 yılları arasında median sternotomi ile mitral kapak cerrahisi uygulanan 80 hasta yaş, cinsiyet, ameliyat öncesi ve sonrasındaki serum üre ve kreatinin değerleri, yapılan ameliyat, kardiyopulmoner bypass (KPB) süresi açısından incelendi. İstatistiksel analiz için Bağımsız Örneklem T ve Ki-Kare testleri uygulandı. Bulgular: Çalışma grubundaki 25'i (%31,3) erkek ve 55'i (%68,7) kadın hastanın yaş ortalaması 56.8±10,7 yıl idi. Ameliyat öncesi ortalama serum üre ve kreatinin değerleri 40,6±17,3 ve 0,91±0,25 mg/dl iken ameliyat sonrası dönemde aynı değerlerin ortalaması sırasıyla 45,2±16,9 ve 1,1±0,36 mg/dl olarak saptandı. En sık yapılan mitral kapak cerrahisinin mitral kapak replasmanı (n= 55, %68,8) olduğu görüldü. Ortalama KPB süresi 85,6±17,3 (aralık= 60-137) dakika idi. Ameliyat sonrası böbrek fonksiyonları değerlendirildiğinde tüm hastaların AKIN (Acute Kidney Injury Network) sınıflamasına göre Evre 1 olduğu saptandı. KPB süresinin uzaması ile ameliyat sonrası daha yüksek serum üre ve kreatinin değerlerinin saptanması arasında belirgin bir ilişki saptandı (P< 0,05). Sonuç: KPB süresinin kısaltılması yönündeki çabalar mitral kapak cerrahisi sonrasında gelişebilecek akut böbrek hasarını önlemede faydalı olacaktır.
Aim: Acute renal injury following cardiac surgery results in the increased rates of mortality and morbidity. The aim of this study was to investigate the impact of cardiopulmonary bypass (CPB) duration over the renal functions. Material and Methods: Eighty patients who had undergone mitral valve surgery via median sternotomy at the Heart and Vascular Surgery Clinic of Tekirdag Namık Kemal University between 2010 and 2019 were investigated in terms of age, gender, preoperative and postoperative serum urea and creatinine counts, type of surgery and CPB duration. Independent samples t and Chi-square test were used for statistical analysis. Results: Mean age was 56.8±10.7 years among the study group including 25 (%31.3) males and 55 (%68.7) females. Mean preoperative serum urea and creatinine counts were 40.6±17.3 and 0.91±0.25 mg/dl whereas mean postoperative counts for the same variables were 45.2±16.9 ve 1.1±0.36 mg/dl, respectively. The most frequently applied mitral valve surgery was the mitral valve replacement (n= 55, %68.8). Mean duration of CPB was 85.6±17.3 (range= 60-137) minutes. All the patients were at stage 1 according to postoperative evaluation of renal functions via AKIN (Acute Kidney Injury Network) classification. Prolonged duration of CPB was significantly related to the elevated levels postoperative serum urea and creatinin (P< 0.05) Conclusion: Efforts to shorten the duration of CPB will be beneficial to prevent acute renal injury that may develop following mitral valve surgery.
Aim: Acute renal injury following cardiac surgery results in the increased rates of mortality and morbidity. The aim of this study was to investigate the impact of cardiopulmonary bypass (CPB) duration over the renal functions. Material and Methods: Eighty patients who had undergone mitral valve surgery via median sternotomy at the Heart and Vascular Surgery Clinic of Tekirdag Namık Kemal University between 2010 and 2019 were investigated in terms of age, gender, preoperative and postoperative serum urea and creatinine counts, type of surgery and CPB duration. Independent samples t and Chi-square test were used for statistical analysis. Results: Mean age was 56.8±10.7 years among the study group including 25 (%31.3) males and 55 (%68.7) females. Mean preoperative serum urea and creatinine counts were 40.6±17.3 and 0.91±0.25 mg/dl whereas mean postoperative counts for the same variables were 45.2±16.9 ve 1.1±0.36 mg/dl, respectively. The most frequently applied mitral valve surgery was the mitral valve replacement (n= 55, %68.8). Mean duration of CPB was 85.6±17.3 (range= 60-137) minutes. All the patients were at stage 1 according to postoperative evaluation of renal functions via AKIN (Acute Kidney Injury Network) classification. Prolonged duration of CPB was significantly related to the elevated levels postoperative serum urea and creatinin (P< 0.05) Conclusion: Efforts to shorten the duration of CPB will be beneficial to prevent acute renal injury that may develop following mitral valve surgery.
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Göğüs Kalp ve Damar Cerrahisi, Thoracic and Cardiovascular Surgery, Akut böbrek hasarı, Acute kidney injury, Böbrek fonksiyon testleri, Kidney function tests, Kalp, Heart, Kalp hastalıkları, Heart diseases, Kardiyopulmoner bypass, Cardiopulmonary bypass, Mitral kapak, Mitral valve, Mitral kapak yetmezliği, Mitral valve insufficiency, Mitral kapak cerrahisi, kardiyopulmoner bypass süresi, renal fonksiyon, akut böbrek hasarı, Mitral valve surgery, cardiopulmonary bypass duration, renal function, acute reanal injury
