YENİ KURULAN MERKEZİMİZİN 4 YILLIK AÇIK KALP AMELİYAT SONUÇLARININ DEĞERLENDİRİLMESİ

AMAC:  Ebulfez Elcibey Kalp ve Damar Cerrahisi Merkezi 2012 yilinda kurulmus ve ilk acik kalp ameliyati 17.7.2012 tarihinde basari ile gerceklestirilmistir. Bu makalede,  4 yilda ameliyat edilen hastalarin sonuclarini retrospektif olarak degerlendirerek literatur ile karsilastirmayi planladik. GEREC VE YONTEM:  17 Temmuz 2012 ve 15.07.2016 tarihleri arasinda 1079 hastaya 1092  kalp ameliyati yapilmistir. Hastalarin verileri, pompa formlari, ekokardiyografi bulgulari ve hastanenin bilgi kayit sisteminden toplanmistir. Hastalarin %96’i konvansiyonel olarak kardiyopulmoner baypas teknigiyle, %3’u calisan kalpte  kardiyopulmoner baypas ile kapak ameliyatlari  ve %1’i de  off-pump carpan kalpte  ameliyat edilmistir. BULGULAR:  Hastalarin 726 (%67,3)’i erkek, 353 (%32,7)’u kadin olup yas ortalamasi  61,68 + 12,75 olarak hesaplanmistir. Yapilan 1092 ameliyatin; 1048’i konvansiyonel, 44’u carpan kalpte  yapilmistir. Hastalarin 74 (%7)’u reoperasyon hastasiydi. 59 hastaya bioprotez kullanildi. Hastalarin %61’i 60 yas ve uzerinde, %44’u 65 yas ve uzerinde, %34’u 70 yas ve uzerinde, %19’u 75 yas ve uzerinde ve %8’i 80 yas ve uzerindeydi. Ortalama  EuroSCORE 3,9 + 2,1 olarak hesaplanmistir. Ortalama ejeksiyon fraksiyonu 43,53 + 12,15 (15-70) olarak hesaplanmistir.  770 (%70,5)  hastaya sadece koroner baypas, 121 (%11) hastaya sadece kapak, 115 (%10) hastaya koroner baypasa ilaveten konkomitant prosedur uygulandi. Postoperatif  morbidite olarak en sik atriyal fibrilasyon %11 oraninda gorulmustur. Erken postoperatif mortalite 70 vaka ile %6,5 olarak hesaplanmistir. SONUC:   Kalp cerrahi bolumumuz  yeni kurulan bir merkez olmasina ragmen vakalarini makul bir morbidite ve mortalite ile yapabilecek bir merkez haline gelmistir. Anahtar kelimeler : kardiyak cerrahi islemler, koroner cerrahisi OBJECTIVE: E bulfez Elcibey Cardiovascular Surgery Clinic of Ankara Training and Education Hospital has been established in 2012 and first open heart operation done on 17 July 2012. In this report we have evaluated our operative results of the literature. MATERIAL AND METHODS: Between the dates 17 July 2012 – 15 July 2016, 1092 heart operation to 1079 patients has been done. Data of patients have been recovered from pump forms ,echocardiography reports and hospital records. In 96% of cases conventional cardiopulmonary bypass technique has been apllied. 3% of patients underwent heart valve operation using cardiopulmonary bypass on beating heart. In 1% of patients off-pump beating heart coronary bypass was done. RESULTS: 726 (%67,3) of patiens were male and 353 (%32,7) of them were female. Aveage age was 61,68 + 12,75 . 1048 of the 1092 operation were conventional open heart operation and 44 of them were beating heart. There were 74 (% 7) reoperation. In 59 patients bioprosthetic heart valve has been used. 61% of patiens were above age 60, 44% above age 65, 34% above 70, 19% above 75 and 8% above age 80 years . Median EuroSCORE values have been estimated to be 3,9±2,1. 770 (%70,5) patient had only coronary bypass Most common morbidity was atrial fibrilation with rate of 11%. Early postoperative mortality was 6,5% with 70 patients. CONCLUSION: Our cardiovascular surgery department although newly established has been succesfully accomplished very complicated cardiac and aortic surgical cases with very low and acceptable mortality and morbidity. Key words : Cardiac surgical procedures, coronary surgery.