Koroner arter baypas cerrahisinde radiyal arter grefti kullanılan hastalarda ameliyat sonrası dönemde brakiyal ve ulnar arterlerde meydana gelen akım ve çap değişikliklerinin incelenmesi
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Tarih
2015
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info:eu-repo/semantics/openAccess
Özet
Amaç: Radiyal arter grefti koroner baypas cerrahisinde yaygın olarak kullanılan bir seçenektir. Bu hastalarda önkol ve el dolaşımı ulnar arter tarafından sağlanmaktadır. Bu çalışmada, koroner baypas cerrahisi için radiyal arter grefti kullanılan hastalarda brakiyal ve ulnar arterlerde meydana gelen akım ve çap değişikliklerini araştırdık. Yöntemler: Kliniğimizde Eylül 2007 ile Eylül 2008 tarihleri arasında elektif koroner baypas cerrahisi uygulanan 20 hastada radiyal arter grefti kullanıldı. Ameliyat sonrası dönemde, Allen Testi ve Doppler ultrasonografi ile önkol ve el dolaşımı için ulnar arterin yeterli olup olmadığı araştırıldı. Brakiyal ve ulnar arterlerin bazal akım ve çap değerleri ölçüldü. Kontrol Doppler ultrasonografi ölçümleri ameliyat sonrası üçüncü ayda yapıldı. Brakiyal ve ulnar arterlerde meydana gelen akım ve çap değişiklikleri kaydedildi. Bulgular: Ameliyat sonrası ölçümlerde ulnar arter akım ve çap değerlerinde anlamlı artış gözlendi. Brakiyal arterde ise kesit alanı olarak anlamlı artış görülürken, akım değerlerinde rölatif bir azalma gözlendi. Çalışmamızda mortalite ve iskemik komplikasyon görülmedi. Nörolojik komplikasyon olarak 4 hastada geçici parestezi saptandı. Sonuç: Koroner arter baypas cerrahisi için radiyal arter kullanımı ulnar ve brakiyal arterlerde önemli değişikliklere yol açar. Bu akım ve çap değişiklikleri erken dönemde renkli Doppler ultrasonografi ile tespit edilebilir. Bu adaptasyon mekanizmaları radiyal arterin greft olarak güvenle çıkarılabileceğini göstermektedir.
Objective: The radial artery is widely used in coronary by- pass surgery. In these patients, forearm and hand circulation is provided by the ulnar artery. This study aimed to investigate post-operative changes in flow and diameter in brachial and ulnar arteries in patients undergoing coronary bypass surgery in which the radial artery is used as graft. Methods: Between September 2007 and September 2008, 20 patients underwent elective coronary bypass surgery at our clinic. The radial artery was used as graft in all cases. Pre-oper- atively, adequacy of the ulnar artery for forearm circulation was investigated by Allen test and duplex ultrasonography. Basal flow and diameter values of the brachial and ulnar arteries were measured. Control duplex ultrasound measurements were per- formed at three months post-operatively. Flow and diameter changes in the brachial and ulnar arteries were recorded. Results: Significant increase was shown in ulnar artery flow and diameter values in post-operative measurements. A significant increase was observed in brachial artery diameter, accompanied by a relative decrease in flow value. There were no mortality or ischemic complications in our study. Transient paresthesia as a neurological complication was observed in 4 patients. Conclusion: Radial artery use for coronary bypass surgery leads to significant changes in ulnar and brachial arteries. All flow and diameter changes can be detected by color Doppler ultrasonography in the early stages. These adaptation mechanisms show that the radial artery can be safely harvested as graft material.
Objective: The radial artery is widely used in coronary by- pass surgery. In these patients, forearm and hand circulation is provided by the ulnar artery. This study aimed to investigate post-operative changes in flow and diameter in brachial and ulnar arteries in patients undergoing coronary bypass surgery in which the radial artery is used as graft. Methods: Between September 2007 and September 2008, 20 patients underwent elective coronary bypass surgery at our clinic. The radial artery was used as graft in all cases. Pre-oper- atively, adequacy of the ulnar artery for forearm circulation was investigated by Allen test and duplex ultrasonography. Basal flow and diameter values of the brachial and ulnar arteries were measured. Control duplex ultrasound measurements were per- formed at three months post-operatively. Flow and diameter changes in the brachial and ulnar arteries were recorded. Results: Significant increase was shown in ulnar artery flow and diameter values in post-operative measurements. A significant increase was observed in brachial artery diameter, accompanied by a relative decrease in flow value. There were no mortality or ischemic complications in our study. Transient paresthesia as a neurological complication was observed in 4 patients. Conclusion: Radial artery use for coronary bypass surgery leads to significant changes in ulnar and brachial arteries. All flow and diameter changes can be detected by color Doppler ultrasonography in the early stages. These adaptation mechanisms show that the radial artery can be safely harvested as graft material.
Açıklama
Anahtar Kelimeler
Kaynak
Türk Kardiyoloji Derneği Arşivi
WoS Q Değeri
Scopus Q Değeri
Q4
Cilt
43
Sayı
7
