ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
Routine Preoperative Carotid Doppler Ultrasonography In Patients Undergoing Coronary Artery Bypass Grafting
Dr. İbrahim GÖKŞİN,a Dr. Baki YAĞCI,b Dr. Ahmet BALTALARLI,a Dr. Vefa ÖZCAN,a
Dr. Mustafa SAÇAR,a Dr. Ercan GÜRSES,c Dr. Fahri ADALI,a Dr. Hülya SUNGURTEKİNc
aKalp Damar Cerrahisi AD, bRadyoloji AD, cAnestezi ve Reanimasyon AD, Pamukkale Üniversitesi Tıp Fakültesi, DENİZLİ
Objective: The purpose of this study is to determine carotid artery involvement, predictive parameters for significant carotid artery disease and those patients needed to carotid endarterectomy (CEA) in patients undergoing coronary artery bypass grafting (CABG).
Material and Methods: In our clinic, 88 patients undergoing CABG operation electively during the period between May and December 2002 were included in this study. Mean age was 61.86 ± 9.14 [32min-82max]. All of the patients were screened routinely with carotid Doppler ultrasonography preoperatively. ³ 70% stenosis in carotid artery was accepted as critic carotid artery disease (CCAD). The patients with significant carotid artery disease (SCAD) [³ 50% stenosis] in group-I compared to the patients with non-significant carotid artery disease (NSCAD) [< 50% stenosis] in group-II regarding to age, sex, hipertension (HT), diabetes mellitus (DM), smoking, peripheral arterial disease (PAD), left main coronary artery (LMCA) disease, number of diseased coronary artery (DCA) and number of distal anastomosis (DA). CEA was performed simultaneously with CABG operation. Fisher’s exact test and independent sample t test were used for statistical analysis.
Results: Carotid artery involvement was detected in 81.8% but CCAD in 5.7% of the patients. CEA was performed in 3.4% of the patients, none of this patients had no cardiac or neurologic morbidity and mortality. Mean age of the patients (66 ± 6.4/60.9 ± 9.1, p= 0.091), PAD (40%/12.8%, p= 0.063) and LMCA disease (30%/8.9%, p= 0.062) in group-I were higher than that of the patients in group-II but not statistically significant. There were no significant differences between group-I and II regarding to sex, HT, DM, smoking, DCA. However, diffuse coronary artery disease in group-I (DA= 3.7 ± 0.82/2.89 ± 0.74, p= 0.002) was significantly higher than that of in group II. Early postoperative mortality rate was 2.3% and post-CABG major stroke rate was 1.1%.
Conclusion: In conclusion, we advise to screen routinely with carotid Doppler ultrasonography in patients undergoing CABG operation with diffuse coronary artery disease.Keywords: Coronary artery bypass, carotid artery disease, ultrasonography, DopplerTurkiye Klinikleri J Med Sci 2005, 25:221-226
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