Omer Dogan
Adana Numune Education and Training Center, Turkey
Posters & Accepted Abstracts: J Diabetes Metab
Bacground: Our aim of this study was to compare the clinical outcomes after coronary artery by-pass grafting (CABG) operations in diabetic and non-diabetic elderly patients using with different surgical approaches. Method: This study was performed between 2009 and 2015. 1300 patients (older than 70 yrs), who treated wit. insuline or oral antidiabetic drugs, were included. In all patients, we used arterial conduits. We compared postoperative outcomes of traditional CABG technique (G1; N=650), and On-Pump Beating Heart (OPBH) (G2). An aortic cross clamp and. side clamp as the main risk factors of peroperative cerebrovascular events was used in G1 patients. In G2, for institution of extracorporeal circulation, we used common femoral artery and. two-staged atrial cannulation for extracorporeal circulation (ECC). Results: 39 patients (26 pts from G1(4%), 13 pts from G2 (2%)) died postoperatively (P=0.022). Postoperative complications have been detected in 166 patients (12.7%) in both groups. 102 patients were from Group1 (15.6%) (P=0.0001). We detected postoperative complications in 64 patients from G2 (9.8%) (P=0.001). Cerebrovascular events (CVE), LCOS, and postoperative renal impairement were more common complication in Group. (P=0001). CVE, renal failure, and LCOS requiring IABP were more common in G1 pts (18.4%) (P=0.001). Complications including stroke, peroperative myocardial infarction, and more than 48 hours mechanical ventilation because of respiratory distress syndrome were more common in G1 patients. Conclusion: On-pump beating heart surgery without the use of aortic cross and side clamp decreased significantly postoperative complications in elderly patients who underwent total arterial CABG. Need for more than 48 hours mechanical ventilation, arrthymia, mediastinitis, cerebrovascular events, and myocardial infarction after surgery were the most occurred complications in these particular group.
Email: ofdogan@hacettepe.edu.tr
