Title Protoci kroz graftove u koronarnoj kirurgiji Title (english) Graft flows in coronary surgery Author Mateja Majnarić Mentor Igor Rudež (mentor)Committee member Hrvoje Gašparović (predsjednik povjerenstva)Committee member Tomislav Meštrović (član povjerenstva)Committee member Igor Rudež (član povjerenstva)Granter University of Zagreb Defense date and country 2019-07-12, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract CILJ: Svrha ovog retrospektivnog istraživanja bila je usporediti kvalitetu učinjenih anastomoza u ovisnosti o vrsti provedenog zahvata (OPCAB i CABG). Također, utvrditi postoje li razlike u anastomozama prema opskrbnim područjima pojedinih koronarnih arterija i vrsti upotrebljenih premosnica. Postavljen cilj odnosio se na vrijednosti mjerene TTFM metodom, te su se prema njima usporeĎivale dvije prethodno navedene vrste operativnih zahvata. ----- MATERIJALI I METODE: Ovo istraživanje obuhvatilo je 411 pacijenata u CABG skupini, te 177 u OPCAB skupini koji su bili liječeni u KB Dubrava u razdoblju od 2015. do 2019. godine. Pacijenti koji su bili uključeni u istraživanje uzeti su iz postojeće baze podataka (CardioBASE). Za svakog pacijenta prikupljeni su podatci o dobi, spolu, godini u kojoj je proveden zahvat, te im je izračunat preoperativni rizik pomoću EuroSCORE-a. Podatci koji su se uspoređivali bili su mjereni TTFM metodom te su uključivali pulsatilni indeks, postotak dijastoličkog punjenja i srednju vrijednost protoka kroz premosnice. ----- REZULTATI: Rezultati su pokazali kako ne postoji značajna razlika između dva zahvata u odnosu na mjerene parametre (PI, MGF i DF). Ipak, naše istraživanje, uspoređujući obje
metode, pokazalo je značajne razlike u opskrbnom području RCA, gdje je CABG skupina postigla više vrijednosti MGF-a (p = 0.040). Nadalje, PI je bio značajno veći u OPCAB skupini u opskrbnom području PD-a (p = 0.009) i OM-a (p = 0.044). U dodatku, OPCAB skupina imala je veće vrijednosti DF-a, također u opskrbnom području PD-a. U opskrbnom području RI prikazane su više vrijednosti PI-a u CABG skupini (p = 0.038). Ostali rezultati nisu se razlikovali između skupina. ----- ZAKLJUČAK: Uspoređujući dvije uhodane metode koronarne kirurgije ovo istraživanje nije uočilo razlike u vrijednostima parametara mjerenih TTFM metodom. Ipak, zaključujemo da, kako bi se dobili ispravni podatci, usporedba bi se trebala vršiti ne samo podjelom na OPCAB i CABG skupinu, već i prema upotrebljenoj vrsti premosnice, te opskrbnom području na kojem se navedeni graft upotrebljava.
Abstract (english) OBJECTIVE: The aim of this study was to compare the quality of coronary anastomosis in dependence of the type of the operative procedure (CABG and OPCAB) and to compare measured values to different coronary territories, as well as the type of the graft that was used. The goal was to validate the parameters measured by the TTFM method, and in regards to them compare the two aortocoronary procedures. ----- MATERIALS AND METHODS: This research included 411 patients in the CABG group, and 177 patients in the OPCAB group that underwent the procedure in University Hospital Dubrava from year 2015 to 2019. Patients data was extracted from the CardioBASE data base. Information about sex, age, year when the procedure was done, and the preoperative risk that was calculated using EuroSCORE were collected for each patient. The compared data was measured with the TTFM method and included pulsatility index, percentage of diastolic
filling and mean graft flow for each graft that was used. ----- RESULTS: The results showed that there is no significant difference between the two procedures regarding the MGF, DF and PI values. However, a significant difference in the
RCA territory was found, in the OPCAB group the values for MGF were higher (p = 0.040). Furthermore, a higher pulsatility index was measured in the CABG group in the PD territory (p = 0.009) and OM territory (p = 0.044). In addition, the OPCAB group had significantly higher DF values in PD territory (p = 0.027). In the RI territory, the CABG group had higher PI values. (p = 0.038). Other results showed no significant difference between the two methods. ----- CONCLUSION: This study shows no significant difference between the two long-established methods for treating CAD when comparing the values of parameters measured with the TTFM method. However, we conclude that, to get the accurate results, the data comparison should only be done by dividing the two previously mentioned groups by the graft that was used, as well as on which coronary territory the anastomosis was done.
Keywords
premosnica
OPCAB
CABG
TTFM
koronarna kirurgija
Keywords (english)
graft
CABG
OPCAB
TTFM
coronary surgery
Language croatian URN:NBN urn:nbn:hr:105:827954 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2021-03-01 10:00:59
