GKD Anest Yoð Bak Dern Derg. 2022; 28(4): 373-377 | DOI: 10.14744/GKDAD.2022.81488

Koroner Arter Baypas Cerrahisi Uygulanan Ýleri Yaþ ve Komorbid Bir Hastada Fast Track Anestezi ve Minimal Ekstrakorporeal Dolaþým Sistemlerinin Birlikte Kullanýmý

Selma Fiþ Topaloðlu¹, Melek Eroðlu¹, Ali Kemal Arslan², Engin Ertürk^3
1Saðlýk Bilimleri Üniversitesi, Ahi Evren Göðüs Kalp ve Damar Cerrahisi Eðitim ve Araþtýrma Hastanesi, Anesteziyolojý ve Reanimasyon Anabilim Dalý, Trabzon, Türkiye
²Saðlýk Bilimleri Üniversitesi, Ahi Evren Göðüs Kalp ve Damar Cerrahisi Eðitim ve Araþtýrma Hastanesi, Kalp Damar Cerrahisi Anabilim Dalý, Trabzon, Türkiye
³Karadeniz Teknik Üniversitesi Týp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalý, Trabzon, Türkiye

Koroner arter baypas cerrahisi uygulanacak olan ileri yaþ ve ek sistemik hastalýklarý mevcut olan hastalarda mortalite ve morbidite riski yüksektir. Bu nedenle seçilen anestezi yöntemi ve cerrahi yaklaþým önem kazanmaktadýr. Fast track kardiyak anestezi (FTKA) protokolü ile hastane ve yoðun bakým ünitelerinde kalýþ süresinin kýsalmasý, dolayýsýyla ileri yaþ ve komorbid hastalarda mortalite ve morbidite riskinin azalmasý saðlanmaktadýr. Son yýllarda açýk kalp cerrahisinde konvansiyonel vücut dýþý dolaþým sistemleri modifiye edilerek minimal ekstrakorporeal dolaþým sistemleri (MECC) kullanýmý yaygýnlaþmaya baþladý. MECC ile konvansiyel sistemde görülen sistemik inflamatuvar cevap azaltýlýr. Bu yazýda, 81 yaþýnda komorbiditeleri olan bir hastada baþarý ile uyguladýðýmýz FTKA protokolü ve MECC kullanýmý birlikteliði sunuldu. Hastaya üçlü koroner arter baypas cerrahisi uygulandý ve postoperatif altýncý gününde þifa ile taburcu edildi. Koroner arter baypas cerrahisi uygulanacak olan ileri yaþ ve ek sistemik hastalýklarý mevcut olan hastalarda seçilen anestezi yöntemi (FTKA) ve cerrahi yaklaþým (MECC) ile risklerin azaltýlabildiði ve baþarýlý sonuçlarýn elde edildiði kanaatindeyiz.

Anahtar Kelimeler: Fast track kardiyak anestezi, minimal ekstrakorporeal dolaþým sistemleri, koroner arter cerrahisi

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Combined use of Fast Track Anesthesia and Minimal Extracorporeal Circulatory Systems in an Advanced Age and Comorbid Patient Undergoing Coronary Artery Bypass Surgery

Selma Fiþ Topaloðlu¹, Melek Eroðlu¹, Ali Kemal Arslan², Engin Ertürk^3
1Department of Anesthesiology and Reanimation, University of Health Sciences, Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Türkiye
²Department of Cardiovascular Surgery, University of Health Sciences, Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Türkiye
³Department of Anesthesiology and Reanimation, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye

The risk of mortality and morbidity is high in patients with advanced age and additional systemic diseases who will undergo coronary artery bypass surgery. For this reason, the chosen anesthesia method and surgical approach gain importance. With the “Fast track cardiac anesthesia” (FTKA) protocol, the length of stay in hospitals and intensive care units is shortened, thus reducing the risk of mortality and morbidity in elderly and comorbid patients. In recent years, the use of Minimal Extracorporeal Circulatory Systems (MECC) has become widespread by modifying conventional extracorporeal circulatory systems in open heart surgery. With MECC, the systemic inflammatory response seen in the conventional system is reduced. In this article, we present the combination of FTCA protocol and MECC use, which we successfully applied in an 81-year-old patient with comorbidities. Our patient underwent triple coronary artery bypass surgery and was discharged on the 6th post-operative day with full recovery. We believe that the risks can be reduced and successful results are obtained with the anesthesia method (FTKA) and surgical approach (MECC) chosen in patients with advanced age and additional systemic diseases who will undergo coronary artery bypass surgery.

Keywords: Fast-track cardiac anesthesia, MECC, coronary artery surgery

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