2GATA Haydarpaşa Eğitim Hastanesi Kalp ve Damar Cerrahisi Servisi, Kadıköy, İstanbul, Türkiye
3Gülhane Askeri Tıp Akademisi, Haydarpaşa Eğitim Hastanesi Kalp Damar Cerrahi Kliniği, Kadıköy/ İstanbul
4Gülhane Askeri Tıp Akademisi, Haydarpaşa Eğitim Hastanesi Kalp Damar Cerrahi Kliniği, Kadıköy/ İstanbul
5Department of Cardiovascular Surgery Adana Numune Education and Research Hospital, Adana, Turkey
6Gülhane Askeri Tıp Akademisi, Haydarpaşa Eğitim Hastanesi Kalp Damar Cerrahi Kliniği, Kadıköy/ İstanbul
Abstract
Objective: The results of single clamp and partial clamp techniques were retrospectively compared in elderly patients (> 70 years) undergoing coronary artery bypass grafting operation (CABG). Methods: A total of 244 elderly patients undergoing CABG between January 1995 and March 2002 in our center were studied. Single-clamp technique was used in 32 cases (Group 1) and partial-clamp technique was used in 212 cases (Group 2). All patients had isolated coronary artery lesions and a primary elective coronary bypass grafting surgery was planned for every case. Preoperative, operative and postoperative variables; age, gender, pre- and post-operative neurological status (stroke, amaurosis fugax, aphasia, hemiplegia, hemiparesis), cerebrovascular diseases, diabetes mellitus, hypertension, number of distal grafts, left ventricular score, durations of aortic cross-clamping and cardiopulmonary bypass (CPB) times, perfusion pressure during CPB, and postoperative cardiac status were recorded. Patients with a history of neurological complications were excluded from the study. Results: Overall, mean age was 71.9 ± 2.18. Patients in Group 1 were significantly older as compared to patients in Group 2 (p < 0.01). Average duration of cross-clamping in Group 1 was significantly longer (p<0.001) compared to Group 2, but there were no differences with regard to the total duration of cardiopulmonary bypass (p = 0.535). No patients had neurological complications in Group 1, however 22 patients in Group 2 had neurological complications (p £ 0.05). Conclusions: Although single-clamp technique was associated with a longer cross-clamp time, the duration of CPB was not increased and the incidence of neurological complications was low.