Yücel Murat
Department of Cardiovascular Surgery, Ankara Bilkent City Hospital, Ankara, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Dec 31;32(4 Suppl 2):148. doi: 10.5606/tgkdc.dergisi.2024.mep-48. eCollection 2024 Nov.
This study aimed to discuss preoperative, intraoperative, and postoperative management strategies in patients with ankylosing spondylitis undergoing cardiac surgery.
A retrospective analysis was performed with patients who underwent cardiac surgery between 2009 and 2024. Fourteen patients diagnosed with ankylosing spondylitis and followed by relevant clinics were identified. These patients were compared with 15 randomly selected patients who had similar profiles in terms of age, sex, and type of cardiac surgery. Age, sex, mode of intubation, length of hospital stay, duration of intubation, postoperative pulmonary complications, transfusion requirements, mobilization time, and the incidence of postoperative venous thromboembolism were evaluated.
Of the patients, 78.6% were male, with a mean age of 55±8 years. The postoperative intubation duration was significantly longer in the ankylosing spondylitis group (14±8 h vs. 6±5 h). Due to intubation difficulty, the need for fiberoptic intubation was higher in the ankylosing spondylitis group (16.6% vs. 0%). There were no significant differences between the groups in terms of hospital stay, postoperative exploration rates, transfusion requirements, or venous thromboembolism incidence. No postoperative sternal dehiscence was observed in either group. The need for rehabilitation due to postoperative pulmonary complications was higher in the ankylosing spondylitis group (33.3% vs. 13.3%). Cardiovascular mortality rates were similar in both groups.
The management of cardiac surgery in patients with ankylosing spondylitis requires a multidisciplinary approach. Appropriate perioperative management, including preoperative patient planning as well as intraoperative and postoperative follow-up and care, is essential.
本研究旨在探讨强直性脊柱炎患者行心脏手术的术前、术中和术后管理策略。
对2009年至2024年间接受心脏手术的患者进行回顾性分析。确定了14例诊断为强直性脊柱炎并在相关诊所随访的患者。将这些患者与15例在年龄、性别和心脏手术类型方面具有相似特征的随机选择的患者进行比较。评估年龄、性别、插管方式、住院时间、插管持续时间、术后肺部并发症、输血需求、活动时间和术后静脉血栓栓塞的发生率。
患者中78.6%为男性,平均年龄55±8岁。强直性脊柱炎组术后插管持续时间明显更长(14±8小时对6±5小时)。由于插管困难,强直性脊柱炎组纤维支气管镜插管的需求更高(16.6%对0%)。两组在住院时间、术后探查率、输血需求或静脉血栓栓塞发生率方面无显著差异。两组均未观察到术后胸骨裂开。强直性脊柱炎组因术后肺部并发症需要康复治疗的比例更高(33.3%对13.3%)。两组心血管死亡率相似。
强直性脊柱炎患者心脏手术的管理需要多学科方法。适当的围手术期管理,包括术前患者规划以及术中和术后的随访与护理至关重要。