CARDIAC RISK FACTORS AND THERAPEUTIC APPROACH IN PERIPHERALARTERIAL EMBOLIES

Fourthy nine patients with peripheral emboli were operated at Bursa Yüksek ih t isas Hospital Cardiovascular Sur­ gery Department between January 1994-January 1996. Thirty cases were men (92,2%) with mean age 54, 3 (39-75 years), 19 cases were women (38,8%), with mean age 56, 1 (35 -73 years). Mean surgical time was 13 hours (1-48). 26 cases (53,7%) with right femoral, 1O cases (20,4%) with left femoral, 2 cases (4, 1%) with right brachial and 1 case (2%) with left brachial emboli were operated on.

48 patients (97,8%) were on full recovery, tor 1 patient infrapopliteal amputation was required in 14 th post operative day. 8 cases (16,3%) had a t romboemboli c history . There was chronic atrial fibr illation in 17 cases (34,7%). Ali cases were examined by echocardiography. 8 cases (16,3%) were having a mitral valve disease, 6(12,2%) of these patients underw ent mitral valve replacement. in 12 patients (24,5%) mitr al regurgitat io n of 1-2 degree and or minimal mitral st enosis were determined. in 7 patients (14,3%) aortic valve regurgitiation of 1-2 degree and/or minimal aortic stenoisis were determined . in 4 patients (8,29) without any lesions in the val­ ves, left atrial diameter was greater than 5 cm. in 9 cases (18.4%) coronary angiography was applied and in ((10.2%) of them serious coronary arter disease with poor left ventricular fu n ction was determined. (8.2%) of this cases und erwen t coronary artery bypass gr efting. As seen, tota lly 1O patients (20.4%) underwent open he­ art surgery after embolectomy. 20 patients (40.8%) are stili being followed routinely because of th eir cardiac pathologies.

We believe that early diagnosis and management may reduce both morbidity and mortality in patients su spec­ ted of a cardia c origin of peripheria l emboli.