予期せぬ心房細動を生き延びた患者の冠動脈再血管化は,

R J Myerburg, A Ghahramani, S M Mallon

Circulation

|December 11, 1975

まとめ

冠動脈バイパス手術を受けた以前のアンギナで心室細動から蘇生した患者は,生存率の改善を示しました. この介入は,このような心疾患の全般的な生存率と比較して,よりよい予後を提供している.

科学分野:

心臓病学心臓病学
心臓外科手術について
介入性心臓病学介入性心臓病学

背景:

予期せぬ心房細動 (VF) の生存者は,以前のアングイナ・ペクトリスを患っていた場合,長期的な死亡リスクが大きい.
治療可能な冠動脈疾患を特定することは,これらの高リスク患者の治療結果を改善するために不可欠です.

研究の目的:

予期せぬ心房細動で蘇生した患者の手術による再血管化の有効性を評価する.
心停止後にバイパス手術を受ける冠動脈疾患の患者の長期的な生存率を評価する.

主な方法:

冠動脈血管図と血液動力学的評価は,VFから蘇生した13人の患者に実施されました.
対応可能な冠動脈病変の患者に外科介入が提案され,11例のうち8例が受け入れられた.

主要な成果:

11人の患者は手術で治療可能な冠動脈の損傷があり,8人はバイパス手術を受けた.
手術後の生存期間は8〜32ヶ月 (平均24ヶ月) であったが,非手術によるVF生存者の1年死亡率は約30%であった.
手術前には,左心室末端ダイアストリック圧の上昇と心臓指数/エジェクション分数の低下が観察されました.

結論:

冠動脈疾患の選択されたVF生存者における冠動脈バイパス手術は,長期的な生存率を大幅に改善します.
予期せぬVFから蘇生した患者が,重大な治療可能な冠動脈疾患を患っている場合,手術による再血管化は検討されるべきである.

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