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U Izhar¹, R C Daly, J A Dearani

¹Division of Cardiovascular Surgery, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.

|November 24, 1999

概括

冠状动脉旁路移植 (CABG) 后的中枢门手术是安全有效的,改善了症状和生存率. 早期干预至关重要,因为左心室功能减少预测死亡率更高.

科学领域:

心血管外科心血管外科
心脏门疾病心脏门疾病
干预心脏病学干预心脏病学

背景情况:

以前经过冠状动脉旁路移植 (CABG) 的患者可能会出现显著的 mitra 门 (MV) 功能障碍.
这种MV功能障碍可能需要进一步的手术干预.

研究的目的:

为了评估米特拉手术的结果,在患者有史以来的CABG.
为了确定死亡率的预测因素,并评估MV修复或更换在这个人群中的安全性和有效性.

主要方法:

在之前的CABG后接受了MV手术的80名患者的回顾性审查.
对患者人口统计,MV疾病病因,手术程序 (MV修复/更换,重复CABG) 和临床结果的分析.
统计分析以确定早期和晚期死亡率的预测因素.

主要成果:

这项研究包括80名患者 (平均年龄为65.5岁),其MV功能障碍源于缺血性,肌肉性,类风湿性或感染性原因.
58%的患者进行了中枢修复,42%的患者进行了更换;48%的患者也进行了重复的CABG.
住院死亡率为8.8%,减少喷射分数 (<50%) 是早期死亡的预测因素. 在1,5,10年生存率分别为83.8%,55.6%和34.4%.

结论:

在先前的CABG之后的中心门手术与可接受的手术风险和症状缓解有关.
左心室功能是医院和长期生存的关键决定因素.
理想情况下,对MV功能障碍的手术应该在显著的左心室功能障碍出现之前进行.

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