冠状动脉旁路移植单独可以纠正中度缺血性 mitrale 吐吗?
L Aklog1, F Filsoufi, K Q Flores
1Divisions of Cardiac Surgery and Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. laklog@partners.org
Circulation
|September 25, 2001
概括
冠状动脉旁路移植 (CABG) 单独用于中度缺血额头吐 (MR) 往往导致持续的中度或严重的MR.同时进行额头除可能是这些患者的更好的选择.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心血管成像 - 心血管成像
背景情况:
- 正在讨论中度性缺血额头吐 (MR) 的最佳管理.
- 手术的选择包括隔离冠状动脉旁路移植 (CABG) 或CABG与 mitra annuloplasty.
研究的目的:
- 评估单独的CABG对中度缺血性MR的早期影响.
- 为了确定单独的CABG是否足以适度缺血性MR.
主要方法:
- 对136名中度缺血性MR患者进行了回顾性分析,这些患者接受了单独的CABG.
- 在外科手术中使用过食管心声学 (TEE) 和术后 transthoracic心声学 (TTE) 来评估MR的严重程度.
主要成果:
- 30天手术后死亡率为2.9%.
- 在89%的病例中,手术内TEE低估了MR的严重程度.
- 手术后的TTE显示,40%的患者仍然有中度或重度的MR,51%有轻度的MR,9%的MR已经消失.
结论:
- 单独用于中度缺血性MR的隔离CABG通常会留下显著的残留吐.
- 在手术期间的TEE可能会低估MR的严重程度.
- 手术前对中度MR的诊断可能表明需要同时进行额头骨解体术.
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