在当代穿皮冠状动脉干预时代的紧急冠状动脉旁路手术
Niranjan Seshadri1, Patrick L Whitlow, Naveen Acharya
1Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Circulation
|October 31, 2002
概括
穿皮冠状动脉干预 (PCI) 后的紧急冠状动脉旁路手术 (CABG) 正在减少,但仍然具有高风险. 女性的性别和病变的严重程度预测需要,而先前的绕道和支架减少它.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 穿皮冠状动脉干预 (PCI) 已经进步,减少了并发症.
- 在PCI之后的紧急冠状动脉旁路手术 (CABG) 仍然存在重大风险.
- 这项研究研究了10年来PCI后的紧急CABG.
研究的目的:
- 为了确定PCI后紧急CABG的患病率.
- 为了识别紧急 CABG 的迹象,预测因素和并发症.
- 分析10年的紧急CABG趋势.
主要方法:
- 对1992年至2000年期间执行的18593个PCI进行了回顾性审查.
- 对紧急CABG的指示进行分析,包括剖析,穿孔和急性关闭.
- 统计分析以确定预测因素和并发症.
主要成果:
- 在0.61%的PCI中,需要紧急CABG.
- 症状包括广泛的剖析 (54%),穿孔/冲刺 (20%) 和急性关闭 (20%).
- 患病率从1.5%下降到0.14% (P<0.001). 患病率从1.5%下降到0.14% (P<0.001). 患病率从1.5%下降到0.14% (P<0.001). 患病率从1.5%下降到0.14% (P<0.001). 患病率从1.5%下降到0.14% (P<0.001). 预测因素:较高的ACC/AHA分数,女性性别. 保护因素:之前的绕道,支架使用.
结论:
- 在PCI后,对紧急CABG的需求显著下降.
- 女性性别和较高的病变严重程度 (ACC/AHA分数) 是危险因素.
- 尽管下降,紧急CABG仍然与高发病率和死亡率有关.
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