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多重动脉移植与冠状动脉绕道移植患者的更好的结果有关
Rodolfo V Rocha1, Derrick Y Tam1,2, Reena Karkhanis1,2
1Division of Cardiac Surgery (R.V.R., D.Y.T., R.K., R.N., S.E.F.), University of Toronto, Ontario, Canada.
Circulation
|November 27, 2018
概括
使用三种动脉移植的冠状动脉绕道移植 (CABG) 与两种动脉移植相比没有改善的结果. 然而,多重动脉移植 (MAG) 在患者长期存活和心脏事件方面显著优于单一动脉移植 (SAG).
科学领域:
- 心血管外科
- 胸部手术
- 心脏手术的结果
背景情况:
- 冠状动脉旁路移植 (CABG) 是冠状动脉疾病的常见手术.
- 之前的研究表明,使用两种动脉移植相比, 一种动脉移植可以改善存活率.
- 使用三种动脉移植的益处尚不清楚.
研究的目的:
- 用三种动脉移植与两种动脉移植进行CABG的临床结果进行比较.
- 评估多重动脉移植 (MAG) 与单个动脉移植 (SAG) 的长期有效性.
主要方法:
- 在加拿大安大略省 (2008 - 2016) 隔离的CABG患者的回顾性队列分析.
- 使用倾向分数匹配进行对比 (3对2动脉移植,MAG对2动脉移植). 这是一个很大的问题.
- 主要结局:死亡,心肌梗塞,中风和重复血管化 (主要心脏和脑血管不良事件).
主要成果:
- 对于主要心脏和脑血管事件或死亡情况,在3个与2个动脉移植之间没有显著的8年结果差异.
- 多重动脉移植 (MAG) 与单一动脉移植 (SAG) 相比,与显著更好的8年结局有关,包括减少主要心脏和脑血管不良事件,改善生存率,减少重复血管化.
- 放射性动脉移植在3个动脉移植组中更为频繁.
结论:
- 在CABG中使用三种动脉移植并没有比8年后的两种动脉移植提供额外的临床益处.
- 在CABG患者中,多重动脉移植 (MAG) 与单一动脉移植 (SAG) 相比,具有更好的长期结果.
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