在缺血性心肌病的手术重血管化过程中提供机械循环支持
Sameer K Singh1, Alice Vinogradsky1, Michael Kirschner1
1Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, New York.
The Annals of thoracic surgery
|February 1, 2024
概括
术后的机械循环支持 (MCS) 可以安全地用于因缺血性心肌病而接受冠状动脉旁路移植 (CABG) 的患者. 虽然手术前的MCS显示可接受的生存率,但手术后的MCS与增加的死亡率有关.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 机械循环支持 机械循环支持
背景情况:
- 缺血性心肌病症对手术复血管化提出了挑战.
- 机械循环支持 (MCS) 越来越多地被认为是高风险的心脏手术患者.
研究的目的:
- 评估外科手术期间机械循环支持 (MCS) 的利用和结果,用于接受冠状动脉旁路移植 (CABG) 的缺血性心肌病患者.
主要方法:
- 追溯分析378名患有射出分数<35%的患者,接受单独的CABG (2015-2021).
- 患者分为没有MCS,手术前MCS或手术后MCS组.
- 主要结局:手术死亡率. 二次结果: 3 年生存率.
主要成果:
- 整体手术死亡率为3.4%,3年生存率为87.0%.
- 术前MCS (n=31) 与没有MCS相比,在手术死亡率 (7.7%与2.9%) 或长期存活率方面没有显著差异.
- 手术后的MCS (n=30) 与手术后 (16.7%) 和晚期死亡率 (63%) 的显著增加有关.
结论:
- 在缺血性心肌病中,选择性外科MCS使用对CABG是安全的.
- 手术前的MCS与可接受的短期和长期生存有关,尽管疾病的严重程度.
- 手术后使用MCS表明患病和死亡风险增加.
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