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在大动脉根置换中进行非计划性冠状动脉旁路移植††

Kavya Rajesh¹, Megan Chung¹, Dov Levine¹

¹Division of Cardiothoracic and Vascular Surgery, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA.

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

|June 27, 2025

概括

在大动脉根置换 (ARR) 期间的非计划性冠状动脉旁路移植 (CABG) 与更高的手术死亡率和长期存活率的降低有关. 这些复杂的病例需要仔细考虑手术策略和患者因素.

科学领域:

心血管外科心血管外科
胸部外科手术胸部外科手术
心脏外科手术心脏外科手术

背景情况:

大动脉根置换 (ARR) 是一项复杂的手术,冠状动脉再植入过程中的意外困难可能需要额外的干预措施.
如果冠状动脉再植入具有挑战性,可能需要在手术期间进行冠状动脉旁路移植 (CABG).

研究的目的:

调查 ARR 患者的结局,这些患者需要计划外的 CABG.
为了确定与需要在ARR期间计划外CABG相关的因素.

主要方法:

从2004年到2021年,在两个中心对2416名接受ARR的患者进行了回顾性分析.
排除计划的CABG;同时进行的CABG被定义为未计划的. 用于比较的倾向性得分匹配 (PSM).
90天的里程碑式分析和多变量后勤回归来评估死亡率和相关因素.

主要成果:

由于各种原因,8.4%的患者进行了非计划的CABG,包括冠状动脉按问题和剖析.
非计划性CABG组在PSM后显示出显著更高的住院死亡率,中风,功能衰竭和呼吸功能衰竭率.
与非计划性CABG相关的因素包括女性性别,慢性病,重新手术,剖析,内心炎和同时进行的门置换;门节约根置换具有保护性.

结论:

在ARR期间非计划的CABG与手术后死亡率的增加有关,并且通常在手术复杂的场景中需要进行.
接受ARR和非计划CABG的患者的生存概率显著降低,无论是早期还是长期.

关键词:

大动脉动脉瘤是一个大动脉动脉瘤.大动脉根替代术冠状动脉旁路移植计划外的程序计划外的程序

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