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计划与紧急冠状动脉绕道移植在选择性大动脉根置换期间:短期和长期结果

Eilon Ram¹, Christopher Lau¹, Alexander Gregg¹

¹Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY 10065, United States.

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

|July 30, 2025

概括

在大动脉根置换 (ARR) 期间的冠状动脉旁路移植 (CABG) 增加了手术死亡率,但没有影响长期存活. 女性和有小大动脉根的患者面临紧急CABG的更高风险.

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) 是一个复杂的程序,通常需要同时进行干预.
在ARR期间,冠状动脉旁路移植 (CABG) 可能是必要的,这会影响患者的治疗结果.
了解CABG对ARR结果的影响对于手术规划和患者管理至关重要.

研究的目的:

评估同期冠状动脉旁路移植 (CABG) 对接受主动脉根置换 (ARR) 患者的结果的影响.
在ARR期间识别与紧急CABG需要相关的风险因素.

主要方法:

对接受选择性大动脉根置换 (ARR) 的患者进行了回顾性队列研究.
患者被分为分层,分为单独的ARR和ARR与同时进行CABG组.
用多变量回归和生存分析来比较结果.

主要成果:

需要CABG的患者年龄较大,患有更多的并发症,其中女性比例较高,以及主动脉根较小的患者.
与单独的ARR相比,接受CABG的患者的手术死亡率明显高 (1.8%与0.2%相比).
紧急CABG与更高的手术死亡率 (11.1%) 和增加的术后并发症有关,包括呼吸和功能障碍.

结论:

同时服用CABG,无论是选择性还是紧急,都会增加ARR患者的手术风险,但不会影响长期生存.
女性性别和较小的大动脉根大小是需要在ARR期间紧急CABG的风险因素.
风险分层和仔细的手术规划对于接受ARR且可能需要CABG的患者至关重要.

关键词:

大动脉节省手术复合门移植复合门移植复合门移植冠状动脉绕道移植冠状动脉绕道移植冠状动脉疾病是一种冠状动脉疾病.植根替代植根替代植根替代

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