全动脉血运重建术与常规冠状动脉搭桥术术后早期比较分析

N. Rudenko, O.Yu. Pukas
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引用次数: 0

摘要

在冠状动脉多血管病变患者中使用全动脉心肌血运重建有许多优点,即移植物的功能持续时间或通畅性。发达国家和发展中国家实施全动脉心肌血运重建的水平仍然很低。目标。根据我们自己的经验分析,确定全动脉血运重建技术对术后早期并发症发生率的影响。材料和方法。从2016年2月22日到2020年12月24日,乌克兰儿童心脏中心连续有390名患者接受了手术。患者被分为两组:第一组接受全动脉心肌血运重建,第二组接受常规冠状动脉搭桥术(CABG)。纳入标准为:缺血性心脏病、稳定型心绞痛或劳力型心绞痛、多血管性冠状动脉疾病、无瓣膜病变。后果两组的30天死亡率均为零。第二组术后出血的频率更高,达1.6%。第二组的手术伤口并发症(感染)也更常见:第一组为1.2%,第二组为0.69%(p=0.906)。同样,肌酸激酶MB水平等实验室参数几乎相同。结论。全动脉心肌血运重建是一种安全的方法,具有良好的即时效果。全动脉心肌血运重建术的并发症发生率与传统冠状动脉旁路移植术没有差异。为了更广泛地应用全动脉心肌血运重建术,有必要继续对术后远期进行研究。
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Comparative Analysis of Early Postoperative Period in Patients with Total Arterial Revascularization and Conventional Coronary Artery Bypass Grafting
The use of total arterial myocardial revascularization in patients with multivessel lesions of the coronary arteries has a number of advantages, namely the duration of functioning or patency of the grafts. The level of total arterial myocardial revascularization implementation in developed and developing countries remains quite low. The aim. Based on the analysis of our own experience, to determine the influence of the technique of total arterial revascularization on the frequency of complications in the early postoperative period. Materials and methods. From February 22, 2016 to December 24, 2020, 390 consecutive patients were operated at the Ukrainian Children’s Cardiac Center. The patients were divided into two groups: participants of the group I underwent total arterial myocardial revascularization, and those includedin the group II underwent conventional coronary artery bypass grafting (CABG). The inclusion criteria were: ischemic heart disease, stable angina or exertional angina, multivascular coronary artery disease, absence of valvular pathology. Results. There was zero 30-day mortality in both groups. The frequency of postoperative bleeding was higher in group II and amounted to 1.6%. Surgical wound complications (infection) were also more common in the group II: 1.2% versus 0.69% (p=0.906) in the group I. Similarly, laboratory parameters such as the level of creatine kinase-MB were almost identical. Conclusions. Total arterial myocardial revascularization is a safe method with good immediate results. The frequency of complications in total arterial myocardial revascularizationdoes not differ from that in conventional CABG. For a wider application of the total arterial myocardial revascularization,it is necessary to continue toconduct studies of the remote postoperative period.
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42
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