额外的冠状动脉搭桥术是否会增加需要瓣膜手术患者的住院死亡率?

H. Benyoussef, Said Makani, Mohammed Yassine Benzha, Amal Haoudar, Aziza Kantri, Chafik El Kettani Hamidi, S. Scadi, Amal El Ouradi, M. Sabry, M. Houssa
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引用次数: 1

摘要

背景:本研究的目的是评估额外冠状动脉血运重建术对接受瓣膜手术患者早期结果的影响。患者和方法:对2000年1月至2018年12月的心脏外科数据库进行回顾性分析。共纳入1667例患者,分为两组:A组单纯瓣膜手术(IVS n = 1608)和B组瓣膜手术联合冠状动脉旁路移植术(VS + CABG n = 59)。组间比较人口学、手术资料及术后结果。结果:联合手术患者比单独瓣膜手术患者年龄大(64.9±9.2岁vs 44.4±13.1岁;P = 0.0001),糖尿病患者比例更高(40.7% vs 6.6%;P = 0.0001)。联合手术组的30天死亡率为18.6%,而单独瓣膜手术组为6.2% (p = 0.001)。此外,术后并发症比静脉注射患者更频繁。此外,我们注意到联合手术患者冠状动脉危险因素的患病率很高。结论:合并冠心病和心瓣膜病的手术死亡率和发病率明显高于静脉注射。在医疗管理方面做出更多努力可能会减少不良后果的发生率。
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Does Additional Coronary Artery Bypass Grafting Increase Hospital Mortality of Patients Requiring Valve Surgery?
Background: The aim of this study was to evaluate the impact of additional coronary revascularization on the early results in patients submitted to valve surgery. Patients and Methods: A retrospective review of the cardiac surgical database between January 2000 and December 2018 was performed. A total of 1667 patients were included and divided into two groups: Group A isolated valve surgery (IVS n = 1608) and Group B with valve surgery combined to coronary artery bypass grafting (VS + CABG n = 59). Demographic, operative data and postoperative outcomes were compared between groups. Results: Patients with combined procedure were older than patients who underwent isolated valvular surgery (64.9 ± 9.2 years vs 44.4 ± 13.1 years; p = 0.0001) and there was a higher proportion of diabetics (40.7% vs 6.6%; p = 0.0001). The 30 days mortality rate in the combined procedure group was 18.6% versus 6.2% in isolated valve surgery (p = 0.001). Also post-operative complications were more frequent than for patients who underwent IVS. Additionally we noted a high prevalence of coronary artery risk factors in patients with combined procedures. Conclusion: Surgical mortality and morbidity of coexisting coronary and heart valve disease were substantially higher than IVS. More efforts in medical management may reduce the incidence of adverse outcomes.
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