【冠状动脉手术中动脉内膜切除术的结果(作者简介)】。

H D Schulte, W Bircks, F Loogen, J Rivas-Martin, P Spiller
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引用次数: 3

摘要

在432例冠状动脉搭桥手术中,58例(13.4%)患者在60条冠状动脉上进行了动脉内膜切除术。除两个静脉膜片外,所有动脉内膜切除的动脉都被隐静脉移植物绕过。大多数患者行右冠状动脉内膜切除术。47例幸存者中有43例进行了临床对照调查,其中30例在术后平均5.2个月进行了冠状动脉造影。31例动脉内膜切除动脉造影显示有26例(83.9%)动脉通畅,而未切除动脉造影显示通畅率为86.4%。住院死亡率高;58例患者中有11例(19%)死亡。所有术后死亡的患者均有三支血管病变伴弥漫性冠状动脉硬化。只有3例术前没有心肌梗死,7例术前有1 - 4例心肌梗死。相对较高的死亡率意味着未来对冠状动脉手术的适应症进行更严格的修订。但并非所有病例术前冠状动脉造影和脑室造影都能清楚地估计局部动脉状况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Results of endarterectomy in coronary artery surgery (author's transl)].

In a series of 432 aortocoronary bypass procedures endarterectomies were performed in 58 patients (13.4%) on 60 coronary arteries. Except of two vein patch grafts all endarterectomized arteries were bypassed with a saphenous vein graft. The majority of the patients had an endarterectomy of the right coronary artery. Clinical control investigations were performed in 43 out of 47 survivors including 30 with coronary angiograms 5.2 months (mean) after surgery. 26 out of 31 endarterectomized arteries (83.9%) were open angiographically whereas the patency rate to non-endarterectomized arteries of the same patients was 86.4%. The hospital mortality was high; 11 out of 58 patients (19%) deceased. All patients who died postoperatively had a three vessel disease with diffuse coronary sclerosis. Only three had no myodardial infarction prior to surgery, seven had one to four infarctions before surgery. The relatively high mortality intends for the future a more strict revision of the indications for coronary surgical procedures. But not in all cases the preoperative coronary angiograms and ventriculograms allow a clear estimation of the local arterial conditions.

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