主动脉瓣置换术并发不同心肌血运重建方法的早期术后结果

K.S. Boyko, B.M. Todurov
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引用次数: 0

摘要

目的:分析手术主动脉瓣置换术(SAVR)术后早期联合血管内或外科心肌血运重建术的效果。材料和方法。在这项回顾性研究中,我们选择了2018年至2022年期间接受SAVR合并心肌血运重建术的成年患者(18岁以上)的病历。结果和讨论。我们选择了95例接受SAVR合并心肌血运重建术的患者(第一组(n = 31)——SAVR联合经皮冠状动脉介入治疗(PCI);第二组(n = 48) - SAVR和CABG的组合)。第一组患者左冠状动脉主干和旋支病变发生率分别减少24.85% (p = 0.011)和23.7% (p = 0.033)。此外,第一组患者术中需要使用两剂以上红细胞团的次数减少了21.4% (p = 0.046)。在术后早期,第一组患者的出血水平低于第二组(180 (150;250) ml vs. 250 (200;305) ml, p = 0.008)。SAVR前行PCI的患者手术时间、体外循环和主动脉交叉夹持时间较短,但术后早期主要并发症在两组间无显著差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early postoperative results after surgical aortic valve replacement concomitant with different methods of myocardial revascularization
The aim – to analyze the results of the early postoperative period of surgical aortic valve replacement (SAVR) combined with endovascular or surgical methods of myocardial revascularization.Materials and methods. For this retrospective study, a selection of medical records of adult patients (over 18 years of age) who underwent SAVR concomitant with myocardial revascularization in the period from 2018 to 2022 was carried out.Results and discussion. We selected 95 patients who were treated with SAVR with concomitant myocardial revascularization (the first group (n = 31) – a combination of SAVR and percutaneous coronary intervention (PCI); the second group (n = 48) – a combination of SAVR and CABG). In patients of the first group, lesions of the main left coronary artery and the circumflex artery were recorded, respectively, by 24.85 % (p = 0.011) and by 23.7 % (p = 0.033) less often. Moreover, the patients of the first group required intraoperative use of more than two doses of blood red cell mass by 21.4 % less often (p = 0.046). In the early postoperative period, a lower level of bleeding was observed in patients of the first group compared to the second group (180 (150; 250) ml vs. 250 (200; 305) ml, p = 0.008).Conclusions. Patients who underwent PCI before SAVR were characterized by a shorter duration of surgery, cardiopulmonary bypass, and aortic cross-clamping, while no significant difference in major early postoperative complications was observed between the study groups.
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