多血管疾病和左心室功能障碍患者接受全动脉血管重建术与传统冠状动脉旁路移植术的短期疗效比较

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiac Surgery Pub Date : 2023-12-13 DOI:10.1155/2023/5557796

Zhi-qin Lin, Zheng Xu, Liang-wan Chen, X. Dai

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引用次数: 0

摘要

背景。多支血管冠状动脉疾病（CAD）和左心室功能障碍（LVD）给 CABG 带来了挑战。我们旨在比较全动脉再通术（TAR）与传统 CABG 在这一高风险人群中的早期疗效。方法。这是一项基于单中心登记的回顾性队列研究，研究对象是2014年1月至2022年12月期间因多血管CAD和LVD而接受孤立CABG的患者。主要结果是院内死亡率。次要结果是早期并发症、3个月时的移植物通畅率、6个月内的再入院率和6个月内的无心绞痛率。结果。本研究共纳入 112 例患者，其中 52 例患者接受了 TAR，60 例患者接受了传统的 CABG。两组患者的基线和手术情况相当。TAR 和传统 CABG 的院内死亡率相似（2 例死亡，3.85% vs 4 例死亡，6.67%，P = 0.810）。TAR的重症监护室（3.5天 vs 5天，p = 0.016）和住院时间（10.5天 vs 12天，p = 0.007）更短。其他术后并发症相似。3 个月时，TAR 的移植物通畅率更高（91.7% vs 83.7%，p = 0.034），6 个月再入院率更低（TAR：2/50，4.0% vs CR：10/56，17.9%，p = 0.024）。两组患者在6个月内摆脱心绞痛的比例相似（TAR：43/50，86.0% vs. CR：42/56，75.0%，p = 0.240）。结论我们的研究结果表明，TAR可为多支血管CAD和LVD患者带来更短的住院时间、更高的早期移植物通畅率和更低的再入院率。然而，还需要进一步的研究，尤其是随访时间更长的大规模随机试验，以充分了解长期临床结果，并证实这些令人鼓舞的早期结果。

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Short-Term Outcomes of Total Arterial Revascularization Compared to Conventional Coronary Artery Bypass Graft in Patients with Multivessel Disease and Left Ventricular Dysfunction

Background. Multivessel coronary artery disease (CAD) and left ventricular dysfunction (LVD) present challenges in CABG. We aimed to compare early outcomes of total arterial revascularization (TAR) versus conventional CABG in this high-risk population. Methods. This was a retrospective cohort study based on a single-center registry of patients who underwent isolated CABG for multivessel CAD and LVD between January 2014 and December 2022. Primary outcome was in-hospital mortality. Secondary outcomes were early complications, graft patency rate at 3 months, readmission rate within 6 months, and freedom from angina rate within 6 months. Results. A total of 112 cases were included in this study; 52 patients for TAR and 60 patients for conventional CABG. Both groups had comparable baselines and operative profiles. In-hospital mortality was similar between TAR and conventional CABG (2 deaths, 3.85% vs 4 deaths, 6.67%, p = 0.810). TAR had shorter ICU (3.5 vs 5 days, p = 0.016) and hospital stay (10.5 vs 12 days, p = 0.007). Other postoperative complications were similar. At 3 months, TAR had superior graft patency (91.7% vs 83.7%, p = 0.034) and lower 6-month readmission (TAR: 2/50, 4.0% vs. CR: 10/56, 17.9%, p = 0.024). Freedom from angina rate within 6 months was similar between the two groups (TAR: 43/50, 86.0% vs. CR: 42/56, 75.0%, p = 0.240). Conclusion. Our findings suggest that TAR may offer benefits in terms of shorter hospital stays, higher early graft patency, and lower readmission rates for patients with multivessel CAD and LVD. However, further research, particularly large-scale, randomized trials with longer follow-up periods, are needed to fully understand the long-term clinical outcomes and confirm these promising early results.

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来源期刊

Journal of Cardiac Surgery 医学-外科

CiteScore

2.90

自引率

12.50%

发文量

976

审稿时长

3-8 weeks

期刊介绍： Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide. With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery. In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.