Xiangyang Wu, Jie Zhu, Yong Mao, Xinqiang Guan, Xiaofeng He, Qi Ma, Xiaopeng Zhang, Shixiong Wang, Yongnan Li
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The Seattle Angina Questionnaire (SAQ) was used to assess angina symptoms both preoperatively and 6 months postsurgery.</p><p><strong>Results: </strong>No significant difference in preoperative clinical characteristics was observed between the two groups. The blunt dissection group had shorter unroofed period (14.69 vs. 18.91 mins, <i>P</i>=0.001), less ventilator time (16.26 vs. 24.62 hours, <i>P</i> < 0.001), and a shorter hospital stay (8.74 vs. 12.89 days, <i>P</i> < 0.001). Although both traditional and blunt dissection techniques significantly improved postoperative SAQ scores including physical limitation due to angina, anginal stability, anginal frequency, treatment satisfaction, and quality of life (<i>P</i> < 0.001), no significant difference was observed between the traditional and blunt dissection techniques for SAQ. No cases of left anterior descending (LAD) injury in the blunt dissection group were observed although seven patients in the conventional group had LAD injuries.</p><p><strong>Conclusions: </strong>In our single-center experience of MB unroofing, the blunt dissection technique is a safe, effective technique that significantly reduces surgical and ventilator time and hospital stay. MB patients with severe angina who underwent the blunt dissection for surgical unroofing experienced significant improvements in anginal symptoms and quality of life six months after the surgery.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9668448/pdf/","citationCount":"0","resultStr":"{\"title\":\"Use of Novel Blunt Dissection Technique for Surgical Unroofing in Myocardial Bridging Patients.\",\"authors\":\"Xiangyang Wu, Jie Zhu, Yong Mao, Xinqiang Guan, Xiaofeng He, Qi Ma, Xiaopeng Zhang, Shixiong Wang, Yongnan Li\",\"doi\":\"10.1155/2022/2370802\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Myocardial bridging (MB) is a congenital anomaly involving the myocardial tissue encasement of a segment of the coronary artery. The purpose of the present study was to assess safety and efficacy of two surgical methods used for treating MB patients at our institute.</p><p><strong>Methods: </strong>Off-pump MB unroofing was performed in 45 adult patients between January 2016 and December 2021 by traditional surgical unroofing techniques (conventional group, <i>n</i> = 26) and blunt dissection techniques (blunt dissection group, <i>n</i> = 19). We retrospectively reviewed our patients by examining the baseline clinical characteristics, risk factors, medications, and diagnostic data for coronary artery disease. The Seattle Angina Questionnaire (SAQ) was used to assess angina symptoms both preoperatively and 6 months postsurgery.</p><p><strong>Results: </strong>No significant difference in preoperative clinical characteristics was observed between the two groups. The blunt dissection group had shorter unroofed period (14.69 vs. 18.91 mins, <i>P</i>=0.001), less ventilator time (16.26 vs. 24.62 hours, <i>P</i> < 0.001), and a shorter hospital stay (8.74 vs. 12.89 days, <i>P</i> < 0.001). Although both traditional and blunt dissection techniques significantly improved postoperative SAQ scores including physical limitation due to angina, anginal stability, anginal frequency, treatment satisfaction, and quality of life (<i>P</i> < 0.001), no significant difference was observed between the traditional and blunt dissection techniques for SAQ. No cases of left anterior descending (LAD) injury in the blunt dissection group were observed although seven patients in the conventional group had LAD injuries.</p><p><strong>Conclusions: </strong>In our single-center experience of MB unroofing, the blunt dissection technique is a safe, effective technique that significantly reduces surgical and ventilator time and hospital stay. MB patients with severe angina who underwent the blunt dissection for surgical unroofing experienced significant improvements in anginal symptoms and quality of life six months after the surgery.</p>\",\"PeriodicalId\":9494,\"journal\":{\"name\":\"Cardiology Research and Practice\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2022-11-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9668448/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiology Research and Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2022/2370802\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiology Research and Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2022/2370802","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景:心肌桥(MB)是一种先天性异常,涉及冠状动脉的一段心肌组织包裹。本研究的目的是评估两种手术方法治疗我院MB患者的安全性和有效性。方法:2016年1月至2021年12月,对45例成人患者采用传统手术去顶技术(常规组,n = 26)和钝性夹层技术(钝性夹层组,n = 19)进行非泵式MB去顶手术。我们通过检查冠状动脉疾病的基线临床特征、危险因素、药物和诊断数据对患者进行回顾性分析。采用西雅图心绞痛问卷(SAQ)评估术前和术后6个月的心绞痛症状。结果:两组患者术前临床特征无明显差异。钝性夹层组无顶时间较短(14.69 vs 18.91 min, P=0.001),呼吸机时间较短(16.26 vs 24.62 h, P < 0.001),住院时间较短(8.74 vs 12.89 d, P < 0.001)。尽管传统和钝性夹层技术均显著提高了术后SAQ评分,包括心绞痛引起的身体限制、心绞痛稳定性、心绞痛频率、治疗满意度和生活质量(P < 0.001),但传统和钝性夹层技术在SAQ方面无显著差异。钝性夹层组无左前降(LAD)损伤,常规组有7例左前降损伤。结论:在我们的单中心经验中,钝性剥离技术是一种安全有效的技术,可显着减少手术和呼吸机时间和住院时间。合并严重心绞痛的MB患者在接受钝性剥离手术后6个月心绞痛症状和生活质量显著改善。
Use of Novel Blunt Dissection Technique for Surgical Unroofing in Myocardial Bridging Patients.
Background: Myocardial bridging (MB) is a congenital anomaly involving the myocardial tissue encasement of a segment of the coronary artery. The purpose of the present study was to assess safety and efficacy of two surgical methods used for treating MB patients at our institute.
Methods: Off-pump MB unroofing was performed in 45 adult patients between January 2016 and December 2021 by traditional surgical unroofing techniques (conventional group, n = 26) and blunt dissection techniques (blunt dissection group, n = 19). We retrospectively reviewed our patients by examining the baseline clinical characteristics, risk factors, medications, and diagnostic data for coronary artery disease. The Seattle Angina Questionnaire (SAQ) was used to assess angina symptoms both preoperatively and 6 months postsurgery.
Results: No significant difference in preoperative clinical characteristics was observed between the two groups. The blunt dissection group had shorter unroofed period (14.69 vs. 18.91 mins, P=0.001), less ventilator time (16.26 vs. 24.62 hours, P < 0.001), and a shorter hospital stay (8.74 vs. 12.89 days, P < 0.001). Although both traditional and blunt dissection techniques significantly improved postoperative SAQ scores including physical limitation due to angina, anginal stability, anginal frequency, treatment satisfaction, and quality of life (P < 0.001), no significant difference was observed between the traditional and blunt dissection techniques for SAQ. No cases of left anterior descending (LAD) injury in the blunt dissection group were observed although seven patients in the conventional group had LAD injuries.
Conclusions: In our single-center experience of MB unroofing, the blunt dissection technique is a safe, effective technique that significantly reduces surgical and ventilator time and hospital stay. MB patients with severe angina who underwent the blunt dissection for surgical unroofing experienced significant improvements in anginal symptoms and quality of life six months after the surgery.
期刊介绍:
Cardiology Research and Practice is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies that focus on the diagnosis and treatment of cardiovascular disease. The journal welcomes submissions related to systemic hypertension, arrhythmia, congestive heart failure, valvular heart disease, vascular disease, congenital heart disease, and cardiomyopathy.