心脏状况不佳患者肾旁和肾下主动脉-髂动脉闭塞性疾病的开放性外科修复的围手术期疗效

IF 0.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
S. Balaji, C. Robinson, S. Yalamuru, Sabarish Kumar, Adharshkumar Maruthupandian, Syed Ahmed, M. Bharat Arun, Ruru Ray
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引用次数: 0

摘要

目的:主髂动脉疾病接受开放手术修复的患者最常见的死亡原因是心脏并发症。由于缺乏关于心脏状态受损患者手术结果的文献,本研究旨在研究心脏状态不佳患者开放性手术修复主动脉髂动脉闭塞性疾病的围手术期结果。方法:2017年1月至2020年12月进行回顾性研究。根据计算机断层扫描血管造影结果,心脏储备不足(超声心动图射血分数≤40%)的主髂动脉闭塞性疾病患者被纳入研究。主要终点是围手术期并发症,包括术中血液动力学并发症和术后早期并发症。结果:2017年至2020年,共有44名勃起功能≤40%的主髂动脉闭塞性疾病(AIOD)患者接受了开放性手术修复。其中,25例(57%)患者肾下主动脉髂关节受累,19例(43%)患者肾旁主动脉髂关节累及。在我们对心脏状况不佳的患者进行肾旁和肾下主动脉-髂动脉闭塞性疾病的开放性手术修复的研究中,26名(59%)患者出现术中血液动力学并发症,11名(25%)患者出现早期术后并发症,结论:尽管心脏状态不佳的AIOD患者的手术风险高于心脏状态正常的患者,但对于这些患者,尤其是在有适当术中监测和管理设施的情况下,采用在线搭桥的开放式手术修复是一种合适的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perioperative outcomes of open surgical repair for juxtarenal and infrarenal aortoiliac occlusive disease in patients with poor cardiac status
Purpose: The most common cause of mortality in patients undergoing open surgical repair for aortoiliac disease is from cardiac complications. As there is a paucity of literature about the surgical outcomes in patients with compromised cardiac status, this study was undertaken to study the perioperative outcomes of open surgical repair for aortoiliac occlusive disease in patients with poor cardiac status. Methodology: A retrospective study was carried out from January 2017 to December 2020. Patients with aortoiliac occlusive disease based on computed tomography angiographic findings with poor cardiac reserve (ejection fraction ≤40% on echocardiography) were included in the study. The primary endpoints were perioperative complications which included intraoperative hemodynamic complications and early postoperative complications. Results: During 2017–2020, a total of 44 patients with aortoiliac occlusive disease (AIOD) with erectile function ≤40% underwent open surgical repair. Of these, 25 (57%) patients had infrarenal aortoiliac involvement and 19 (43%) had juxtarenal aortoiliac involvement. In our study of open surgical repair for juxtarenal and infrarenal aortoiliac occlusive disease in patients with poor cardiac status, intraoperative hemodynamic complications were noted in 26 (59%) patients, early postoperative complications were noted in 11 (25%), and mortality rate was 4.5%. Conclusion: Even though AIOD patients with poor cardiac status are at high operative risk than patients with normal cardiac status, open surgical repair with in-line bypass can be considered as a suitable option in these patients, especially where facilities for appropriate intraoperative monitoring and management are available.
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