[1]马浩 张世成 宋仰午 黄思源 赵栋 凤玮.单纯冠状动脉旁路移植术治疗左心室室壁瘤的回顾性队列研究[J].心血管病学进展,2023,(5):465.[doi:10.16806/j.cnki.issn.1004-3934.2023.05.019]
 MA Hao,ZHANG Shicheng,SONG Yangwu,et al.Surgical Effects of Coronary Artery Bypass Grafting Alone for Patients with Left Ventricular Aneurysm:A Retrospective Cohort Study[J].Advances in Cardiovascular Diseases,2023,(5):465.[doi:10.16806/j.cnki.issn.1004-3934.2023.05.019]
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单纯冠状动脉旁路移植术治疗左心室室壁瘤的回顾性队列研究()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2023年5期
页码:
465
栏目:
论著
出版日期:
2023-05-25

文章信息/Info

Title:
Surgical Effects of Coronary Artery Bypass Grafting Alone for Patients with Left Ventricular Aneurysm:A Retrospective Cohort Study
作者:
马浩 张世成 宋仰午 黄思源 赵栋 凤玮
(中国医学科学院 北京协和医学院 国家心血管病中心 国家心血管疾病临床医学研究中心 阜外医院心外科,北京 100037 )
Author(s):
MA Hao ZHANG Shicheng SONG Yangwu Huang Siyuan ZHAO Dong FENG Wei
(Department of Cardiac Surgery,Fuwai Hospital,National Clinical Research Center for Cardiovascular Disease,National Center of Cardiovascular Diseases,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100037,China)
关键词:
左心室室壁瘤冠状动脉旁路移植术左室射血分数左心室舒张末期内经二尖瓣反流
Keywords:
Left ventricular aneurysmCoronary artery bypass graftingLeft ventricular ejection fractionLeft ventricle end-diastolic dimensionMitral regurgitation
DOI:
10.16806/j.cnki.issn.1004-3934.2023.05.019
摘要:
目的 评估左心室室壁瘤患者单纯行冠状动脉旁路移植术(CABG)治疗的效果,并探讨不良事件的潜在危险因素。方法 回顾性分析2017年7月—2021年3月于中国医学科学院阜外医院单纯行CABG治疗的121例左心室室壁瘤患者的临床资料。研究终点为主要不良心脑血管事件(MACCEs)。Kaplan-Meier分析评估患者免于MACCEs的生存率,亚组分析探讨影响患者预后的危险因素。结果 平均随访时间为(27.1±14.1)个月,术后左心室舒张末期内径和左室射血分数较术前显著改善。手术死亡率和围手术期心肌梗死发生率为1.5%。1年和2年的总体生存率分别为95.5%和91.6%,免于MACCEs的生存率分别为94.6%和92.1%。术前少量及中量的二尖瓣反流(2+或3+级)会增加MACCEs的发生风险(P=0.021)和死亡率(P=0.007),左室射血分数<40%也增加了MACCEs的发生风险(P=0.002)。结论 单纯行CABG治疗左心室室壁瘤是一种可行的方法,术后中期随访结果令人满意。
Abstract:
Objective The aim of this study was to evaluate the outcome of coronary artery bypass grafting(CABG) alone in patients with left ventricular aneurysm(LVA) and to explore the potential risk factors for adverse events. Methods A total of 121 consecutive patients with LVA underwent CABG alone from July 2017 to March 2021 in Fuwai Hospital,Chinese Academy of Medical Sciences. The endpoint was the major adverse cardiovascular and cerebrovascular events(MACCEs). Kaplan-Meier analysis was performed to evaluate MACCEs-free survival rate ,and subgroup analysis was used to explore risk factors affecting patient prognosis. Results The mean follow-up time was (27.1±14.1) months. Both the postoperative left ventricular end-diastolic dimension and left ventricular ejection fraction(LVEF) were improved significantly than those before surgery. Both operative mortality and the incidence of perioperative myocardial infarction were 1.5%. The overall survival at 1 and 2 years was 95.5% and 91.6%, and the MACCE s-free survival was 94.6% and 92.1%,respectively. Mitral regurgitation(MR=2+or3+grade) increased the risk of MACCEs(P=0.021) and mortality(P=0.007),and lower LVEF(<40%) also increased the risk of MACCEs(P=0.002). Conclusion The treatment of CABG alone for LVA is effective,and the mid-term follow-up results after surgery are satisfactory

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更新日期/Last Update: 2023-06-29