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【J Thorac Cardiovasc Surg】冠状动脉架桥移植术后心
Volume 137, Issue 1, January 2009, Pages 60-64
The impact of placing multiple grafts to each myocardial territory on long-term survival after coronary artery bypass grafting
Objective
Incomplete myocardial revascularization decreases survival for patients undergoing coronary artery bypass grafting. The effects of constructing multiple grafts to each major diseased artery territory are unknown. We aimed to determine the impact on long-term survival after coronary artery bypass grafting of placing multiple grafts to each myocardial territory.
Methods
We reviewed data from 1129 consecutive patients who underwent coronary artery bypass grafting at our institution between 1997 and 2007 and compared outcomes between patients who received multiple grafts to each major diseased artery territory (n = 549) with those of patients who received single grafts to each territory (n = 580). We assessed long-term survival with Kaplan–Meier curves generated by log-rank tests, adjusting for confounding factors with Cox proportional hazards regression analysis.
Results
Patients who received multiple grafts to each major diseased artery territory had longer cardiopulmonary bypass and aortic crossclamp times than patients who received single grafts per territory. Patient groups had similar early outcomes, including 30-day mortalities (1.3% vs 1.4%, P > .999) and incidences of major adverse cardiac events (2.9% vs 2.2%, P = .57). Cox regression 10-year survival curves were also similar between groups (adjusted hazard ratio 0.94, 95% confidence interval 0.67–1.34, P = .74).
Conclusion
Patients who received multiple grafts to each major diseased artery territory had early outcomes similar to those who received single grafts per territory. Constructing multiple grafts to each major diseased artery territory increases operative time and does not improve long-term survival. The Journal of Thoracic and Cardiovascular Surgery
Volume 137, Issue 1, January 2009, Pages 60-64
The impact of placing multiple grafts to each myocardial territory on long-term survival after coronary artery bypass grafting
冠状动脉架桥移植术后心肌局部多处移植对长期生存的影响
Objective
Incomplete myocardial revascularization decreases survival for patients undergoing coronary artery bypass grafting. The effects of constructing multiple grafts to each major diseased artery territory are unknown. We aimed to determine the impact on long-term survival after coronary artery bypass grafting of placing multiple grafts to each myocardial territory.
目的：心肌血管不完全重建会降低经历了冠状动脉架桥移植术的病人的存活率。在每一个主要病变的动脉区域构建多个移植物的影响尚未可知。我们试图去确认，每个心肌局部多处移植的冠状动脉架桥移植术对长期生存率的影响。
Methods
We reviewed data from 1129 consecutive patients who underwent coronary artery bypass grafting at our institution between 1997 and 2007 and compared outcomes between patients who received multiple grafts to each major diseased artery territory (n = 549) with those of patients who received single grafts to each territory (n = 580). We assessed long-term survival with Kaplan–Meier curves generated by log-rank tests, adjusting for confounding factors with Cox proportional hazards regression analysis.
方法：我们回顾了从1997年到2007年在我们所接受了冠状动脉架桥移植术的1129名连续病人的数据，对每个主要病变动脉区域接受多个移植物的病人（n=549）和仅接受单个移植物的病人（n=580）的预后进行了比较。我们用长期秩合检验生成的Kaplan-Meier曲线评价了长期生存率，用Cox比例风险回归分析的方法调整了干扰因素。
Results
Patients who received multiple grafts to each major diseased artery territory had longer cardiopulmonary bypass and aortic crossclamp times than patients who received single grafts per territory. Patient groups had similar early outcomes, including 30-day mortalities (1.3% vs 1.4%, P > .999) and incidences of major adverse cardiac events (2.9% vs 2.2%, P = .57). Cox regression 10-year survival curves were also similar between groups (adjusted hazard ratio 0.94, 95% confidence interval 0.67–1.34, P = .74).
结果：每一个主要病变动脉区域接受了多处移植的病人与仅接受单个移植的病人相比，心肺架桥更长，主动脉阻断时间更长。病人间早期预后情况相似，包括30天内的死亡率（1.3%比1.4%，P>0.999）主要不良心脏事件的发生率（2.9%比2.2%，P=0.57）。Cox回归10年的生存曲线在两组间也很相似（调整后的死亡比为0.94，95%可信区间0.67-1.34，P=0.74）。
Conclusion
Patients who received multiple grafts to each major diseased artery territory had early outcomes similar to those who received single grafts per territory. Constructing multiple grafts to each major diseased artery territory increases operative time and does not improve long-term survival.
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作者:admin@医学,生命科学 2011-05-07 05:11
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