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【medical-news】最小体外循环系统VS非体外循环下
The advantages that off-pump (OP)CABG surgery has over full cardiopulmonary bypass in terms of reduced morbidity are well documented, although revascularization with this technique can be difficult in individuals with complex lesions. Initial experience with the minimal extracorporeal circulation system (MECC) indicates that this method might also confer considerable postoperative benefits compared with full cardiopulmonary bypass. Now, Mazzei and colleagues have conducted a prospective trial to directly compare the early and 1-year outcomes of myocardial revascularization performed with the use of either OPCABG or MECC.
In total, 300 patients were randomized on a 1:1 basis to receive coronary surgery with OPCABG or MECC. The mean duration of coronary surgery with MECC was significantly longer than that of surgery with OPCABG (P = 0.027); however, 30-day mortality, duration of stay in intensive care, duration of hospitalization, the complications rate, and the need for allogeneic transfusion were similar in the two groups. The levels and patterns of release of interleukin 6, creatine kinase and S-100 protein—markers of systemic inflammation, myocardial injury and brain injury, respectively—were also similar in the two groups. Mortality at 1 year was 2.7% in the MECC group and 3.4% in the OPCABG group (P = 0.99). Residual perfusion defects on myocardial nuclear scans performed at 1 year were less frequent among patients in the MECC group than among those in the OPCABG group, but the difference was not significant.
The authors conclude that MECC might confer similar postoperative benefits to OPCABG, while facilitating revascularization in individuals with complex lesions.
http://www.nature.com/ncpcardio/journal/v5/n1/full/ncpcardio1050.html [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-07-30 17:33
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