王进 1肖锋 1杨阳 1李西慧 1宋波 1信维强 1李岩1
作者信息
- 1. 100034 北京 北京大学第一医院心脏外科
- 折叠
摘要
Abstract
Objective To probe into the early effect of surgical treatment in coronary atherosclerotic heart disease (CAD) patients with moderate-to-severe ischemic mitral regurgitation (IMR). Methods A total of 175 CAD patients with moderate-to-severe IMR undergoing coronary artery bypass grafting (CABG) from December 1999 to December 2010 were analyzed retrospectively. Based on the method applied during surgery, 108 patients were assigned to CABG group, undergoing CABG alone, and 67 to CABG+MVP/R group, undergoing CABG plus concomitant mitral valvuloplasty/repair (MVP/R). Differences between groups were compared in age, gender, numbers of the conduits, application of intra-aortic balloon pump (IABP) and ventricular assist device (VAD), perioperative mortality, and other concomitant procedures (I.e. Aortic valve replacement, resection of the heart wall aneurysm, repair of the septal defect repair). Differences within the groups were looked for in terms of left atrial diameter (LA), left ventricular ending diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), mitral regurgitation degree, systolic pulmonary artery pressure (sPAP), and cardiac function (NYHA classification), pre-operatively and post-operatively. Results The differences between the groups showed no statistical significance in terms of age, gender, numbers of conduits, application of IABP and VAD, peri-operative mortality, and concomitant procedures (P>0.05). LA, LVEDD, mitral regurgitation, sPAP, and cardiac function (NYHA classification) after operation were improved obviously in both groups compared with that before operation (P<0.0l). There was no statistical significance in LVEF before and after operation (P>0.05). Conclusions The comprehensive and aggressive surgery did not result in more ideal early effect to CAD patients with moderate-to-severe IMR. Based on the total revascularization, we can choose simpler, safer, and more effective surgical methods.关键词
冠状动脉分流术/二尖瓣闭锁不全/心血管外科手术Key words
coronary artery bypass/mitral valve insufficiency/cardiovascular surgical procedures分类
医药卫生
