南方医科大学学报2016，Vol.36Issue(3)：327-331,5.DOI:10.3969/j.issn.1673-4254.2016.03.06
不同血运重建方式治疗复杂冠状动脉病变合并左心功能不全的围术期疗效比较
Different approaches to revascularization for complex coronary artery disease and left ventricular dysfunction:analysis of perioperative outcomes
申磊磊 1龚志云 1王嵘 1高长青 1肖苍松 1陈韵岱 2孙志军 2吴扬 1王瑶 1荆晶2
作者信息
- 1. 中国人民解放军总医院心血管外科，北京 100853
- 2. 中国人民解放军总医院心血管内科，北京 100853
- 折叠
摘要
Abstract
Objective To compare the perioperative outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for treatment of complex coronary artery disease and left ventricular dysfunction. Methods The clinical data of 966 patients admitted to our hospital from January 2003 to December 2013 with coronary artery disease and left ventricular dysfunction (ejection fraction ≤50%) were retrospectively reviewed. Among the patients, 386 underwent CABG and 580 received PCI. After matching for EuroSCORE risk factors and preoperative echocardiographic parameters, 135 patients with CABG and 135 with PCI were enrolled in this study. With hospital mortality and perioperative major complications as the endpoints, the early outcomes of the procedures were evaluated. Perioperative echocardiography was performed to evaluate the change of left ventricular geometry and function. Results Compared with CABG group, PCI group had significantly higher incidences of chronic lung disease (8.1%vs 0.7%, P=0.003) and recent myocardial infarction (64.4%vs 31.9%, P=0.000) but significantly lower left-main disease (12.6% vs 23.7%, P=0.018); the other baseline characteristics were comparable between the two groups. Patients with CABG had a greater number of treated target vessels than those with PCI (2.90±0.81 vs 1.67±0.73, P=0.000), and complete revascularization was more common in CABG group (94.8%vs 51.8%, P=0.000). No significant difference was found in perioperative variations of LVEF between the two groups, but patients with CABG had a greater variation in LVEDD than those with PCI. The hospital mortality and other major complications were similar between the two groups. Conclusion Both CABG and PCI are safe and reliable revascularization strategies for complex coronary artery disease and left ventricular dysfunction, but CABG can achieve a higher rate of complete revascularization and better improves the left ventricular function.关键词
血运重建/冠状动脉旁路移植术/经皮冠状动脉介入术/左心功能不全Key words
myocardial revascularization/coronary artery bypass grafting/percutaneous coronary intervention/left ventricular dysfunction引用本文复制引用
申磊磊,龚志云,王嵘,高长青,肖苍松,陈韵岱,孙志军,吴扬,王瑶,荆晶..不同血运重建方式治疗复杂冠状动脉病变合并左心功能不全的围术期疗效比较[J].南方医科大学学报,2016,36(3):327-331,5.
