Bar-El Y, Goor D A
Department of Thoracic and Cardiovascular Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel.
J Thorac Cardiovasc Surg. 1992 Aug;104(2):469-74.
In 632 consecutive primary operations for coronary bypass grafting, the effect of instrumentation of the ascending aorta on the prevalence of stroke was evaluated. There were five surgical pathology groups: group A: soft aorta with no palpable disease, 463 patients; group B: distinctly palpable aorta with focal atheromas necessitating minor surgical modifications, 132 patients; group C, unclampable aorta (no plane for crossclamping the aorta without compression of atheromas was present), 16 patients; group D, untouchable aorta, in which the entire ascending aortic wall was involved by atheromatosis (these aortas were not touched), 14 patients; group E, aneurysmal aorta with soft walls, 7 patients. There were four strokes (0.63%), all related to instrumentations of the aorta. There were no cerebrovascular accidents in patients in whom precautions were taken. Of all risk factors studied, age was the only predictive one for major atheromatosis of the aorta (chi 2 test, p less than 0.001). Of the 30 patients in groups C and D, only one was younger than 60 years.
在632例连续的冠状动脉搭桥初次手术中，评估了升主动脉插管对中风发生率的影响。有五个手术病理组：A组：主动脉柔软，无明显病变，463例患者；B组：主动脉明显可触及，有局灶性动脉粥样硬化，需要进行小的手术调整，132例患者；C组：无法夹闭的主动脉（不存在不压迫动脉粥样硬化就能进行主动脉交叉夹闭的层面），16例患者；D组：无法触及的主动脉，整个升主动脉壁均受累于动脉粥样硬化（这些主动脉未被触碰），14例患者；E组：主动脉瘤，壁柔软，7例患者。发生了4例中风（0.63%），均与主动脉插管有关。采取预防措施的患者未发生脑血管意外。在所有研究的危险因素中，年龄是主动脉严重动脉粥样硬化的唯一预测因素（卡方检验，p<0.001）。在C组和D组的30例患者中，只有1例年龄小于60岁。
