Tommaso C L, Vogel J H, Vogel R A
University of Maryland, School of Medicine, Baltimore.
Cathet Cardiovasc Diagn. 1992 Mar;25(3):169-73. doi: 10.1002/ccd.1810250302.
To assess the outcome of PTCA in circulatory supported patients with left main coronary artery (LMCA) stenosis, the National Registry of Elective Supported Angioplasty data bank was searched. Patients entered in the registry were considered high-risk PTCA and the PTCA was performed using percutaneous cardiopulmonary bypass (PCPB). Criteria for high risk was left ventricular ejection fraction less than or equal to 25% or a target lesion supplying greater than or equal to 50% of functioning myocardium. Of 455 patients entered in the registry, 61 (13.3%) had LMCA stenosis greater than or equal to 60%. There were 42 patients in whom the PTCA target vessel was the LMCA (PTCA-LMCA) and 19 in whom it was vessel(s) other than the LMCA (PTCA-OTHER). The mean age was similar in the 2 groups (65 +/- 10 vs. 68 +/- 9 yrs, p = ns). The left ventricular ejection fraction (LVEF) was higher in PTCA-LMCA than in PTCA-other (38 +/- 16% vs. 27 +/- 16%, p less than 0.05). The number of vessels dilated/patient was higher in PTCA-LMCA than in PTCA-OTHER (2.1 +/- 1.0 vs. 1.1 +/- 0.3, p less than 0.001). There were a total of 10 in-hospital deaths (16%) in patients with LMCA greater than or equal to 60% stenosis. This exceeds the mortality of the patients with less than 60% LMCA stenosis entered in the registry (4.5%, p less than 0.001). There were 6 in-hospital deaths (14%) in PTCA-LMCA and 4 (21%) in PTCA-OTHER (p = ns).(ABSTRACT TRUNCATED AT 250 WORDS)
为评估经皮冠状动脉腔内血管成形术（PTCA）治疗循环支持下左主干冠状动脉（LMCA）狭窄患者的疗效，检索了国家择期支持血管成形术登记数据库。登记入组的患者被视为高危PTCA患者，并采用经皮心肺旁路（PCPB）进行PTCA。高危标准为左心室射血分数小于或等于25%，或目标病变供应大于或等于50%的有功能心肌。在登记入组的455例患者中，61例（13.3%）LMCA狭窄大于或等于60%。其中42例患者PTCA的靶血管为LMCA（PTCA-LMCA组），19例患者PTCA的靶血管为LMCA以外的血管（PTCA-OTHER组）。两组患者的平均年龄相似（65±10岁 vs. 68±9岁，p=无统计学差异）。PTCA-LMCA组的左心室射血分数（LVEF）高于PTCA-OTHER组（38±16% vs. 27±16%，p<0.05）。PTCA-LMCA组患者扩张血管的数量高于PTCA-OTHER组（2.1±1.0 vs. 1.1±0.3，p<0.001）。LMCA狭窄大于或等于60%的患者共有10例住院死亡（16%）。这超过了登记入组的LMCA狭窄小于60%患者的死亡率（4.5%，p<0.001）。PTCA-LMCA组有6例住院死亡（14%），PTCA-OTHER组有4例（21%）（p=无统计学差异）。（摘要截短至250字）
