Brilakis Emmanouil S, Orford James L, Fasseas Panayotis, Wilson Stephanie H, Melby Steven, Lennon Ryan J, Berger Peter B
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Am J Cardiol. 2005 Aug 15;96(4):512-4. doi: 10.1016/j.amjcard.2005.04.011.
We report on the incidence of adverse cardiac events in 350 patients who underwent noncardiac surgery within 2 months of successful balloon angioplasty (BA) at our institution between 1988 and 2001. Three patients died perioperatively (n = 1) or had myocardial infarction (n = 2) (0.9%, 95% confidence interval [CI] 0.2% to 2.5%), which is a lower incidence than that reported for patients undergoing noncardiac surgery after stenting (3.9% to 32%). One patient died, and 2 had a nonfatal myocardial infarction. All 3 (1.6%, 95% CI 0.3% to 4.6%) were among the 188 patients who underwent surgery within 2 weeks of BA. Repeat target vessel revascularization was performed in 10 patients (2.9%, 95% CI 1.4% to 5.2%): in 3 (1.6%, 95% CI 0.3% to 4.6%) of 188 patients who underwent surgery within 2 weeks of BA and in 7 (5.1%, 95% CI 2.1% to 10.2%) of 138 patients who underwent surgery within 3 to 7 weeks of BA. Therefore, in patients in whom percutaneous coronary revascularization is required before noncardiac surgery, BA appears to be safe, especially in patients who need to undergo surgery early after percutaneous coronary intervention.
我们报告了1988年至2001年间在我们机构成功进行球囊血管成形术（BA）后2个月内接受非心脏手术的350例患者发生不良心脏事件的发生率。3例患者围手术期死亡（n = 1）或发生心肌梗死（n = 2）（0.9%，95%置信区间[CI] 0.2%至2.5%），这一发生率低于报道的支架置入术后接受非心脏手术患者的发生率（3.9%至32%）。1例患者死亡，2例发生非致命性心肌梗死。所有3例（1.6%，95%CI 0.3%至4.6%）均在BA后2周内接受手术的188例患者中。10例患者（2.9%，95%CI 1.4%至5.2%）进行了靶血管再次血运重建：在BA后2周内接受手术的188例患者中有3例（1.6%，95%CI 0.3%至4.6%），在BA后3至7周内接受手术的138例患者中有7例（5.1%，95%CI 2.1%至10.2%）。因此，对于在非心脏手术前需要进行经皮冠状动脉血运重建的患者，BA似乎是安全的，尤其是在经皮冠状动脉介入治疗后需要尽早进行手术的患者中。
