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肥胖对采用主动脉非接触技术的非体外循环冠状动脉旁路移植术患者预后的影响。

Impact of obesity on outcome of patients undergoing off-pump coronary artery bypass grafting using aorta no-touch technique.

作者信息

Prapas Sotirios N, Panagiotopoulos Ioannis A, Salama Ayyad Mohamed A K, Protogeros Demetrios A, Linardakis Ioannis N, Kotsis Vasilios N, Katinioti Anastasia A, Michalopoulos Argyris S

机构信息

Department of Cardiac Surgery, Henry Dunant Hospital, Athens, Greece.

出版信息

Interact Cardiovasc Thorac Surg. 2010 Sep;11(3):234-7. doi: 10.1510/icvts.2010.234443. Epub 2010 Jun 11.

Abstract

We prospectively examined 1359 adult patients undergoing isolated coronary revascularization with the Pi-circuit technique, consisting of beating heart, aorta no-touch, use of composite grafts, and off-pump arterial revascularization. Patients were divided into two groups based on body weight; Group A consisting of 295 (21.7%) obese patients [body mass index (BMI) > or =30 kg/m(2)] and Group B of 1064 (79.3%) non-obese patients (BMI <30 kg/m(2)). Advanced age and emergency surgery favored the non-obese group [63.0+/-10.4 vs. 65.3+/-9.6 years (P<0.0005) and 10.2% vs. 17.1% (P=0.004), with an increase in the number of octogenarians among them (1.7% Group A vs. 5.4% in Group B, P=0.11)]. The use of double internal mammary arteries (90.5% in Group A vs. 86.9% in Group B, P=0.109), the mean number of distal anastomoses (2.8+/-0.9 in Group A vs. 2.7+/-0.9 in Group B, P=0.5) and the number of sequential anastomoses performed (28.1% in Group A vs. 31% in Group B, P=0.3) were similar. No difference in morbidity rates was detected. All cause in-hospital mortality was comparable. Survival was similar in both groups also. Obesity is not a risk factor for morbidity and mortality in this group of patients.

摘要

我们前瞻性地研究了1359例接受Pi-circuit技术进行单纯冠状动脉血运重建的成年患者,该技术包括心脏不停跳、不接触主动脉、使用复合移植物以及非体外循环动脉血运重建。根据体重将患者分为两组;A组由295例(21.7%)肥胖患者[体重指数(BMI)≥30 kg/m²]组成,B组由1064例(79.3%)非肥胖患者(BMI<30 kg/m²)组成。高龄和急诊手术更常见于非肥胖组[63.0±10.4岁对65.3±9.6岁(P<0.0005),10.2%对17.1%(P=0.004),其中八旬老人数量增加(A组1.7%对B组5.4%,P=0.11)]。双侧乳内动脉的使用情况(A组90.5%对B组86.9%,P=0.109)、远端吻合口的平均数量(A组2.8±0.9对B组2.7±0.9,P=0.5)以及序贯吻合的数量(A组28.1%对B组31%,P=0.3)相似。未检测到发病率的差异。所有原因导致的住院死亡率相当。两组的生存率也相似。在这组患者中,肥胖不是发病和死亡的危险因素。

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