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
Department of Cardiac Surgery, Henry Dunant Hospital, Athens, Greece.
Interact Cardiovasc Thorac Surg. 2010 Sep;11(3):234-7. doi: 10.1510/icvts.2010.234443. Epub 2010 Jun 11.
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.
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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