Zhao L X, Zhang J, Liu D H, Ma N, Zang S H, Zhang L, Luo H, Zhang X, Sun X K, Qiao C H
Department of Cardiovascular Sugery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhonghua Yi Xue Za Zhi. 2020 May 12;100(18):1385-1389. doi: 10.3760/cma.j.cn112137-20191218-02765.
To evaluate the medium-and long-term outcomes of cardiac assist devices after coronary artery bypass grafting (CABG) in patients with left ventricular dysfunction. From January 2012 to May 2018, a total of 127 patients with low left ventricular ejection fraction (LVEF) value (≤40%) undergoing CABG in the Department of Cardiovascular Surgery of the First Affiliated Hospital of Zhengzhou University were selected. Meanwhile, another 2 454 cases with LVEF55% were also enrolled as controls. Clinical data of intra-aortic balloon pump (IABP) and extracorporeal membrane oxygenation (ECMO) application were compared and analyzed. All patients were followed up at the Outpatient Clinic at different time points (3 and 6 months after surgery, then every year). Compared to the control group, IABP usage (10.2% vs 0.8%), ECMO usage (6.3% vs 0.3%) and the mortality (4.7% vs 0.7%) were higher (all 0.05) in the left ventricular dysfunction group. Additionally, Intensive Care Unit stay [(50±12) h vs (33±10) h] and the hospital stay after surgery [(15±3) d vs (11±4) d] was longer in the left ventricular dysfunction group (all 0.05). In the left ventricular dysfunction group, LVEF at 3, 6 month and 1 year was (48±8)%, (51±9)%, and (55±9)%, respectively, and then maintained stable. Patients with left ventricular dysfunction who received coronary artery bypass grafting had a high rate of cardiac assist devicesuse, however, optimal perioperative management can save the lives of some patients, whose medium-and long-term outcome are good. Therefore, it is worthy of being recommended in clinical practice.
评估冠状动脉旁路移植术（CABG）后心脏辅助装置在左心室功能不全患者中的中长期疗效。选取2012年1月至2018年5月在郑州大学第一附属医院心血管外科行CABG的127例左心室射血分数（LVEF）值较低（≤40%）的患者。同时，另纳入2454例LVEF≥55%的患者作为对照。比较并分析主动脉内球囊反搏（IABP）和体外膜肺氧合（ECMO）应用的临床资料。所有患者在不同时间点（术后3个月和6个月，然后每年）在门诊进行随访。与对照组相比，左心室功能不全组的IABP使用率（10.2% vs 0.8%）、ECMO使用率（6.3% vs 0.3%）和死亡率（4.7% vs 0.7%）更高（均P<0.05）。此外，左心室功能不全组的重症监护病房停留时间[（50±12）h vs（33±10）h]和术后住院时间[（15±3）d vs（11±4）d]更长（均P<0.05）。在左心室功能不全组中，术后3个月、6个月和1年的LVEF分别为（48±8）%、（51±9）%和（55±9）%，然后保持稳定。接受冠状动脉旁路移植术的左心室功能不全患者心脏辅助装置使用率较高，然而，优化围手术期管理可挽救部分患者生命，其中长期疗效良好。因此，值得在临床实践中推荐。
