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冠状动脉内膜切除术:术后血管造影结果。

Coronary Endarterectomy: Postoperative Angiographic Results.

机构信息

Department of Cardiology, University Hospital of Tinaztepe, Izmir, Turkey.

Department of Cardiovascular Surgery, University Hospital of Tinaztepe, Izmir, Turkey.

出版信息

J Coll Physicians Surg Pak. 2022 Aug;32(8):969-974. doi: 10.29271/jcpsp.2022.08.969.

DOI:10.29271/jcpsp.2022.08.969
PMID:35932117
Abstract

OBJECTIVE

To compare the postoperative graft patency rates of patients who had undergone coronary endarterectomies (CE) during coronary bypass surgery to those of patients who had not had CE, based on postoperative coronary angiography.

STUDY DESIGN

Comparative descriptive study.

PLACE AND DURATION OF STUDY

Coronary Angiography Unit, Tınaztepe University Faculty of Medicine, Turkey, from November 2010 through June 2021.

METHODOLOGY

Patients who had undergone CE during coronary bypass surgery were included. Postoperative morbidity results and the patency rates of the vessels with and without endarterectomy were evaluated via coronary angiographies that had been performed.

RESULTS

The patency rate in vessels that underwent coronary endarterectomy was determined to be 73.4% according to coronary angiographies performed after an average of 47.7 months. The patency rate in vessels without endarterectomy was 63.7%. The highest patency rate was found in the left anterior descending artery (LAD) in both CE and conventional bypass coronary arteries and the lowest patency rate was found in the diagonal artery (D) in both CE and conventional bypass coronary arteries. In the comparison of vessels with and without CE, the patency rate was found to be 66.6% in patients with CE on the right coronary artery (RCA) and 45.7% in patients without CE on the right coronary artery and the difference was statistically significant (p<0.037).

CONCLUSION

Coronary endarterectomy should be used when it is believed that a simple anastomosis would not provide adequate patency during coronary bypass surgery because the primary goal should be to achieve full revascularization and a long-term patency rate.

KEY WORDS

Coronary angiography, Coronary bypass grafting, Endarterectomy, Patency rate.

摘要

目的

通过术后冠状动脉造影比较行冠状动脉旁路移植术(CABG)时行冠状动脉内膜切除术(CE)患者与未行 CE 患者的术后移植血管通畅率。

研究设计

对比描述性研究。

地点和研究时间

土耳其 Tınaztepe 大学医学院冠状动脉造影室,2010 年 11 月至 2021 年 6 月。

方法

纳入在 CABG 中进行 CE 的患者。通过术后平均 47.7 个月进行的冠状动脉造影评估术后发病率结果和行与未行内膜切除术血管的通畅率。

结果

根据平均 47.7 个月后进行的冠状动脉造影,CE 组血管通畅率为 73.4%。未行内膜切除术的血管通畅率为 63.7%。CE 和常规旁路冠状动脉中左前降支(LAD)的通畅率最高,CE 和常规旁路冠状动脉中对角支(D)的通畅率最低。在比较有和无 CE 的血管时,CE 右冠状动脉(RCA)患者的通畅率为 66.6%,无 CE 右冠状动脉患者的通畅率为 45.7%,差异具有统计学意义(p<0.037)。

结论

在 CABG 中,如果认为单纯吻合术不能提供足够的通畅率,则应使用冠状动脉内膜切除术,因为主要目标应该是实现完全血运重建和长期通畅率。

关键词

冠状动脉造影、冠状动脉旁路移植术、内膜切除术、通畅率。

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