Cizre State Hospital Department of Cardiovascular Surgery Sirnak Turkey Department of Cardiovascular Surgery, Cizre State Hospital, Sirnak, Turkey.
Department of Cardiovascular Surgery, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Braz J Cardiovasc Surg. 2023 Oct 6;38(6):e20220463. doi: 10.21470/1678-9741-2022-0463.
The aim of this study is to compare the postoperative outcomes and early mortality of peripheral and central cannulation techniques in cardiac reoperations using propensity score matching analysis.
In this retrospective cohort, patients who underwent cardiac reoperations with median resternotomy were analyzed in terms of propensity score matching. Between November 2010 and September 2020, 257 patients underwent cardiac reoperations via central (Group 1) or peripheral (Group 2) cannulation. A 1:1 propensity score matching was performed to balance the influence of potential confounding factors to compare postoperative data and mortality rate.
There were no significant differences when comparing the matched groups regarding early mortality (P=0.51), major cardiac injury (P=0.99), prolonged ventilation (P=0.16), and postoperative stroke (P=0.99). The development of acute renal failure (P=0.02) was statistically less frequent in Group 1.
Performing cardiopulmonary bypass via peripheral cannulation increases acute renal failure in cardiac reoperations. In contrast, peripheral or central cannulation have similar early mortality rate in cardiac reoperations.
引言：本研究旨在通过倾向评分匹配分析比较外周和中心插管技术在心脏再次手术中的术后结果和早期死亡率。
方法：在这项回顾性队列研究中，对接受正中胸骨切开术的心脏再次手术患者进行了倾向评分匹配分析。2010 年 11 月至 2020 年 9 月期间，257 例行心脏再次手术的患者采用中心（组 1）或外周（组 2）插管。进行 1:1 倾向评分匹配以平衡潜在混杂因素的影响，以比较术后数据和死亡率。
结果：在比较两组患者的早期死亡率（P=0.51）、主要心脏损伤（P=0.99）、延长通气（P=0.16）和术后中风（P=0.99）时，无显著差异。组 1 的急性肾衰竭（P=0.02）的发生率明显较低。
结论：在外周插管进行体外循环会增加心脏再次手术中的急性肾衰竭。相比之下，外周或中心插管在心脏再次手术中的早期死亡率相似。
