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Association between cardiopulmonary bypass time and 90-day post-operative mortality in patients undergoing arch replacement with the frozen elephant trunk: a retrospective cohort study.升主动脉替换术中使用全主动脉弓象鼻技术与体外循环时间和术后 90 天死亡率的相关性：一项回顾性队列研究。
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4
Prognostic Impact of Prolonged Cross-Clamp Time in Coronary Artery Bypass Grafting.冠状动脉旁路移植术中长时间阻断时间的预后影响
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Cardiopulmonary bypass time: every minute counts.体外循环时间：分秒必争。
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Incidence and progression of cardiac surgery-associated acute kidney injury and its relationship with bypass and cross clamp time.心脏手术相关急性肾损伤的发生率、进展及其与体外循环和主动脉阻断时间的关系。
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Cross-clamp time is an independent predictor of mortality and morbidity in low- and high-risk cardiac patients.阻断时间是低危和高危心脏患者死亡率和发病率的独立预测因子。
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体外循环时间与主动脉阻断时间对冠状动脉旁路移植术后并发症的预测价值比较。

Difference Between Cardiopulmonary Bypass Time and Aortic Cross-Clamping Time as a Predictor of Complications After Coronary Artery Bypass Grafting.

机构信息

Department of Cardiovascular Surgery, Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, Ceará, Brazil.

Department of Cardiovascular Surgery, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.

出版信息

Braz J Cardiovasc Surg. 2024 Mar 1;39(2):e20230104. doi: 10.21470/1678-9741-2023-0104.

DOI:10.21470/1678-9741-2023-0104
PMID:38426431
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10903005/
Abstract

INTRODUCTION

Along with cardiopulmonary bypass time, aortic cross-clamping time is directly related to the risk of complications after heart surgery. The influence of the time difference between cardiopulmonary bypass and cross-clamping times (TDC-C) remains poorly understood.

OBJECTIVE

To assess the impact of cardiopulmonary bypass time in relation to cross-clamping time on immediate results after coronary artery bypass grafting in the Registro Paulista de Cirurgia Cardiovascular (REPLICCAR) II.

METHODS

Analysis of 3,090 patients included in REPLICCAR II database was performed. The Society of Thoracic Surgeons outcomes were evaluated (mortality, kidney failure, deep wound infection, reoperation, cerebrovascular accident, and prolonged ventilation time). A cutoff point was adopted, from which the increase of this difference would affect each outcome.

RESULTS

After a cutoff point determination, all patients were divided into Group 1 (cardiopulmonary bypass time < 140 min., TDC-C < 30 min.), Group 2 (cardiopulmonary bypass time < 140 min., TDC-C > 30 min.), Group 3 (cardiopulmonary bypass time > 140 min., TDC-C < 30 min.), and Group 4 (cardiopulmonary bypass time > 140 min., TDC-C > 30 min.). After univariate logistic regression, Group 2 showed significant association with reoperation (odds ratio: 1.64, 95% confidence interval: 1.01-2.66), stroke (odds ratio: 3.85, 95% confidence interval: 1.99-7.63), kidney failure (odds ratio: 1.90, 95% confidence interval: 1.32-2.74), and in-hospital mortality (odds ratio: 2.17, 95% confidence interval: 1.30-3.60).

CONCLUSION

TDC-C serves as a predictive factor for complications following coronary artery bypass grafting. We strongly recommend that future studies incorporate this metric to improve the prediction of complications.

摘要

简介

与体外循环时间一样，主动脉阻断时间与心脏手术后并发症的风险直接相关。心肺转流时间与阻断时间差值（TDC-C）的影响仍知之甚少。

目的

评估体外循环时间与冠状动脉旁路移植术（CABG）后即刻结果的关系在圣保罗心血管手术登记处（REPLICCAR）II 中的作用。

方法

对 REPLICCAR II 数据库中的 3090 例患者进行分析。评估胸外科医师协会的结果（死亡率、肾功能衰竭、深部伤口感染、再次手术、脑血管意外和通气时间延长）。采用一个截止点，从这个截止点开始，这种差异的增加将影响每个结果。

结果

确定截止点后，所有患者分为 4 组：1 组（体外循环时间<140 分钟，TDC-C<30 分钟）；2 组（体外循环时间<140 分钟，TDC-C>30 分钟）；3 组（体外循环时间>140 分钟，TDC-C<30 分钟）；4 组（体外循环时间>140 分钟，TDC-C>30 分钟）。单因素逻辑回归后，2 组与再次手术（比值比：1.64，95%置信区间：1.01-2.66）、中风（比值比：3.85，95%置信区间：1.99-7.63）、肾功能衰竭（比值比：1.90，95%置信区间：1.32-2.74）和住院死亡率（比值比：2.17，95%置信区间：1.30-3.60）显著相关。

结论

TDC-C 是 CABG 后并发症的预测因素。我们强烈建议未来的研究纳入这一指标，以提高并发症预测的准确性。