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主动脉冠状动脉搭桥术后再次手术。1041例连续首次手术患者中53例的结果。

Reoperation after aortocoronary bypass procedure. Results in 53 patients in a group of 1041 with consecutive first operations.

作者信息

Laird-Meeter K, van den Brand M J, Serruys P W, Penn O C, Haalebos M M, Bos E, Hugenholtz P G

出版信息

Br Heart J. 1983 Aug;50(2):157-62. doi: 10.1136/hrt.50.2.157.

Abstract

Of 1041 patients with consecutive aortocoronary bypass operations, 53 (5.1%) underwent reoperation during a mean follow-up time of three and a half years. The operative mortality of first operations was 1.2%, and of reoperations 3.8%. The anatomical reason for reoperation was failure of the bypass graft in 41 (77%) patients, which in 18 was accompanied by progression of disease. Progression alone was seen in seven (13%). When symptoms occurred within six months after the first operation, failure of the bypass graft(s) was nearly always found--in 32 out of 36 instances. Progression in non-bypassed arteries was seen only when symptoms occurred later. Late results in angina pectoris were less favourable in the group undergoing reoperation: 31 (65%) of the 48 operated on twice and 406 (46%) of the 877 patients operated on once still had angina at late follow-up. The same fraction in both groups was improved by operation: 88% versus 89%.

摘要

在1041例接受连续性主动脉冠状动脉搭桥手术的患者中,53例(5.1%)在平均3.5年的随访期内接受了再次手术。首次手术的手术死亡率为1.2%,再次手术的为3.8%。再次手术的解剖学原因是41例(77%)患者的搭桥移植物失败,其中18例伴有疾病进展。仅疾病进展的有7例(13%)。当症状在首次手术后6个月内出现时,几乎总能发现搭桥移植物失败——36例中有32例如此。仅在症状出现较晚时才可见未搭桥动脉的进展。再次手术组心绞痛的远期结果较差:48例接受两次手术的患者中有31例(65%),877例接受一次手术的患者中有406例(46%)在远期随访时仍有心绞痛。两组中相同比例的患者通过手术得到改善:分别为88%和89%。

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