Mustonen P K, Hippeläinen M J, Rehnberg L S
Department of Surgery, Kuopio University Hospital, Finland.
Ann Chir Gynaecol. 1996;85(1):44-50.
The incidence and significance of postoperative conduction defects after coronary artery bypass surgery were investigated prospectively in 181 patients. Several pre- and perioperative variables, especially the temperature in three regions of the myocardium, were recorded as explanatory variables. The incidence of conduction defect(s) in the immediate postoperative electrocardiogram (ECG) was 55.8%, and 35.9% of the patients had a conduction defect when leaving hospital. Two patients had a permanent third degree atrioventricular (AV) block. Five pacemakers were implanted. Left main coronary artery stenosis was more common (P < 0.01), and the perioperative myocardial temperatures (P < 0.05-0.01) were lower in patients with conduction defects. These patients had also low postoperative cardiac output more often (P < 0.001), their creatine kinase myocardial (MB) fraction values were higher (P < 0.01), and they stayed in hospital longer (P < 0.05). Right bundle branch block had no significant association with the studied variables.
前瞻性研究了181例冠状动脉搭桥手术后传导缺陷的发生率及其意义。记录了几个术前和围手术期变量，特别是心肌三个区域的温度作为解释变量。术后即刻心电图（ECG）传导缺陷的发生率为55.8%，出院时35.9%的患者存在传导缺陷。两名患者发生永久性三度房室（AV）传导阻滞。植入了五个起搏器。左主干冠状动脉狭窄更为常见（P<0.01），传导缺陷患者的围手术期心肌温度较低（P<0.05 - 0.01）。这些患者术后心输出量低的情况也更常见（P<0.001），其肌酸激酶心肌（MB）同工酶值更高（P<0.01），住院时间更长（P<0.05）。右束支传导阻滞与所研究的变量无显著关联。
