Gade P V, Ascher E, Cunningham J N, Kallakuri S, Scheinman M, Scherer H, Robertazzi R, Hingorani A
Division of Vascular Surgery, Maimonides Medical Center, Brooklyn, New York 11219, USA.
Am J Surg. 1998 Aug;176(2):144-6. doi: 10.1016/s0002-9610(98)00164-0.
We report here the results of combined coronary artery bypass grafting (CABG) and abdominal aortic aneurysm (AAA) repair and the factors associated with higher mortality following this procedure.
The authors performed a retrospective chart review of 26 patients who underwent combined CABG and AAA repair between March 1990 and October 1996.
No postoperative myocardial infarction or major cardiac complications were noted. A morbidity rate of 38% (n = 10) and mortality rate of 11% (n = 3) were noted. Comparative analysis of nonsurvivors (n = 3) versus survivors (n = 23) revealed the following: ejection fraction (EF) was significantly lower (33% +/- 3% versus 44% +/- 14%, P < 0.05), duration of cardiopulmonary bypass (CPB) was significantly longer (239 +/- 122 minutes versus 141 +/- 54 minutes, P < 0.05), and incidence of postoperative respiratory failure (67% versus 17%, P = 0.001) were significantly higher in nonsurvivors. No differences in mean age, gender distribution, incidence of hypertension or diabetes were noted between the groups.
Combined CABG and AAA repair protected patients from postoperative aneurysm rupture and myocardial infarction. Poor EF, prolonged CPB, and postoperative respiratory failure were associated with higher mortality.
我们在此报告冠状动脉旁路移植术（CABG）与腹主动脉瘤（AAA）修复联合手术的结果以及该手术后与较高死亡率相关的因素。
作者对1990年3月至1996年10月期间接受CABG与AAA修复联合手术的26例患者进行了回顾性病历审查。
未观察到术后心肌梗死或重大心脏并发症。观察到发病率为38%（n = 10），死亡率为11%（n = 3）。对非幸存者（n = 3）与幸存者（n = 23）的比较分析显示如下：射血分数（EF）显著更低（33%±3%对44%±14%，P < 0.05），体外循环（CPB）时间显著更长（239±122分钟对141±54分钟，P < 0.05），且非幸存者术后呼吸衰竭的发生率显著更高（67%对17%，P = 0.001）。两组之间在平均年龄、性别分布、高血压或糖尿病发生率方面未观察到差异。
CABG与AAA修复联合手术可使患者免于术后动脉瘤破裂和心肌梗死。EF差、CPB时间延长和术后呼吸衰竭与较高死亡率相关。
