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首页> 外文期刊>The American Journal of Cardiology >Outcome in Patients Having Salvage Coronary Artery Bypass Grafting
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Outcome in Patients Having Salvage Coronary Artery Bypass Grafting

机译：抢救冠状动脉搭桥术患者的结果

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Salvage coronary artery bypass grafting (CABG) is often performed for cardiogenic shock on compassionate basis without clinical data justifying this aggressive approach. The aim of this study was to analyze early and intermediate outcomes after salvage CABG. We retrospectively reviewed the data of 85 patients who underwent salvage CABG at 11 European cardiac surgery centers. Salvage CABG was defined according to the EuroSCORE criteria, that is, a procedure performed in patients requiring cardiopulmonary resuscitation (external cardiac massage) en route to the operating theater or before induction of anesthesia. A percutaneous coronary intervention procedure preceded salvage CABG in 55 patients (64.7%). Thirty patients (35.3%) died during the inhospital stay. The mean EuroSCORE II was 32.0% and the observed-to-expected ratio was 1.08. Salvage CABG was associated with high rates of postoperative stroke (9.4%), restemotomy for bleeding (23.5%), restemotomy for hemodynamic instability (15.3%), dialysis (18.8%), severe gastrointestinal complications (12.9%), and deep sternal wound infection (10.6%). Survival at 1, 3, and 5 years was 58.6%, 49.8%, and 40.9%, respectively. Twenty patients (23.5%) were postoperatively treated with extracorporeal membrane oxygenation (ECMO). The rates of adverse events after ECM were particularly high (stroke 40%, resternotomy for bleeding 60%, dialysis 35%, gastrointestinal complications 30%, and deep sternal wound infection 30%). Of patients treated with ECMO, 8 (40%) survived to discharge, and 1-year survival was 29.2%. Salvage CABG is associated with high risk of immediate mortality and severe adverse events. However, the observed immediate and intermediate outcome justify coronary surgery in these critically ill patients. A number of these patients are currently treated by ECMO, and its results are encouraging. (C) 2015 Elsevier Inc. All rights reserved.
机译：挽救性冠状动脉搭桥术（CABG）通常是在富有同情心的基础上针对心源性休克进行的，而没有临床数据证明这种积极的方法是合理的。这项研究的目的是分析挽救CABG后的早期和中期结果。我们回顾性地回顾了欧洲11个心脏外科手术中心接受CABG抢救的85例患者的数据。抢救性CABG是根据EuroSCORE标准定义的，即在需要进行心肺复苏术（外部心脏按摩）的患者在手术室途中或在麻醉诱导之前执行的程序。 55例（64.7％）患者在挽救CABG之前进行了冠状动脉介入治疗。 30例患者（35.3％）在住院期间死亡。 EuroSCORE II的平均值为32.0％，观察与预期的比率为1.08。抢救性CABG与术后中风发生率高（9.4％），出血性再狭窄（23.5％），血液动力学不稳定性的再狭窄（15.3％），透析（18.8％），严重的胃肠道并发症（12.9％）和胸骨深伤口相关感染（10.6％）。 1、3和5年生存率分别为58.6％，49.8％和40.9％。术后接受体外膜氧合（ECMO）治疗20例（23.5％）。 ECM后的不良事件发生率特别高（中风40％，再造血术60％，透析35％，胃肠道并发症30％，胸骨深部伤口感染30％）。在接受ECMO治疗的患者中，有8名（40％）存活到出院，而1年生存率为29.2％。抢救CABG与立即死亡和严重不良事件的高风险有关。但是，观察到的即刻和中间结局证明了对这些危重患者进行冠状动脉外科手术是合理的。 ECMO目前正在治疗其中许多患者，其结果令人鼓舞。 （C）2015 Elsevier Inc.保留所有权利。

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