Prognostic Impact of Prolonged Cross-Clamp Time in Coronary Artery Bypass Grafting

Vito G. Ruggieri; Karl Bounader; Jean Philippe Verhoye; Francesco Onorati; Antonino S. Rubino; Giuseppe Gatti; Tuomas Tauriainen; Marisa De Feo; Daniel Reichart; Magnus Dalén; Peter Svenarud; Giuseppe Faggian; Giuseppe Santarpino; Daniele Maselli; Riccardo Gherli; Giovanni Mariscalco; Antonio Salsano; Francesco Nicolini; Tiziano Gherli; Matteo Saccocci; Juhani K.E. Airaksinen; Sidney Chocron; Andrea Perrotti; Fausto Biancari

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Prognostic Impact of Prolonged Cross-Clamp Time in Coronary Artery Bypass Grafting

机译：延长交叉钳位时间在冠状动脉旁路移植中的预后影响

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BackgroundThe prognostic impact of cross-clamp time (XCT) in patients undergoing isolated coronary artery bypass grafting (CABG) has not been thoroughly investigated. Material and Methods2957 patients who underwent on-pump isolated CABG from the prospective multicentre E-CABG study were the subjects of this analysis. ResultsThe mean XCT in this series was 58±25minutes Cross-clamp time was >60 minutes in 1134 patients (38.3%), >75minutes in 619 patients (20.9%) and >90minutes in 296 patients (10.0%). Multivariate analysis showed that XCT was an independent predictor of 30-day mortality (p 75minutes (2.9% vs. 1.7%, p=0.002, OR 3.479, 95%CI 1.609–7.520). Analysis of 428 propensity score matched pairs showed that XCT >75minutes was associated with significantly increased risk of early mortality, prolonged use of inotropes, postoperative use of intra-aortic balloon pump, use of extracorporeal membrane oxygenation, atrial fibrillation, prolonged stay in the intensive care unit and of composite major adverse events. ConclusionsIsolated CABG is currently performed with prolonged XCT in a significant number of patients and this seems to be a determinant of poor early outcome.

机译：背景技术尚未彻底研究了孤立的冠状动脉旁路接枝（CABG）患者患者交叉钳位时间（XCT）的预后影响。方法和方法2957从前瞻性多期面E-CABG研究中接受泵浦隔离CABG的患者是该分析的主题。结果XCT在该系列中的XCT为58±25分钟的交叉钳时间> 634名患者60分钟（38.3％），> 75分钟，> 75分钟，296名患者（10.0％）和90.9％）。多变量分析表明，XCT是30天死亡率的独立预测因子（P 75分钟（2.9％vs.1.7％，P = 0.002，或3.479,95％CI 1.609-7.520）。428分的分数匹配对显示XCT > 75分钟与早期死亡率的风险显着增加，长时间使用鞘翅目，主动脉内球囊泵的术后使用，使用体外膜氧合，心房颤动，长时间停留在重症监护病房和综合主要不良事件中。结论了CABG目前在大量患者中延长了XCT，这似乎是早期结果差的决定因素。

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《Heart, lung & circulation》 |2018年第12期|共7页
作者
Vito G. Ruggieri; Karl Bounader; Jean Philippe Verhoye; Francesco Onorati; Antonino S. Rubino; Giuseppe Gatti; Tuomas Tauriainen; Marisa De Feo; Daniel Reichart; Magnus Dalén; Peter Svenarud; Giuseppe Faggian; Giuseppe Santarpino; Daniele Maselli; Riccardo Gherli; Giovanni Mariscalco; Antonio Salsano; Francesco Nicolini; Tiziano Gherli; Matteo Saccocci; Juhani K.E. Airaksinen; Sidney Chocron; Andrea Perrotti; Fausto Biancari;
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作者单位

Division of Cardiothoracic and Vascular Surgery Pontchaillou University Hospital;

Division of Cardiothoracic and Vascular Surgery Pontchaillou University Hospital;

Division of Cardiothoracic and Vascular Surgery Pontchaillou University Hospital;

Division of Cardiovascular Surgery Verona University Hospital;

Centro Clinico-Diagnostico “G.B. Morgagni” Centro Cuore;

Division of Cardiac Surgery Ospedali Riuniti;

Department of Surgery Oulu University Hospital and University of Oulu;

Division of Cardiac Surgery Department of Cardiothoracic Sciences Second University of Naples;

Hamburg University Heart Center;

Department of Molecular Medicine and Surgery Department of Cardiothoracic Surgery and;

Department of Molecular Medicine and Surgery Department of Cardiothoracic Surgery and;

Division of Cardiovascular Surgery Verona University Hospital;

Cardiovascular Center Paracelsus Medical University;

Department of Cardiac Surgery St. Anna Hospital;

Department of Cardiovascular Sciences Cardiac Surgery Unit S. Camillo-Forlanini Hospital;

Department of Cardiovascular Sciences Clinical Sciences Wing University of Leicester Glenfield;

Division of Cardiac Surgery University of Genoa;

Division of Cardiac Surgery University of Parma;

Division of Cardiac Surgery University of Parma;

Department of Cardiac Surgery Centro Cardiologico–Fondazione Monzino IRCCS University of Milan;

Heart Center Turku University Hospital University of Turku;

Department of Thoracic and Cardio-Vascular Surgery University Hospital Jean Minjoz;

Department of Thoracic and Cardio-Vascular Surgery University Hospital Jean Minjoz;

Department of Surgery Oulu University Hospital and University of Oulu;

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正文语种 eng
中图分类心脏、血管（循环系）疾病;
关键词
Coronary artery bypass; CABG; Cardiac surgery; Cross-clamping; Cross clamp; Myocardial ischaemia;

机译：冠状动脉旁路;CABG;心脏手术;交叉夹紧;交叉夹;心肌缺血;

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1. Prognostic Impact of Prolonged Cross-Clamp Time in Coronary Artery Bypass Grafting [J] . Vito G. Ruggieri, Karl Bounader, Jean Philippe Verhoye, Heart, lung & circulation . 2018,第12期

机译：延长交叉钳位时间在冠状动脉旁路移植中的预后影响
2. Metabolic derangement and cardiac injury early after reperfusion following intermittent cross-clamp fibrillation in patients undergoing coronary artery bypass graft surgery using conventional or miniaturized cardiopulmonary bypass [J] . NguyenB.A.V., SuleimanM.-S., AndersonJ.R., Molecular and Cellular Biochemistry: An International Journal for Chemical Biology . 2014,第1a2期

机译：使用常规或小型体外循环进行冠状动脉搭桥手术的患者在间歇性交叉钳夹心纤颤后再灌注后早期的代谢紊乱和心脏损伤
3. Competition between native flow and graft flow after coronary artery bypass grafting. Impact on indications for coronary artery bypass grafting for localized stenosis with giant aneurysms due to Kawasaki disease. [J] . Tsuda E, Fujita H, Yagihara T, Pediatric cardiology . 2008,第2期

机译：冠状动脉旁路移植术后天然血流与移植血流之间的竞争。对川崎病致巨大动脉瘤的局限性狭窄的冠状动脉旁路移植术适应症的影响。
4. Early results of carotid endarterectomy and coronary artery bypass grafting as a simultaneous surgery for patients with combined hemodynamic significant stenoses of the coronary and carotid arteries [C] . D. Matsuganov, D. Saratovkina, O. Pyatkova, International Conference on Mechanics, Resource and Diagnostics of Materials and Structures . 2020

机译：颈动脉内切除术和冠状动脉旁路嫁接作为冠状动脉和颈动脉组合血流动脉术患者同时手术的颈动脉旁路和冠状动脉旁路嫁接
5. Off-pump coronary artery bypass graft vs. on-pump coronary artery bypass graft surgery: What matters---procedure volume or specificity/specialization? [D] . Tsulukidze, M. Maka. 2012

机译：体外循环冠状动脉搭桥术与体外循环冠状动脉搭桥术：重要的是-手术量或特异性/专长？
6. Prognostic Impact of Multiple Prior Percutaneous Coronary Interventions in Patients Undergoing Coronary Artery Bypass Grafting [O] . Fausto Biancari, Magnus Dalén, Vito G. Ruggieri, 2018

机译：多次先前经皮冠状动脉介入治疗对接受冠状动脉旁路移植术的患者的预后影响
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机译：第二次国际侵入式体外技术研讨会雅典，201600年6月9日至11日演化的小型化体外系统1002封闭式电路系统挑战，所有心肺旁路案例案例零售型侵入性体外循环术中的闭塞体外循环从意外地体温过低的患者：一项潜在研究是小型化成人心肺旁路的局限性吗？我们的发现在透析患者中透露阀门手术和冠状动脉旁路手术。可能最小的体外循环有助于获得更好的结果？006 umpact在经历冠状动脉旁路接枝的术语中的最小体外循环。我们是否一直在寻找错误的方向？007Coronary动脉旁路接枝在跳动心脏上，对心肺旁路或最小的体外流量进行全文侵袭性体外循环术后冠状动脉旁路饲养后的含量造成血液递送（DO2）和消费（VO2）在心脏外科灌注指数和脉搏血管血管血管血管血管血管灌注中的灌注脉络膜微栓术期间，在进行手术主动脉瓣膜置换术中的患者中，进行最小侵入性或常规体外流通012Assement of自动躯体感应诱发潜力，用于检测心脏外科术中术中的术中神经寄生虫013minimal侵袭体外循环。侵入性主动脉瓣外科014周年内侵入体外循环在内镜二尖瓣外科015Air常规心肺旁路的处理能力与最小化的体外电路采用融合氧化含量016多侵袭体外循环和细胞销售减少冠状动脉旁路接枝手术后减少炎症吗？

Prognostic Impact of Prolonged Cross-Clamp Time in Coronary Artery Bypass Grafting

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