摘要
目的:研究混合型左主干病变和左主干同等病变患者行外科血运重建术的风险状况。方法和结果:回顾分析1997年1月至2002年12月行冠状动脉搭桥术(CABG)患者的医疗记录。研究共纳入210例患者,其中30.5%(64例)为左主干病变,49.5%(104例)为左主干同等病变,20%(42例)为混合型狭窄病变。混合型左冠状动脉疾病与极高的术后死亡率相关。
Objective: To study the risk profile associated with surgical revascularization for mixed left main and left main equivalent diseases. Methods and results: Retrospective analysis of medical records of patients who underwent CABG from January 1997 and December 2002 were studied. 210 patients were included of which 30.5%(64) had left main, 49.5%(104) had left main equivalent and 20%(42) had mixed type of stenotic disease. The mixed type left coronary disease was associated with very high post-operative mortality. The factors associated with mortality were degree of left main artery stenosis, cardiopulmonary bypass pump time, no. of packed cell units transfused during surgery, post-operative low cardiac output, re-exploration of chest and no. of days spent as intubated. Low cardiac output, chest re-exploration and no. of days intubated were independently associated with mortality. Conclusions: “Mixed left main and left main equivalent disease”makes a large proportion of left sided CAD. It is a unique subtype associated with very high risk, and it should be treated with extra caution. Characterization of its risk profile should be done with larger studies to improve the outcome.
