Risk factors for perioperative cardiac complications after lumbar fusion surgery
Risk factors for perioperative cardiac complications after lumbar fusion surgery
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DOI：
10.2176/nmc.47.495
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发表时间：
2007-11-01
影响因子：
1.9
通讯作者：
Jang, Jee-Soo
中科院分区：
文献类型：
--
作者：
Lee, Dong Yeob;Lee, Sang-Ho;Jang, Jee-Soo
心脏并发症是非心脏手术后围手术期死亡的主要原因。本研究回顾性分析了2005年1月至2006年12月连续901例腰椎融合术患者脊柱融合术后围手术期心脏并发症。围手术期发生心脏并发症7例（0.8%），男4例，女3例，年龄62 ~ 75岁（平均66.6岁）（心肌梗死6例，心绞痛1例）。4例经椎间孔微创腰椎椎间融合术后出现心脏并发症，3例前路腰椎椎间融合术后出现心脏并发症。术前患者无任何与心脏疾病相关的症状。常见的特征是年龄超过60岁，有高血压和/或糖尿病病史，存在腹主动脉和/或髂总动脉钙化动脉粥样硬化。5例患者在重症监护室保守治疗后病情好转。经皮冠状动脉成形术1例，冠状动脉搭桥术1例。腰椎融合术前应考虑围手术期心脏并发症的可能性，特别是有高血压和/或糖尿病、腹主动脉和/或髂总动脉钙化动脉粥样硬化的老年患者。
Cardiac complication is a leading cause of death in the perioperative period after non-cardiac surgery. The present study retrospectively investigated perioperative cardiac complications after spinal fusion surgery in 901 consecutive adult patients who underwent fusion surgery in the lumbar spine from January 2005 to December 2006. Cardiac complications developed in seven patients (0.8%), four males and three females aged 62 to 75 years (mean 66.6 years), in the perioperative period (myocardial infarction in 6 and angina pectoris in 1). Cardiac complications developed after mini-open transforaminal lumbar interbody fusion in four patients and after anterior lumbar interbody fusion in three. No patient had any symptoms related to cardiac disease before surgery. Common features were age over 60 years, a medical history of hypertension and/or diabetes mellitus, and presence of calcified atherosclerosis of the abdominal aorta and/or common iliac arteries. Five patients improved after conservative medical treatment in an intensive care unit. Percutaneous transluminal coronary angioplasty was performed in one patient and coronary artery bypass graft surgery in one. The possibility of perioperative cardiac complications should be considered before lumbar fusion surgery, especially in elderly patients with hypertension and/or diabetes mellitus, and calcified atherosclerosis of the abdominal aorta and/or common iliac arteries.