Sequential postoperative assessment of left ventricular performance with gated cardiac blood pool imaging following aortocoronary bypass surgery.
Sequential postoperative assessment of left ventricular performance with gated cardiac blood pool imaging following aortocoronary bypass surgery.
复制标题
主动脉冠状动脉搭桥手术后通过门控心脏血池成像对左心室性能进行连续术后评估。
DOI：
10.1016/0002-8703(81)90384-7
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发表时间：
1981
影响因子：
4.8
通讯作者：
Miller,RR
中科院分区：
文献类型：
--
作者：
Reduto,LA;Lawrie,GM;Reid,JW;Whissenand,HH;Noon,GP;Kanon,D;DeBakey,ME;Miller,RR
通过对 57 名接受主动脉冠状动脉搭桥手术的患者进行门控心脏血池成像，评估常温间歇性缺血性停搏 (IIA) 和心脏麻痹 (C) 对左心室 (LV) 性能的比较影响。在 34 名患者中，采用了 IIA； 23 名患者接受了 C 治疗。患者在术前、术后即刻（每隔 30 分钟）以及术后 1 周依次进行研究。 C 组和 IIA 组在平均 (± SEM) 年龄、心绞痛类别、病变血管数量、既往心肌梗死或术前射血分数 (EF) 方面没有差异（50 ± 3% 与 50 ± 2% [p= ns]）。 C 组的主动脉交叉钳夹时间比 IIA 组更长（50 ± 5 分钟 vs 28 ± 3 分钟 [p= 0.001]）。在六项连续的术后研究中，在 10 名接受 C 治疗的患者和 16 名接受 IIA 治疗的患者中观察到短暂的 LV 功能障碍（绝对 EF 下降≥ 7%）。到出院时，26 名患者中有 24 名已恢复至术前 EF。心脏麻痹组出院时的平均 EF 与术前 EF 相比没有差异；在 IIA 组中，EF 与术前相比有所增加（50 ± 2% vs 55 ± 2% [p< 0.01]）。这些数据表明，对于术前左心室功能正常的患者，C 型和 IIA 型在主动脉冠状动脉搭桥手术期间均可提供令人满意的心肌保存。
The comparative effects of normothermic intermittent ischemic arrest (IIA) and cardioplegia (C) on left ventricular (LV) performance were assessed by gated cardiac blood pool imaging in 57 patients undergoing aortocoronary bypass surgery. In 34 patients, IIA was employed; 23 patients received C. Patients were studied preoperatively, sequentially in the immediate postoperative period at 30-minute intervals, and at 1 week after the operation. C and IIA groups did not differ in mean (± SEM) age, anginal class, number of diseased vessels, previous myocardial infarction, or preoperative ejection fraction (EF) (50 ± 3% vs 50 ± 2% [p= ns]). Aortic cross clamp time was greater with C than IIA (50 ± 5 minutes vs 28 ± 3 minutes [p= 0.001]). During the six sequential postoperative studies, transient LV dysfunction (≥ 7% decrease in absolute EF) was observed in 10 patients receiving C and in 16 patients receiving IIA. By time of discharge, 24 of 26 patients had returned to preoperative EF. Mean EF at discharge in the cardioplegia group did not differ compared to preoperative EF; in the IIA group, EF increased compared to preoperative EF (50 ± 2% vs 55 ± 2% [p< 0.01]). These data suggest that in patients with normal preoperative LV performance both C and IIA afford satisfactory myocardial preservation during aortocoronary bypass surgery.