DETERMINANTS OF OPERATIVE SURVIVAL FOLLOWING COMBINED MITRAL-VALVE REPLACEMENT AND CORONARY REVASCULARIZATION
DETERMINANTS OF OPERATIVE SURVIVAL FOLLOWING COMBINED MITRAL-VALVE REPLACEMENT AND CORONARY REVASCULARIZATION
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DOI：
10.1016/s0003-4975(10)62992-x
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发表时间：
1982-01-01
影响因子：
4.6
通讯作者：
VANDEVANTER, S
中科院分区：
文献类型：
--
作者：
DISESA, VJ;COHN, LH;VANDEVANTER, S
为了确定二尖瓣置换术（MVR）和冠状动脉旁路移植术（CABG）联合手术后的手术生存率，对100例患者进行了评价。男63例，女37例，平均年龄62岁。36例患者为纽约心脏协会（NYHA）心功能III级，64例为心功能IV级。76例患者以二尖瓣返流为主，24例二尖瓣狭窄。急诊手术15例，择期或半择期手术85例。手术死亡18例（18%），其中择期手术9例（10.5%），急诊手术9例（60%），P < 0.01。与手术死亡相关的重要术前因素是NYHA心功能分级、肺血管阻力增加、心脏指数降低和射血分数降低。存活率没有因性别、年龄或冠状动脉疾病程度而异。钾停搏液心肌保护和完全冠状动脉血运重建显著降低了择期组患者的手术死亡率，但没有改变急诊组的死亡率。
To determine the operative survival rate following combined mitral valve replacement (MVR) and coronary artery bypass graft (CABG) operation, 100 patients were evaluated. There were 63 men and 37 women; the mean age was 62 yr. Thirty-six patients were in New York Heart Association (NYHA) Functional Class III, and 64 were in Functional Class IV. Mitral regurgitation was predominant in 76 patients; mitral stenosis in 24. Emergency operations were performed in 15 patients, and elective or semielective operations were performed in 85. There were 18 operative deaths (18%): 9 in patients having elective operations (10.5%) and 9 in those having emergency operations (60%; P < 0.01). Significant preoperative factors related to operative death were NYHA functional class, increased pulmonary vascular resistance, lower cardiac index and lower ejection fraction in the nonsurvivors. The rate of survival did not differ according to sex, age or degree of coronary artery disease. Myocardial protection with K cardioplegia and complete coronary revascularization significantly reduced operative mortality in the elective group of patients but did not alter the mortality in the emergency group.