Outcome of noncardiac operations in patients with severe coronary artery disease successfully treated preoperatively with coronary angioplasty.
Outcome of noncardiac operations in patients with severe coronary artery disease successfully treated preoperatively with coronary angioplasty.
复制标题
术前通过冠状动脉血管成形术成功治疗的严重冠状动脉疾病患者的非心脏手术结果。
作者：
K. Huber;M. Evans;J. Bresnahan;R. Gibbons;D. Holmes
对50例（平均年龄68岁）严重冠状动脉疾病患者进行围手术期心肌梗死和死亡的风险进行了评估，这些患者在成功的经皮腔内冠状动脉成形术实现血运重建后接受了非心脏手术。在血管成形术之前，根据临床变量和专业诊断测试结果的评估，所有患者都被认为是围手术期并发症的高风险患者。在50例患者中，31例患有加拿大心脏协会III级或IV级心绞痛或不稳定型心绞痛。所有接受功能测试的患者均获得阳性结果。在导管插入术中，38例患者（76%）有多支血管病变。这50名患者在血管成形术后平均9天接受了54次非心脏手术。围手术期心肌梗死的总发生率为5.6%，死亡率为1.9%。发生2例非致死性非Q波梗死和1例致死性Q波梗死。对于成功接受血管成形术治疗严重冠状动脉疾病的患者，与非心脏外科手术相关的重大心脏并发症的风险较低。
The risk of perioperative myocardial infarction and death was evaluated in 50 patients (mean age, 68 years) with severe coronary artery disease who underwent a noncardiac operation after revascularization had been achieved by successful percutaneous transluminal coronary angioplasty. Before angioplasty, all patients were thought to be at high risk for perioperative complications on the basis of assessment of clinical variables and findings on specialized diagnostic tests. Of the 50 patients, 31 had Canadian Heart Association class III or IV angina or unstable angina. All patients who underwent functional testing had positive results. At catheterization, 38 patients (76%) had multivessel disease. The 50 patients underwent 54 noncardiac operations at a median of 9 days after angioplasty. The overall frequency of perioperative myocardial infarction was 5.6%, and the mortality was 1.9%. Two nonfatal non-Q-wave infarctions and one fatal Q-wave infarction occurred. In patients who have undergone successful angioplasty for severe coronary artery disease, the risk of major cardiac complications associated with a noncardiac surgical procedure is low.