Surgical treatment of coronary artery disease: pure graft operations, with a study of 741 patients followed 3--7 yr.
Surgical treatment of coronary artery disease: pure graft operations, with a study of 741 patients followed 3--7 yr.
复制标题
冠状动脉疾病的手术治疗：纯移植手术，对 741 名患者进行了 3--7 年随访的研究。
DOI：
10.1016/0033-0620(75)90013-4
复制
发表时间：
1975
影响因子：
9.1
通讯作者：
Floyd D. Loop
中科院分区：
文献类型：
--
作者：
William C. Sheldon;Gustavo Rincon;A. Pichard;Mehdi Razavi;Chalit Cheanvechai;Floyd D. Loop
本报告回顾了1967年至1974年6828例单纯旁路移植手术的经验，未进行相关的心脏手术。本组住院死亡率为1.4%。1971年以前围手术期心肌梗死的发生率为6.9%，过去3年为4.1%。在术后平均超过12个月的研究中，移植物通畅率为83.6%，89%的患者有一个或多个功能正常的移植物。从1967年到1970年，741例连续患者采用纯移植技术进行手术，与另一组相似但未手术的患者相比，生存率似乎有所提高。手术组的平均年死亡率为3.3%（包括手术死亡率），而医疗组为8.8%。孤立性前降支、双支和三支血管受累患者的生存率差异最为显著。在741例患者亚组中，移植动脉新发闭塞的发生率与进行手术的病变的严重程度相关，与移植物通畅性无关。动脉造影显示未移植动脉的新闭塞是罕见的，并且在观察期间很少有患者发生显著的新病变。症状改善与术后动脉造影确定的血运重建的完整性有关。
This report reviews the experience with bypass graft surgery in the pure form, without associated cardiac procedures, in 6828 patients operated upon from 1967 through 1974. The hospital mortality rate in this group was 1.4%. The incidence of definite perioperative myocardial infarction was 6.9% prior to 1971, and 4.1% in the past 3 yr. Graft patency in postoperative studies performed an average of over 12 mo after surgery was 83.6%, and 89% of patients had one or more functioning grafts. In a subgroup of 741 consecutive patients operated upon with pure graft techniques from 1967 through 1970, survival seemed to be improved when compared to another group of similar, but nonoperated patients. The average annual mortality rate was 3.3% per yr in the surgical group (including surgical mortality) compared to 8.8% per year in the medical group. Differences in survival were most striking in patients with isolated anterior descending, double and triple vessel involvement. In the 741-patient subgroup the incidence of new occlusions of grafted arteries was related to the severity of the lesion (s) for which the operation was performed, and unrelated to graft patency. Arteriographically demonstrated new occlusions of ungrafted arteries were infrequent, and few patients developed significant new lesions during the period of observation. Symptomatic improvement is related to completeness of revascularization as determined by postoperative arteriography.