Myocardial damage after minimally invasive coronary artery bypass grafting on the beating heart.
Myocardial damage after minimally invasive coronary artery bypass grafting on the beating heart.
复制标题
对跳动的心脏进行微创冠状动脉旁路移植术后的心肌损伤。
DOI：
10.1016/s0003-4975(98)00733-4
复制
发表时间：
1998
影响因子：
4.6
通讯作者：
P. Mair
中科院分区：
文献类型：
--
作者：
J. Bonatti;H. Hangler;C. Hörmann;J. Mair;J. Falkensammer;P. Mair
背景在传统的冠状动脉旁路移植术中，围手术期心肌梗死的发生率在2%-6%的范围内;然而，如果使用敏感的心肌标志物蛋白来检测围手术期心肌损伤，则观察到显著更高的发生率。对于微创直接冠状动脉旁路移植术，很少有数据是关于心肌标志物蛋白release.Methods15例（11男，4女;平均年龄，59.6 ± 8.5岁）接受微创直接冠状动脉旁路移植术通过微创开胸术的心脏跳动。心电图和经食管和经胸超声心动图，以及肌酸激酶MB质量浓度和心肌肌钙蛋白I水平的测定用于缺血monitoring.ResultsOne患者有围手术期心肌梗死根据标准标准，尽管机械循环支持死亡。在9例术中或术后出现短暂性缺血体征的患者中，4例（44%）的心肌肌钙蛋白I水平测定显示了小但明确的缺血性损伤。在这4例患者中的2例病理结果可以检测到血管造影restudies.ConclusionsSubclinical心肌损伤是一个常见的事件，微创冠状动脉旁路移植术的心脏跳动。心肌肌钙蛋白I可作为微创直接冠状动脉旁路移植术围术期心肌梗死的诊断工具。
BackgroundIn conventional coronary artery bypass grafting, the rate of perioperative myocardial infarction is reported in the 2% to 6% range; however, significantly higher rates are observed if sensitive myocardial marker proteins are used to detect perioperative myocardial damage. For minimally invasive direct coronary artery bypass grafting, few data are available concerning myocardial marker protein release.MethodsFifteen consecutive patients (11 male, 4 female; mean age, 59.6 ± 8.5 years) received minimally invasive direct coronary artery bypass grafting procedures via minithoracotomy on the beating heart. Electrocardiography and transesophageal and transthoracic echocardiography as well as determination of creatine kinase-MB mass concentration and cardiac troponin I level were used for ischemic monitoring.ResultsOne patient had a perioperative myocardial infarction according to standard criteria and died despite mechanical circulatory support. Determination of cardiac troponin I level showed small but definitive ischemic damage in 4 of 9 patients (44%) who presented transient ischemic signs intraoperatively or postoperatively. In 2 of these 4 patients pathologic findings could be detected on angiographic restudies.ConclusionsSubclinical myocardial injury is a common event in minimally invasive coronary artery bypass grafting on the beating heart. Cardiac troponin I could serve as an adequate diagnostic tool for diagnosis of perioperative myocardial infarction in minimally invasive direct coronary artery bypass grafting.