电邮这篇文章 主动脉内球囊反搏辅助冠状动脉旁路移植术和冠状动脉支架置入术治疗左心室射血分数降低和缺血性二尖瓣关闭不全患者的经验
- 作者: Kostyamin Y.1, Mikhailichenko V.2, Basiyan-Kuhto N.1, Grekov I.1
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隶属关系:
- State educational institution “Donetsk national medical University. M. Gorky”
- Medical Academy named after S.I. Georgievsky of Vernadsky CFU
- 期: 卷 29, 编号 3 (2021)
- 页面: 419-426
- 栏目: Original study
- URL: https://journals.rcsi.science/pavlovj/article/view/60221
- DOI: https://doi.org/10.17816/PAVLOVJ60221
- ID: 60221
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详细
绪论左心室 (LV) 缺血性扩张的最常见原因是冠状动脉 (CA) 的长期动脉粥样硬化。 这些患者的黄金护理标准是冠状动脉旁路移植术和二尖瓣置换术/修复术。 主动脉内球囊反搏 (IABP) 被用作这种病理患者的术前准备。
目的：左室射血分数（EF）降低和冠状动脉多血管病变患者在使用 IABP 伴随冠状动脉旁路移植术和冠状动脉支架置入术期间缺血性发生的二尖瓣反流（MR）程度和临床结果的变化分析。
材料与方法。本文介绍了 186 例缺血性二尖瓣功能不全患者的治疗结果，这些患者因左心室射血分数低而接受 IABC 作为术前准备。 患者被分为2组。 第 1 组包括 132 名接受冠状动脉旁路移植术的患者。 第 2 组包括 54 名接受冠状动脉支架置入术的患者。 基于超声心动图数据，研究了LV心肌血运重建前后LV MR和 EF的动态。
结果。第一组中，在使用 IABC 的背景下，术后早期 MR 程度降低了 58%（p <0.05）(基于改变vena contracta（vc，宽度的测量瓣膜上的反流）和 54% (p <0, 05) - 手术后超过 6 个月。第二组中，在使用 IABA 的背景下，术后早期 MR 程度（基于 vc）显着降低了 42%（p <0.05）和 41%（p <0.05）。 0.05) 超过 6 个月 手术治疗后。
结论。低 LV EF、中度和重度 MR 以及冠状动脉病变显着的患者中使用 IABP 可以通过消除二尖瓣矫正的需要来减少手术治疗的持续时间和使用体外循环的时间直接在手术血运重建期间和长期（超过 6 个月）期间的功能不全。
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作者简介
Yuri Kostyamin
State educational institution “Donetsk national medical University. M. Gorky”
Email: kostiamin@mail.ru
ORCID iD: 0000-0003-0141-8719
SPIN 代码: 8687-0660
MD, Cand. Sci. (Med.)
乌克兰, DonetskVyacheslav Mikhailichenko
Medical Academy named after S.I. Georgievsky of Vernadsky CFU
Email: pancreas1978@mail.ru
ORCID iD: 0000-0003-4204-5912
SPIN 代码: 4606-8664
MD, Dr. Sci. (Med.), Professor
俄罗斯联邦, SimferopolNaira Basiyan-Kuhto
State educational institution “Donetsk national medical University. M. Gorky”
Email: naira-251088@mail.ru
ORCID iD: 0000-0002-3554-4505
MD, Cand. Sci. (Med.)
乌克兰, DonetskIlya Grekov
State educational institution “Donetsk national medical University. M. Gorky”
编辑信件的主要联系方式.
Email: ilya.grekov.1998@gmail.com
ORCID iD: 0000-0002-6140-5760
6th year student
乌克兰, Donetsk参考
- Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. European Heart Journal. 2017;38(36):2739–91. doi: 10.1093/eurheartj/ehx391
- Kron IL, Acker MA, Adams DH, et al. 2015 The American Association for Thoracic Surgery Consensus Guidelines: Ischemic mitral valve regurgitation. The Journal of Thoracic and Cardiovascular Surgery. 2016;151(4):940–56. doi: 10.1016/j.jtcvs.2015.08.127
- Roffi M, Patrono C, Collet J-P, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). European Heart Journal. 2016;37(3):267–315. doi: 10.1093/eurheartj/ehv320
- Bokeriya LA, Gudkova RG. Serdechno-sosudistaya khirurgiya — 2015. Bolezni i vrozhdennyye anomalii sistemy krovoobrashcheniya. Moscow: NTsSSKh im. A.N. Bakuleva RAMN; 2016. (In Russ).
- De Bruyne B, Pijls NH, Kalesan B, et al. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. The New England Journal of Medicine. 2012;367(11):991–1001. doi: 10.1056/NEJMoa1205361
- Khubulava GG, Marchenko SP, Aleksanyan MG, et al. Mitral valve repair with coronary artery bypass grafting in patients with ischemic mitral regurgitation. Bulletin of the Russian Military Medical Academy. 2013;(1):6–10. (In Russ.).
- Bokeriya LA, Skopin II, Mironenko VA. Ishemicheskaya mitral’naya regurgitatsiya. Sovremennyye podkhody k khirurgicheskomu lecheniyu. Russian Journal of Surgery. 2002;(2):14–21. (In Russ).
- Bursi F, Enriquez-Sarano M, Jacobsen SJ, et al. Mitral regurgitation after myocardial infarction: a review. The American Journal of Medicine. 2006;119(2):103–12. doi: 10.1016/j.amjmed.2005.08.025
- Borger MA, Alam A, Murphy PM, et al. Chronic ischemic mitral regurgitation: repair, replace or rethink? The Annals of Thoracic Surgery. 2006;81(3):1153–61. doi: 10.1016/j.athoracsur.2005.08.080
- Szeto WY, Gorman RC, Gorman JH 3rd, et al. Ischemic mitral regurgitation. In: Cohn L.C. Cardiac Surgery in the Adult. 3rd ed. New York: McGraw-Hill; 2003. P. 785–802.
- Deppe А–C, Weber С, Liakopoulos ОJ, et al. Preoperative intra-aortic balloon pump use in high-risk patients prior to coronary artery bypass graft surgery decreases the risk for morbidity and mortality – A meta-analysis of 9,212 patients. Journal of Cardiac Surgery. 2017;32(3):177–85. doi: 10.1111/jocs.13114
- Poirier Y, Voisine P, Plourde G, et al. Efficacy and safety of preoperative intra-aortic balloon pump use in patients undergoing cardiac surgery: a systematic review and metaanalysis. International Journal of Cardiology. 2016;207:67–79. doi: 10.1016/j.ijcard.2016.01.045
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