Cardiovascular surgery (London, England) · 2000
The safety of combined cardiac and vascular operations: how much is too much?
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Gangemi J J, Kron I L, Ross S D, Tribble C G, Kern J A
Аннотация
OBJECTIVE: The purpose of this study was to identify factors correlating with a poor outcome following combined cardiac and vascular procedures.
METHODS: We reviewed 45 consecutive patients undergoing combined cardiac and vascular operations. These included cardiac/CEA (n=27), cardiac/AAA (n=13), cardiac/AAA/one other vascular reconstruction (n=4), and cardiac/renal artery bypass (n=1). Group I included all patients with no morbidity or mortality (n=41) and Group II included patients who died or suffered significant morbidity (stroke, renal failure) (n=4).
RESULTS: Overall mortality was 4.4% (2/45). These two patients underwent cardiac surgery combined with two additional vascular procedures (cardiac/AAA/other). In patients undergoing cardiac/CEA or cardiac/AAA, there were no deaths and one stroke (contralateral to CEA). Group II had significantly decreased ejection fraction (39%+/-6% vs 52%+/-1%) and an increased number of procedures (2.75 vs 2.04).
CONCLUSIONS: Combined cardiac surgery and vascular reconstruction can be performed safely. However, multiple vascular reconstructions or the presence of decreased ejection fraction increased operative risk.
METHODS: We reviewed 45 consecutive patients undergoing combined cardiac and vascular operations. These included cardiac/CEA (n=27), cardiac/AAA (n=13), cardiac/AAA/one other vascular reconstruction (n=4), and cardiac/renal artery bypass (n=1). Group I included all patients with no morbidity or mortality (n=41) and Group II included patients who died or suffered significant morbidity (stroke, renal failure) (n=4).
RESULTS: Overall mortality was 4.4% (2/45). These two patients underwent cardiac surgery combined with two additional vascular procedures (cardiac/AAA/other). In patients undergoing cardiac/CEA or cardiac/AAA, there were no deaths and one stroke (contralateral to CEA). Group II had significantly decreased ejection fraction (39%+/-6% vs 52%+/-1%) and an increased number of procedures (2.75 vs 2.04).
CONCLUSIONS: Combined cardiac surgery and vascular reconstruction can be performed safely. However, multiple vascular reconstructions or the presence of decreased ejection fraction increased operative risk.
Предметные рубрики MeSH
AgedAortic Aneurysm, AbdominalCardiac Surgical ProceduresCombined Modality TherapyCoronary Artery BypassEndarterectomy, CarotidFemaleHeart Valve ProsthesisHumansMaleOutcome Assessment, Health CarePostoperative ComplicationsRenal Artery ObstructionRetrospective StudiesRisk FactorsVascular Surgical Procedures