The long-term follow-up result of surgical non-transplantation treatment of ischemic heart disease
10.3760/cma.j.issn.1001-4497.2010.04.003
- VernacularTitle:缺血性心肌病非移植外科治疗远期效果
- Author:
Dan ZHU
;
Zhe WANG
;
Anqing CHEN
;
Qiang ZHAO
- Publication Type:Journal Article
- Keywords:
Coronary disease;
Myocardial ischemic;
Heart aneurysm;
Cardiac surgical procedures;
Endoventriculoplasty
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2010;26(4):224-226
- CountryChina
- Language:Chinese
-
Abstract:
Objective The aim of this study is to review the experience of using non-transplantation procedure treating ischemic heart disease. Methods Between Jan of 2000 and Jan of 2008, 74 patients with ischemic heart disease comprised the study group, including 66 males and 8 females. The age of the group ranged from 36-79 years, mean 63.3 ±9.28years. The patients underwent non-transplantation procedure according to the preoperative tests. To evaluate the aimed vessels and the survival myocardial viability, coronary angiography, echocardiography, radioisotope scanning and dobutamine-stress echo-test were used. The cardiac function data were analyzed before and after operation. Results Seventy-one cases underwent coronary artery bypass [mean (3.26 ± 1.14) grafts/case], containing 54 arterial grafts and 177 veinuos grafts. The mechanical assistance was applied in 51 cases including 1ABP 50 cases(67.6% ), IABP and ECMO 1 case(1.4%). Postoperative complication contained re-thoracotomy for bleeding 1 case ( 1.4% ), wound infection 3 cases (4.1%), renal dysfunction 3 cases(4.1%), low cardiac output 11 cases(14.9 %). The in-hospital mortality was 10.8% ( 8 cases ). The follow-up time ranged from 17 to 107 months, mean (47.47±24.51 ) months. The follow-up mortality rate was 3.0%. The re-hospitalization for cardiovascular events taken place in 6 cases(9.1% ). The cardiac function improved postoperatively. EF increased from preoperative 0.33 to postoperative 0.47. The diameter of the left ventricular decreased markedly. The left ventricular end-systolic diamension decreased from preoperative 47.6 mm to postoperative 43.4 mm. Conclusion Selected patients with ischemic heart disease, potentially eligible for transplantation, can be managed by the non-transplantation surgery. In those patients post-operative quality of life is satisfactory, with comparable survival and low risk of re-hospitalization.
