Feasibility study of SYNTAX Ⅱ score in guiding the strategy of two-staged hybrid coronary artery revascularization
10.3969/j.issn.1004-8812.2019.01.005
- VernacularTitle:SYNTAX Ⅱ评分系统指导分站式杂交冠状动脉血运重建术策略的可行性研究
- Author:
Xin-Ye XU
1
;
Yun-Peng LING
;
Li-Jun GUO
Author Information
1. 北京大学第三医院心内科 卫生部心血管分子生物学与调节肽卫生部重点实验室分子心血管教育部重点实验室 分子心血管教育部重点实验室
- Keywords:
Hybrid coronary revascularizasion;
SYNTAX Ⅰ score;
Minimally invasive direct coronary artery bypass grafting
- From:
Chinese Journal of Interventional Cardiology
2019;27(1):16-22
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the feasibility of selecting the hybrid operation strategy according to the preoperative SYNTAX Ⅱ score by analyzing the characteristics of the SYNTAX score and the changes of the SYNTAX Ⅱ score in the different stages of the hybrid coronary artery bypass surgery. Methods Patients admitted in our hospital from Jan 1, 2016 to December 31, 2017 who received staged hybrid coronary revascularization (first stage CABG, followed by second stage PCI) were reviewed. The total SYNTAX Ⅱ scores before and after minimally invasive direct coronary artery bypass grafting (MIDCAB) were compared. Results A total of 50 patients were analyzed and scored by coronary angiography with lumen stenosis exceeding 50％. The SYNTAX Ⅰ score before MIDCAB was 36.00 points (13.00, 70.50) and the ratio of SYNTAX Ⅰ score>33 points was 58％ (29/50). After MIDCAB operation, the residual SYNTAX Ⅰ score was 11.50 points (7.00, 18.50), which decreased by 25.50 points (19.00, 33.75). According to the SYNTAX Ⅱ score before MIDCAB, a proportion of 10％ (5/50) patients who received PCI procedure showed a lower 4-year mortality than the CABG operation. The forecasted proportion SYNTAX Ⅱ score after MIDCAB increased to 38％ (19/50) while the actual proportion after MIDCAB was 42％ (21/50). The consistency between the forecasted value and the actual value was 90％ (45/50, P=0.125, McNemar test). Conclusions Using SYNTAX Ⅱ score to predict PCI or CABG treatment after MIDCAB is feasiable. The changes in SYNTAX Ⅱ score before and after MIDCAB was mainly resulted from the improvement in creatinine level after operation.
