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ЗАДАТЬ ВОПРОС РЕДАКТОРУ РАЗДЕЛА (ответ в течение нескольких дней)

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04 января 2002 00:00   |   Alistair G. Roysea, Colin F. Royseb, James Tatoulisa

Total arterial coronary revascularization and factors influencing in-hospital mortality

 a Department of Cardiothoracic Surgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia
b Department of Anaesthesia, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Corresponding author. Suite 3, Private Medical Centre, P.O. Box 2135, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia. Tel.: 3−9342−8908; fax: 3−9342−8908
e−mail: alistair.royse@nwhcn.org.au
Objective: To determine if arterial conduit selection or more efficient arterial revascularization techniques influence in-hospital mortality. Methods: Data from patients undergoing coronary artery bypass surgery at Royal Melbourne Hospital, Australia, between 1 January 1996 and 30 June 1998 (n = 1681) was collected prospectively. Logistic regression analysis was performed. Results: Independent preoperative predictors of increased in-hospital mortality included renal failure, redo coronary artery surgery and intra-aortic balloon pump use. In-hospital mortality for total arterial revascularization 0.7%, radial artery use 0.9%, pedicled arterial revascularization 0.2%, composite arterial conduit 0.4%, and the exclusive Y graft operation 0.3%. These were all associated with reduced in-hospital mortality. Mortality when vein graft was used was 2.9%. Most patients received total arterial revascularization, which was considered the primary surgical strategy. Conclusion: Total arterial revascularization, radial artery use and complex arterial reconstructions were associated with reduced in-hospital mortality. Preoperative renal failure, intra-aortic balloon pump use and redo coronary surgery predicted greater in-hospital mortality.
 

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