PDF(Pubmed)
Abstract：
Use of bilateral internal thoracic artery (BITA) as graft in coronary artery bypass grafting (CABG) is controversial because it is related to higher in-hospital mortality, incidence of sternal wound-related infection, and an increase in surgical time. The primary objective of this study is to evaluate in-hospital mortality and mortality within 30 days from discharge. The secondary objective is to evaluate the occurrence of deep sternal wound infection in a 90-day follow-up.
This is a retrospective review of the medical records of 152 patients undergoing elective CABG with the use of BITA and cardiopulmonary bypass (CPB). These patients were divided into two groups, diabetics and non-diabetics. Patients with acute myocardial infarction and concomitant valvular disease were not included in the sample.
Preoperative characteristics did not show significant differences between the groups, which allowed a comparative analysis. The variables electrocardiography time and aortic clamping time were higher in the diabetic group, with a significant statistical difference (P<0.0001). In-hospital mortality occurred in three patients, and there was no mortality up to 30 days in both groups. There was no significant difference in the primary end point between groups (P=0.56). Deep sternal wound infection was present in only one patient and showed no significant difference in the secondary outcome between groups (P=0.40).
We did not observe a higher mortality and occurrence of deep sternal wound infection with the use of BITA in diabetic patients compared to non-diabetics, even with greater CPB and aortic clamping times in diabetics.
This is a retrospective review of the medical records of 152 patients undergoing elective CABG with the use of BITA and cardiopulmonary bypass (CPB). These patients were divided into two groups, diabetics and non-diabetics. Patients with acute myocardial infarction and concomitant valvular disease were not included in the sample.
Preoperative characteristics did not show significant differences between the groups, which allowed a comparative analysis. The variables electrocardiography time and aortic clamping time were higher in the diabetic group, with a significant statistical difference (P<0.0001). In-hospital mortality occurred in three patients, and there was no mortality up to 30 days in both groups. There was no significant difference in the primary end point between groups (P=0.56). Deep sternal wound infection was present in only one patient and showed no significant difference in the secondary outcome between groups (P=0.40).
We did not observe a higher mortality and occurrence of deep sternal wound infection with the use of BITA in diabetic patients compared to non-diabetics, even with greater CPB and aortic clamping times in diabetics.
摘要：
在冠状动脉旁路移植术（CABG）中使用双侧胸廓内动脉（BITA）作为移植物是有争议的，因为它与更高的住院死亡率有关。胸骨伤口相关感染的发生率，手术时间的增加.这项研究的主要目的是评估住院死亡率和出院后30天内的死亡率。次要目标是在90天的随访中评估深部胸骨伤口感染的发生。
这是对152例使用BITA和体外循环（CPB）进行选择性CABG的患者的医疗记录的回顾性回顾。这些患者被分为两组，糖尿病患者和非糖尿病患者。样本中未包括患有急性心肌梗死和伴随的瓣膜疾病的患者。
术前特征在两组之间没有显着差异，这允许进行比较分析。糖尿病组的心电图时间和主动脉阻断时间变量较高，具有显著统计学差异(P<0.0001)。3名患者发生院内死亡，两组在30天内没有死亡。两组之间的主要终点没有显着差异（P=0.56）。胸骨深部伤口感染仅在1例患者中出现，两组之间的次要结局没有显着差异（P=0.40）。
与非糖尿病患者相比，我们没有观察到糖尿病患者使用BITA的死亡率和胸骨深部伤口感染的发生率更高。即使糖尿病患者的CPB和主动脉阻断时间更长。
这是对152例使用BITA和体外循环（CPB）进行选择性CABG的患者的医疗记录的回顾性回顾。这些患者被分为两组，糖尿病患者和非糖尿病患者。样本中未包括患有急性心肌梗死和伴随的瓣膜疾病的患者。
术前特征在两组之间没有显着差异，这允许进行比较分析。糖尿病组的心电图时间和主动脉阻断时间变量较高，具有显著统计学差异(P<0.0001)。3名患者发生院内死亡，两组在30天内没有死亡。两组之间的主要终点没有显着差异（P=0.56）。胸骨深部伤口感染仅在1例患者中出现，两组之间的次要结局没有显着差异（P=0.40）。
与非糖尿病患者相比，我们没有观察到糖尿病患者使用BITA的死亡率和胸骨深部伤口感染的发生率更高。即使糖尿病患者的CPB和主动脉阻断时间更长。
