Вінцеве шунтування в пацієнтів високого ризику (літературний огляд)

  • О. К. Гогаєва ДУ «Національний інститут серцево-судинної хірургії імені М. М. Амосова НАМН України», м. Київ, Україна
DOI: https://doi.org/10.30702/ujcvs/20.3803/002007-012
Ключові слова: шкала EuroSCORE, пацієнт високого ризику, вінцеве шунтування, працююче серце

Анотація

Ішемічна хвороба серця залишається однією з найголовніших причин захворюваності та смертності населення розвинених країн. З кожним роком збільшується кількість операцій вінцевого шунтування, особливо пацієнтам високого ризику.

Мета роботи – провести огляд літератури з проблем вінцевого шунтування у пацієнтів високого ризику.

Результати: розглянуті та порівняні шкали ризику, які використовуються в кардіохірургії для визначення ступеня тяжкості пацієнта та вірогідності летального наслідку. Визначені основні похибки шкал EuroSCORE I, II та можливості їх використання в мініінвазивній хірургії. За даними сучасних рандомізованих досліджень, які порівнюють методику вінцевого шунтування на працюючому серці та в умовах штучного кровообігу, не отримано чіткої різниці за ускладненнями залежно від використання штучного кровообігу. Однак треба звернути увагу на малий відсоток пацієнтів високого ризику (18 %, у дослідженні CORONARY). Водночас у роботах багатьох авторів підтримується думка про переваги застосування методики вінцевого шунтування на працюючому серці пацієнтам високого ризику.

Посилання

  1. Mitka M. Heart disease a global health threat. JAMA. 2004;291:2533. https://doi.org/10.1001/jama.291.21.2533
  2. Head SJ, Kaul S, Mack MJ, Serruys PW, Taggart DP, Holmes DR Jr, et al. The rationale for Heart Team decision-making for patients with stable, complex coronary artery disease. Eur Heart J. 2013; 34:2510–8. https://doi.org/10.1093/eurheartj/eht059
  3. Grabowski M, Cacko A, Filipiak KJ, Opolski G. To develop new or to improve existing tools for risk stratification in acute coronary syndromes? Cardiology. 2011;118:124–8. https://doi.org/10.1159/000327168
  4. Michel P, Roques F, Nashef SA; EuroSCORE Project Group. Logistic or additive EuroSCORE for high-risk patients? Eur J Cardiothorac Surg. 2003;23:684–7. https://doi.org/10.1016/s1010-7940(03)00074-5
  5. Nashef SAM, Roques F, Sharples LD, Nilsson J, Smith C, Goldstone AR, et al. EuroSCORE II. Eur J Cardiothorac Surg. 2012;41:734–44; discussion 744–5. https://doi.org/10.1093/ejcts/ezs043
  6. Stavridis G, Panaretos D, Kadda O, Panagiotakos DB. Validation of the EuroSCORE II in a Greek cardiac surgical population: a prospective study. Open Cardiovasc Med. J 2017;11:94–101. https://doi.org/10.2174/1874192401711010094
  7. Garcia-Valentin A, Mestres CA, Bernabeu E, Bahamonde JA, Martin I, Rueda C, et al. Validation and quality measurements for EuroSCORE and EuroSCORE II in the Spanish cardiac surgical population: a prospective, multicentre study. Eur J Cardiothorac Surg. 2016;49:399–405. https://doi.org/10.1093/ejcts/ezv090
  8. Kieser TM, Rose MS, Head SJ. Comparison of logistic EuroSCORE and EuroSCORE II in predicting operative mortality of 1125 total arterial operations. Eur J Cardiothorac Surg. 2016;50:509–18. https://doi.org/10.1093/ejcts/ezw072
  9. Hogervorst EK, Rosseel PMJ, van de Watering LMG, Brand A, Bentala M, van der Meer BJM, et al. Prospective validation of the EuroSCORE II risk model in a single Dutch cardiac surgery centre. Neth Heart J. 2018;26:540–51. https://doi.org/10.1007/s12471-018-1161-x
  10. Provenchere S, Chevalier A, Ghodbane W, Bouleti C, Montravers P, Longrois D, et al. Is the EuroSCORE II reliable to estimate operative mortality among octogenarians? PLoS One. 2017;12:e0187056. https://doi.org/10.1371/journal.pone.0187056
  11. Margaryan R, Moscarelli M, Gasbarri T, Bianchi G, Kallushi E, Cerillo AG, et al. EuroSCORE performance in minimally invasive cardiac surgery: discrimination ability and external calibration. Innovations (Phila). 2017;12:282–6. https://doi.org/10.1097/IMI.0000000000000377
  12. Kunt AS, Darcin OT, Andac MH. Coronary artery bypass surgery in high-risk patients. Curr Control Trials Cardiovasc Med. 2005;6(1):13. https://doi.org/10.1186/1468-6708-6-13
  13. Durand E, Borz B, Godin M, Tron C, Litzler PY, Bessou JP, et al. Performance analysis of EuroSCORE II compared to the original logistic EuroSCORE and STS scores for predicting 30-day mortality after transcatheter aortic valve replacement. Am J Cardiol. 2013;111:891–7. https://doi.org/10.1016/j.amjcard.2012.11.056
  14. Hemmann K, Sirotina M, De Rosa S, Ehrlich JR, Fox H, Weber J, et al. The STS score is the strongest predictor of long-term survival following transcatheter aortic valve implantation, whereas access route (transapical versus transfemoral) has no predictive value beyond the periprocedural phase. Interact Cardiovasc Thorac Surg. 2013;17:359–64. https://doi.org/10.1093/icvts/ivt132
  15. Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017;38:2739–91. https://doi.org/10.1093/eurheartj/ehx391
  16. Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019 Jan 7;40(2):87–165. https://doi.org/10.1093/eurheartj/ehy394
  17. Cheng DC, Bainbridge D, Martin JE, Novick RJ; Evidence-Based Perioperative Clinical Outcomes Research Group. Does off-pump coronary artery bypass reduce mortality, morbidity, and resource utilization when compared with conventional coronary artery bypass? A meta-analysis of randomized trials. Anesthesiology. 2005;102:188-203. https://doi.org/10.1097/00000542-200501000-00028
  18. Lamy A, Devereaux PJ, Prabhakaran D, Taggart DP, Hu S, Paolasso E, et al. Effects of off-pump and on-pump coronary-artery bypass grafting at 1 year. N Engl J Med. 2013;368:1179–88. https://doi.org/10.1056/NEJMoa1301228
  19. Diegeler A, Borgermann J, Kappert U, Breuer M, Boning A, Ursulescu A, et al.; GOPCABE Study Group. Off-pump versus on-pump coronary-artery bypass grafting in elderly patients. N Engl J Med. 2013;368:1189–98. https://doi.org/10.1056/NEJMoa1211666
  20. Lamy A, Devereaux PJ, Prabhakaran D, Taggart DP, Hu S, Straka Z, et al.; CORONARY Investigators. Five-year outcomes after off-pump or on-pump coronary-artery bypass grafting. N Engl J Med. 2016;375:2359–68. https://doi.org/10.1056/NEJMoa1601564
  21. Lazar HL. Should off-pump coronary artery bypass grafting be abandoned? Circulation. 2013;128:406–13. https://doi.org/10.1161/CIRCULATIONAHA.113.003388
  22. Polomsky M, Puskas JD. Off-pump coronary artery bypass grafting – The current state. Circ J. 2012;76:784–90. https://doi.org/10.1253/circj.cj-12-0111
  23. Briffa N. Off pump coronary artery bypass: A passing fad or ready for prime time? Eur Heart J. 2008;29:1346–9. https://doi.org/10.1093/eurheartj/ehn128
  24. Badhwar V, Rankin JS, Thourani VH, D’Agostino RS, Habib RH, Shahian DM, et al. The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2018 Update on Research: Outcomes Analysis, Quality Improvement, and Patient Safety. Ann Thorac Surg. 2018 Jul;106(1):8–13. https://doi.org/10.1016/j.athoracsur.2018.04.052
  25. D’Agostino RS, Jacobs JP, Badhwar V, Fernandez FG, Paone G, Wormuth DW, et al. The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2018 Update on Outcomes and Quality. The Annals of Thoracic Surgery. 2018;105(1):15–23. https://doi.org/10.1016/j.athoracsur.2017.10.035
  26. Kirmani BH, Holmes MV, Muir AD. Long-Term Survival and Freedom From Reintervention After Off-Pump Coronary Artery Bypass Grafting: A Propensity-Matched Study. Circulation. 2016;134(17):1209–20. https://doi.org/10.1161/CIRCULATIONAHA.116.021933
  27. Matkovic M, Tutus V, Bilbija I, Milin Lazovic J, Savic M, Cubrilo M, et al. Long Term Outcomes of The Off-Pump and On-Pump Coronary Artery Bypass Grafting In A High-Volume Center. Sci Rep. 2019;9:8567. https://doi.org/10.1038/s41598-019-45093-3
  28. Calafiore AM, Prapas S, Osman A, Di Mauro M. Coronary artery bypass grafting off-pump or on-pump: another brick in the wall. Ann Transl Med. 2017;5(7):168. https://doi.org/10.21037/atm.2017.03.52
  29. Puskas J, Cheng D, Knight J, Angelini G, Decannier D, Diegeler A, et al. Off-pump versus conventional coronary artery bypass grafting: A meta-analysis and consensus statement from the 2004 ISMICS consensus conference. Innovations (Phila). 2005;1:3–27. https://doi.org/10.1097/01243895-200512000-00002
  30. Panesar SS, Athanasiou T, Nair S, Rao C, Jones C, Nicolaou M, et al. Early outcomes in the elderly: a meta-analysis of 4921 patients undergoing coronary artery bypass grafting–comparison between off-pump and on-pump techniques. Heart. 2006;92(12):1808–16. https://doi.org/10.1136/hrt.2006.088450
  31. Tashiro T, Nakamura K, Morishige N, Iwakuma A, Tachikawa Y, Shibano R, et al. Off-pump coronary artery bypass grafting in patients with end-stage renal disease on hemodialysis. J Card Surg. 2002;17(5):377–82. https://doi.org/10.1111/j.1540-8191.2001.tb01162.x
  32. Sharony R, Bizekis CS, Kanchuger M, Galloway AC, Saunders PC, Applebaum R, et al. Off-pump coronary artery bypass grafting reduces mortality and stroke in patients with atheromatous aortas: a case control study. Circulation. 2003;108(Suppl 1):II15–20. https://doi.org/10.1161/01.cir.0000087448.65888.21
  33. Nagpal AD, Bhatnagar G, Cutrara CA, Ahmed SM, McKenzie N, Quantz M, et al. Early outcomes of coronary artery bypass with and without cardiopulmonary bypass in octogenarians. Can J Cardiol. 2006;22:849–53. https://doi.org/10.1016/s0828-282x(06)70303-8
  34. Srinivasan AK, Grayson AD, Fabri BM. On-pump versus off-pump coronary artery bypass grafting in diabetic patients: A propensity score analysis. Ann Thorac Surg. 2004;78:1604–9. https://doi.org/10.1016/j.athoracsur.2004.04.080
  35. Mack MJ, Pfister A, Bachand D, Emery R, Magee MJ, Connolly M, et al. Comparison of coronary bypass surgery with and without cardiopulmonary bypass in patients with multivessel disease. J Thorac Cardiovasc Surg. 2004;127:167–73. https://doi.org/10.1016/j.jtcvs.2003.08.032
  36. Emmert MY, Salzberg SP, Seifert B, Rodriguez H, Plass A, Hoerstrup SP, et al. Is off-pump superior to conventional coronary artery bypass grafting in diabetic patients with multivessel disease? Eur J Cardiothorac Surg. 2011;40:233–9. https://doi.org/10.1016/j.ejcts.2010.11.003
  37. Li Z, Denton T, Yeo KK, Parker JP, White R, Young JN, et al. Off-pump bypass surgery and postoperative stroke: California coronary bypass outcomes reporting program. Ann Thorac Surg. 2010;90:753–9. https://doi.org/10.1016/j.athoracsur.2010.04.018
  38. Mukherjee D, Ahmed K, Baig K, Patel VM, Darzi A, Athanasiou T. Conversion and safety in off-pump coronary artery bypass: A system failure that needs re-emphasis. Ann Thorac Surg. 2011;91:630–9. https://doi.org/10.1016/j.athoracsur.2010.10.031
  39. Vassiliades TA, Jr, Nielsen JL, Lonquist JL. Hemodynamic collapse during off-pump coronary artery bypass grafting.Ann Thorac Surg. 2002;73:1874–9. https://doi.org/10.1016/s0003-4975(02)03592-0
  40. Jin R, Hiratzka LF, Grunkemeier GL, Krause A, Page US 3rd. Aborted off-pump coronary artery bypass patients have much worse outcomes than on-pump or successful off-pump patients. Circulation. 2005;112(9 Suppl):I332–7. https://doi.org/10.1161/CIRCULATIONAHA.104.526228
  41. Mukherjee D, Rao C, Ibrahim M, Ahmed K, Ashrafian H, Protopapas A, et al. Meta-analysis of organ damage after conversion from off-pump coronary artery bypass procedures. Ann Thorac Surg. 2011;92:755–61. https://doi.org/10.1016/j.athoracsur.2011.05.037
  42. Edgerton JR, Dewey TM, Magee MJ, Herbert MA, Prince SL, Jones KK, et al. Conversion in off-pump coronary artery bypass grafting: An analysis of predictors and outcomes. Ann Thorac Surg. 2003;76:1138–42. https://doi.org/10.1016/s0003-4975(03)00747-1
  43. Mujanovic E, Kabil E, Hadziselimovic M, Softic M, Azabagic A, Bergsland J. Conversions in off-pump coronary surgery. Heart Surg Forum. 2003;6:135–7. https://doi.org/10.1532/hsf.885
  44. Hayatsu Y, Ruel M, Sun LY. Renal insufficiency and severe coronary artery disease: should coronary artery bypass grafting, off-pump coronary artery bypass grafting or percutaneous coronary intervention be performed? Current Opinion in Cardiology. Curr Opin Cardiol. 2019 Nov;34(6):645–9. https://doi.org/10.1097/HCO.0000000000000687
  45. Raja SG. Total arterial off-pump coronary revascularization: The Holy Grail? Current Opinion in Cardiology. Curr Opin Cardiol. 2019 Sep;34(5):552–6. https://doi.org/10.1097/HCO.0000000000000645
  46. Garcia Fuster R, Montero JA, Gil O, Hornero F, Canovas SJ, Dalma MJ, et al. Advantages of off-pump coronary bypass surgery in high-risk patients. Rev Esp Cardiol. 2002;55:383–90.
  47. Dhurandhar V, Saxena A, Parikh R, Vallely MP, Wilson MK, Butcher JK, et al. Outcomes of On-Pump versus Off- Pump Coronary Artery Bypass Graft Surgery in the High Risk (AusSCORE > 5). Heart Lung Circ. 2015;24:1216–24. https://doi.org/10.1016/j.hlc.2015.02.009
  48. Kowalewski M, Pawliszak W, Malvindi PG, Bokszanski MP, Perlinski D, Raffa GM, et al. Off-pump coronary artery bypass grafting improves short-term outcomes in high-risk patients compared with on-pump coronary artery bypass grafting: Meta-analysis. J Thorac Cardiovasc Surg 2016;151:60–77. e1–58. https://doi.org/10.1016/j.jtcvs.2015.08.042
  49. Wang J, Gu C, Gao M, Yu W, Li H, Zhang F, et al. Comparison of the incidence of postoperative neurologic complications after on-pump versus off-pump coronary artery bypass grafting in high-risk patients: A meta-analysis of 11 studies. Int J Cardiol. 2015;185:195–7. https://doi.org/10.1016/j.ijcard.2015.03.115
  50. Hlavicka J, Straka Z, Jelinek S, Budera P, Vanek T, Maly M, et al. Off-pump versus on-pump coronary artery bypass grafting surgery in high-risk patients: PRAGUE-6 trial at 30 days and 1 year. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2016;160:263–70. https://doi.org/10.5507/bp.2015.059
  51. Cartier R. Off-pump coronary artery revascularization in octogenarians: is it better? Current Opinion in Cardiology. 2009 Nov;24(6):544–52. https://doi.org/10.1097/HCO.0b013e32833124f5
  52. Kerendi F, Morris CD, Puskas JD. Off-pump coronary bypass surgery for high-risk patients: only in expert centers? Current Opinion in Cardiology. 2008;23(6):573–8. https://doi.org/10.1097/HCO.0b013e328312c311
Опубліковано
2020-03-24
Як цитувати
Гогаєва, О. К. (2020). Вінцеве шунтування в пацієнтів високого ризику (літературний огляд). Український журнал серцево-судинної хірургії, (1 (38), 7-12. https://doi.org/10.30702/ujcvs/20.3803/002007-012
Номер
Український журнал серцево-судинної хірургії № 1 (38) 2020
Розділ
ІШЕМІЧНА ХВОРОБА СЕРЦЯ

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