Early Efficacy Of Two Kinds Of Revascularization In The Patients With Coronary Heart Disease Complicated With Left Ventricular Dysfunction

BackgroundWith the developments of society and the aging of the population,the prevalence of coronary heart disease(CHD)is increasing year by year.Long-term coronary artery stenosis or occlusion causes myocardial ischemia or infarction,The three mechanisms of scar formation and myocardial stunning and myocardial hibernation gradually develop left cardiac dysfunction,leading to left ventricular dysfunction(LVD).At present,revascularization is one of the common and effective methods for the treatment of CHD with LVD,which can improve the symptoms of cardiac insufficiency in these patients and reduce the incidence of cardiac events.In recent years,with the continuous advancements of medical technology and scientific research,new ideas and new technologies for the treatment of CHD have emerged in an endless stream.However,the key to the treatment of such patients is still how to obtain a safe and reliable way of revascularization.ObjectiveComparing the analysis of on-pump beating heart coronary artery bypass grafting(On-PBH)and off-pump coronary artery bypass grafting(OPCABG)for patients with coronary heart disease combined with left ventricular dysfunction under cardiopulmonary bypass Early efficacy.MethodsThe clinical data of 88 patients admitted to the First Affiliated Hospital of Xinxiang Medical University from September 2015 to December 2017 with CHD complicated with LVD(left ventricular ejection fraction LVEF?50%)were retrospectively reviewed.Among the patients,37 underwent On-PBH and 51 received OPCABG.The perioperative data were collected between the two groups.The left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter(LVEDD)were measured by echocardiography before and after surgery for 3 months to evaluate the change of left ventricular function and geometry.ResultsThere was no statistic difference in any baseline characteristics between the two groups(P>0.05).The number of grafts in the On-PBH group was higher than that of the OPCABG g r o u p(P<0.05).Compared with On-PBH group,the operation time,ventilator-assisted time,post operative hospital stay,CSICU hospital stay,blood transfusion and hospitalization were significantly reduced(P <0.0 5),postoperative complications and IABP(P<0.05).There was no significant difference in vasoactive drugs and recurrence of angina within 3 months between the two groups(P>0.05).At 3h and 24 h after operation,cTnI in both On-PBH and OPCABG groups was significantly higher than before operation(P<0.05),and cTnI levels in On-PBH group at 3h and 24 h after operation were significantly higher than those in OPCABG group(P < 0.05).Left ventricular ejection fraction and left ventricular end diastolic diameter were significantly improved in the two groups(P<0.01);the LVEF and LVEDD of OPCABG group improved significantly after surgery for 3 months compared with On-PBH(P<0.05)?There was statistical significant differences in terms of LVEF before and after surgery between the two groups(P<0.05),there was statistical significant differences in terms of LVEDD before and after surgery between the two groups(P<0.05).ConclusionFor patients with CHD complicated with LVD,both On-PBH and OPCABG are effective and feasible treaments;Two revascularization methods can significantly improve the early cardiac function of patients,but the OPCABG group is more significant than On-PBH in early efficiency.