冠動脈再建術人工心肺離脱期にみられる左室局所壁運動異常の検討

抄録

To determine if a relationship exists between intraoperative regional wall-motio abnormalities (RWMAs) and postoperative adverse outcomes, 87 patients who were undergoing elective coronary artery bypass graft surgery were studied prospectively using continuous transesophageal echocardiography (TEE). New RWMAs occured in 47% (41) of the patients during operation and in 31% (27) during cardio-pulmonary bypass terminating period (WEAN). Thirty patients had abnornal CK-MB level at ICU arrival (ENZ), and there were 10 perioperative myocardial infarctions (PMI) and 17 low-output syndromes (LOS) during ICU stay. RWMA in WEAN was significantly assosiated with all of the postoperative adverse outcomes and had 4.0-fold increase in the odds of PMI (95% confidence interval: 1.03-15.6), 3.3-fold of LOS (C.I.: 1.1-9.7), and 4.8-fold of ENZ (C.I.: 1.8-12.6). We conclude that patient subgroup who are at high risk for developing postoperative adverse outcomes can be identified intraoperatively by TEE.