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Master Thesis

Incidence et signification clinique de la variation du strain VG péri-CEC en chirurgie cardiaque : comparaison de la chirurgie de remplacement valvulaire aortique et de la chirurgie de revascularisation myocardique

Abstract : To assess the intraoperative factors associated with AvgGLS deterioration after cardiac surgery we retrospectively analyzed 2 cohorts of patients with CABG or AVR surgery. The objective was to investigate the role of the type of procedure in the incidenceand severity of AvgGLS impairment after CPB. Methods: surgery was performed with normothermic CPB and blood cardioplegia. AvgGLS was measured by TEE under general anesthesia before and after CPB. We recorded demographic and procedural data, early post-operative complications, ventilator time, ICU and hospital LOS, MACE occurrence and survival. A threshold of +10% was defined as a decrease of AvgGLS. Results: 145 patients (AVR: 71, CABG 74) with complete TEE were included and retrospectively analyzed. AvgGLS was decreased in 73.2% of AVR group and 62.1% of CABG group (NS). AvgGLS decreased significantly after CPB in both groups: CABG: -13.6+/-4.3 vs -10.9+/-5.5, p = 0.0002 and AVR -13.1+/-4 vs -10.3+/-4.3 p = 0.0001. AVR and CABG groups were significantly different for LV weight, CPB time, clamp time, ICU LOS. There was no difference between groups for age, pre and postop LVEF, pre and postop CPBAvgGLS, hematocrit, troponine, hospital LOS and complication rate. Conclusion: perioperative AvgGLS alteration occurs in 67.6% of our cardiac surgery patients. Despite significant anatomical and procedural differences, AVR and CABG patients have similar rate and depth of AvgGLS alteration after CPB.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03167604
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Submitted on : Friday, March 12, 2021 - 11:27:06 AM
Last modification on : Monday, October 11, 2021 - 1:25:03 PM
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  • HAL Id : dumas-03167604, version 1

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Charlotte Leclercq. Incidence et signification clinique de la variation du strain VG péri-CEC en chirurgie cardiaque : comparaison de la chirurgie de remplacement valvulaire aortique et de la chirurgie de revascularisation myocardique. Médecine humaine et pathologie. 2021. ⟨dumas-03167604⟩

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