Objective:To investigate the perioperative safety of off-pump coronary artery bypass grafting(OPCABG)in syphilis seropositive patients.Methods:A retrospective study was conducted to select 868 patients who received OPCAB treatment in the Department of Cardiovascular Surgery of the First Affiliated Hospital of Nanjing Medical University from January 2019 to December 2022.According to the results of preoperative treponema pallidum gelatin particle agglutination test(TPPA),they were divided into a research group(20 cases)and a control group(848 cases).The proportion of propensity score 1:1 was used to match,forming 20 cases in the research group and 20 cases in the control group.The cardiovascular indicators related to syphilis infection,the number of grafts,operation time,mechanical ventilation time,length of intensive care unit(ICU)stay,postoperative complication rate and mortality were compared between the two groups,and statistical analysis was conducted.Results:The differences of cardiovascular indicators related to syphilis infection in the observation group and the control group were not statistically significant(all P＞0.05),such as the proportion of aortic valve regurgitation(20%vs.15%),the diameter of the ascending aorta(30.2±2.2)mm vs.(30.0±3.1)mm,and the proportion of coronary ostium stenosis(5%vs.0%).Surgery-related indicators in the two groups,such as the number of grafts(3.9±0.8 vs.3.4±0.8),the operation time(259.8±52.3 min vs.257.0±49.4 min),the mechanical ventilation time(37.8±25.0)h vs.33.0±12.8)h,and the length of ICU stay(3.7±2.1)d vs.(3.8±2.1)d showed no statistical difference(all P＞0.05).There were no statistically significant differences between the groups in complications such as the incidence rates of postoperative blood transfusion,pulmonary infection,malignant arrhythmia,dialysis,intra-aortic balloon pump(IABP)therapy and perioperative mortality(all P＞0.05).Conclusion:OPCABG can be safely performed on TPPA positive coronary heart disease patients,and definitive diagnosis and individualized treatment of these patients can reduce the surgeon's risk of syphilis infection.
维普
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