|
Cardiovascular (heart) surgery is surgery on the heart or great vessels performed by cardiac surgeons. Frequently, it is done to treat complications of ischemic heart disease (for example, coronary artery bypass grafting), correct congenital heart disease, or treat valvular heart disease from various causes including endocarditis, rheumatic heart disease and atherosclerosis. It also includes heart transplantation. ==Risks== The development of cardiac surgery and cardiopulmonary bypass techniques has reduced the mortality rates of these surgeries to relatively low ranks. For instance, repairs of congenital heart defects are currently estimated to have 4–6% mortality rates. A major concern with cardiac surgery is the incidence of neurological damage. Stroke occurs in 2–3% of all people undergoing cardiac surgery, and is higher in patients at risk for stroke. A more subtle constellation of neurocognitive deficits attributed to cardiopulmonary bypass is known as postperfusion syndrome, sometimes called "pumphead". The symptoms of postperfusion syndrome were initially felt to be permanent, but were shown to be transient with no permanent neurological impairment. Hospital readmissions often occur in cardiac surgery patients; in 2010, approximately 18.5% of patients who had a heart valve procedure in the United States were readmitted within 30 days of the initial hospitalization.〔Weiss AJ, Elixhauser A, Steiner C. ''Readmissions to U.S. Hospitals by Procedure, 2010.'' HCUP Statistical Brief #154. Agency for Healthcare Research and Quality. April 2013.()〕 In order to assess the performance of surgical units and individual surgeons, a popular risk model has been created called the EuroSCORE. This takes a number of health factors from a patient and using precalculated logistic regression coefficients attempts to give a percentage chance of survival to discharge. Within the UK this EuroSCORE was used to give a breakdown of all the centres for cardiothoracic surgery and to give some indication of whether the units and their individuals surgeons performed within an acceptable range. The results are available on the CQC website.〔http://heartsurgery.cqc.org.uk/ CQC website for heart surgery outcomes in the UK for 3 years ending March 2009〕 Neuropsychological and psychopathologic changes following open heart surgery have been recognized from the very beginning of modern heart surgery. Variables correlated with nonpsychotic mental disorder after cardiac surgery must be divided into pre-, intra- and postoperative. The incidence, phenomenology, and duration of symptoms diverge from patient to patient, and are difficult to define. One wonders whether any of the patients in either group in this analysis underwent any mechanical cardiac valve replacement. If so, one has to consider Skumin syndrome, described by Victor Skumin in 1978 as a "cardioprosthetic psychopathological syndrome" associated with mechanical heart valve implant and manifested by irrational fear, anxiety, depression, sleep disorder, and asthenia.〔Ruzza, Andrea. ("Nonpsychotic mental disorder after open heart surgery" ) ''Asian Cardiovascular and Thoracic Annals'' (2013)〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Cardiac surgery」の詳細全文を読む スポンサード リンク
|