非体外循环心脏不停跳冠状动脉搭桥术(附40例报告)

OFF-PUMP CORONARY ARTERY BYPASS GRAFTING WITH BEATING-HEART IN 40 CASES

目的 :评价非体外循环心脏不停跳冠状动脉搭桥术的临床价值及意义。方法 :自 2 0 0 1年 6月至 2 0 0 3年 1 0月 ,采用非体外循环心脏不停跳技术 ,给 4 0例冠心病患者行冠状动脉搭桥术 (OPCABG) ,术中使用 CTS心脏固定器。有 3例患者术前使用主动脉内球囊反搏 (IABP)。选用的血管材料有 :乳内动脉 4 2支、桡动脉 2 5支、大隐静脉 4 9支、头静脉 1支。共搭桥 1 1 7支 ,平均 2 .93支。结果 :术后心绞痛症状全部缓解 ,全组无围术期急性心肌梗死 ,无死亡病例。住院 1 3～ 4 5 d,平均 1 9.5 2 d。结论 :非体外循环冠状动脉搭桥手术简便、安全、有效、经济 ,不仅适用于多支病变患者 。

Objective:To evaluate the clinial value and significance of off pump coronary artery bypass grafting.Methods:From June 2001 to October 2003 , off pump coronary artery bypass grafting with beating heart were applied to 40 patients suffering from severe coronary artery disease. Stabilizers of CTS were used during operation. Inter aortic ballon pump (IABP) was used in 3 cases preoperatively. The grafts include: bilateral mammary artery in 42 cases, radial artery in 25 cases, saphenous vein in 49 cases,and cephalic vein in 1 case. The average number of graft is 2 93 pieces per case.Result:No off pump was changed to on pump and nor myocardium infarction condition happened post operatively and nor mortality in this group. All cases recovered smoothly. Patients stayed in hospital from 13～45 days,no an average of 19 52 days.Conclusion:Off pump coronary artery bypass grafting is safe, effective,economical for multivascular diseases and severe cases.