自体桡动脉在老年患者冠状动脉旁路移植手术中的应用

The radial artery for coronary bypass grafting in the elderly

目的探讨自体桡动脉材料在老年患者冠状动脉旁路移植手术中应用的临床特点.方法总结131例老年患者(60～76岁)和92例非老年患者(41～59岁)在施行冠状动脉旁路移植手术中应用自体桡动脉的临床资料,分析老年患者使用自体桡动脉作为移植材料的特点和获取后的变化.结果采用非体外循环技术的老年患者87例,非老年患者49例,采用体外循环技术的老年患者44例和非老年患者43例.老年组应用自体桡动脉134支,平均移植3.2支,动脉桥(桡动脉+内乳动脉)2.0支,死亡1例,死于术后恶性心率失常及严重低心排;非老年组应用自体桡动脉94支,平均移植3.2支,动脉桥(桡动脉+内乳动脉)2.0支.两组均未发生术后移植血管痉挛、手臂缺血坏死或功能减退.结论自体桡动脉在老年患者冠状动脉旁路移植术中应用可获得较好的近期临床效果.

Objective To evaluate the feasibility of the use of autologous radial artery (RA) in the coronary bypass grafting in the elderly Methods From June 1998 to December 2003, 131 cases of coronary bypass revascularization with autologous RA in patient aged at least 60 years old were performed under off pump coronary artery bypass and warm heart bypass Results Totally 134 RAs were used The mean number of anastomoses performed per patient was 3 2, including 2 0 arterial graft One patient died (0 8%) No perioperative spasm occurred There was no ischemia or function reduction in harvested hands Conclusions The clinical results are good in coronary bypass operations using autologous RA in elderly patients It provides one more selection of arterial graft for elderly patients