全动脉化冠状动脉旁路移植74例

Total arterial coronary artery bypass grafts for myocardial revascularization: Report of 74 cases

目的:介绍全动脉化冠状动脉旁路移植(CABG)的早期效果和经验.方法:74例全动脉化CABG的患者.74例患者分别在体外循环(CPB)和非CPB下行CABG.应用左乳内动脉(IMA)1例,左IMA加单挠动脉(RA)14例,左IMA加双RA 54例,双IMA加双RA 3例,双RA 2例.人均搭桥4.7(1～7)支,序贯吻合66例,'Y'和'T'型吻合分别为15和6例.结果:围手术期无死亡.本组患者随访5～18(平均12.2)个月,均恢复良好,无心绞痛症状再发.多普勒和16排CT示血管桥无狭窄通畅.结论:全动脉化CABG取得好的早期效果,是一种值得积极推广的方法.

AIM ： To evaluate the early outcome of total arterial coronary artery bypass grafts myocardial revaseularization. METHODS：Seventy-four （59 male and 15 female） patients with mean age of 61.5 years underwent coronary bypass operation using total arterial grafts, 68 receiving the surgical procedure under on pumping and 6 off pumping. Left internal mammary artery （IMA） was used in 1 case, left IMA and single radial artery （RA） in 14 ,left IMA and bilateral RA in 54, bilateral IMA and RA in 3 and bilateral RA in 2. Mean conduits were 4.7 （ 1-7 ） grafts. Anastomosis of sequence was performed in 66 eases, Y-composite graft in 15 cases and T-composite graft in 6 incases. RESULTS：There was no death in early postoperative period. No angina pectoris recurred during the follow-up study for 5-18 （mean 12.2） months. Uultrasonongraphy and CT（light-speed16） scan showed that artery grafts were patent in all patients. CONCLUSION：Application of IMA and RA in coronary surgery can achieve satisfactory results.