降主动脉“Y”形血管桥在微创冠状动脉搭桥术中的应用

The using of "Y" blood vessel graft anastomosis in coronary artery bypass surgery

目的探讨降主动脉“Y”形血管桥在冠状动脉搭桥术的临床疗效和价值。方法对 16例升主动脉增宽、钙化的冠心患者在胸腔镜下游离乳内动脉,小切口左侧开胸非体外循环下实施冠状动脉搭桥术,其中男11例,女5例。年龄51～75岁,平均(60．5±10．5)岁。均为多支冠状动脉病变。术中应用“Y”形血管桥与降主动脉端侧吻合。结果全组无死亡,术后机械辅助呼吸平均(8．7±6．5)h。ICU叫滞留时间平均(3．1±0．5)d。全组病例均未输血。术后随访1～17个月。所有患者心绞痛症状消失,活动量增加。结论采用降主动脉“Y”形血管桥供血可避免升主动脉壁损伤是实施冠状动脉搭桥术微创化的一种新术式。早期结果令人满意。

Objective To review the clinical results of descending thoracicaorta ＂＇Y＂ blood vessel graft anastomosis, Methods 16 patients whose ascending aorta were calcificated underwent coronary bypass surgery with MIDCAB, Age range was from 51 to 75 years with a mean of 60.5 ± 10.5 years. Patients suffered from multi-vessel disease, We used many minimally invasive techniques including ＂Y＂ blood vessel graft anastomosis, anastomosis of blood vessel graft to descending aorta, minimally invasive direct and thoracoscope assist, etc. Results All patients were survived. The mean duration of intuhafion was 8.7± 6.5 hours. The average ICU stay were 3.1 ± 0.5 days. All patients were not blood transfused, All survived patients had no symptoms of angina during the short-term follow-up（ 1 to 17 months）. Conclnsion Descending thoracic aorta ＂Y＂ blood vessel graft anastomosis was a new procedure for minimally invasive direct coronary artery bypass. The earlier outcome was satisfacted,