非体外循环下冠脉搭桥术28例临床分析

Clinical Analysis of Off-Pump Coronary Artery Bypass Grafting on Beating Heart:A Report of 28 Cases

目的评价非体外循环下冠脉搭桥术的临床效果。方法2001年8月-2006年10月共行非体外循环下冠脉搭桥术28例。采用胸骨正中切口,取乳内动脉、大隐静脉及桡动脉,使用心肌表面局部固定器及冠状动脉塞子,连续缝合搭桥共62支,平均(2.2±0.8)支。结果全部手术成功,无死亡病例,术后心功能明显改善,随访3～24个月,所有患者心绞痛均明显缓解。结论非体外循环下冠脉搭桥术临床效果好,费用低,手术安全,减少体外循环术后并发症,适宜单、多支冠状动脉病变和具有高风险因素的患者。

Objective To assess the clinic effect of off-pump coronary artery bypass grafting（OPCABG） on the beating heart. Methods The clinical data of 28 cases with OPCABG from 2001 to 2006 were analyzed retrospectively. In the median incision of sternum,with internal mammary artery,great saphenous vein or radial artery,62 branches （average 2.2 ± 0. 8） of continues suture bypass grafting were made by local fixed appliance on myocardium and coronary cork. Results All operation achieved success. The cardiac function was improved obviously. The follow-up of 3 to 24 months showed that the angina cordis was remitted in all cases. Conclusions OPCABG is a safe and less expensive therapeutic modality for patients requiring myocardial revascularization. The postoperative complications in extracorporeal circulation operation should be avoided. OPCABG is a proper choice for single-or multi-branched coronary artery disease and patients with high risky factor.