超声刀在骨骼化乳内动脉采取中的应用

The application of ultrasonic scalpel in skeletonized internal mammary artery harvesting

目的总结超声刀在骨骼化乳内动脉血管桥采取中的使用经验。方法回顾性分析日本顺天堂大学医院60例接受了超声刀采取的双侧乳内动脉血管桥进行单纯冠状动脉旁路移植术冠心病患者的临床资料及随访资料。结果远端吻合口平均（4．1±1．5）个。术后并发严重心律失常2例，脑梗塞合并败血症、弥漫性血管内凝血合并多脏器功能衰竭各1例，肺部感染2例，手术死亡2例。术后随访（15．6±3．2）个月，远期无死亡或心脏性事件患者。结论超声刀的应用使乳内动脉的骨骼化采取变得安全、简单。骨骼化双侧乳内动脉在冠状动脉旁路移植中具有良好的早期效果。

Objective To summarize and analyze the clinical experience in the use of ultrasonic scalpel in skeletonized internal mammary artery harvesting. Methods A retro-respective review was made to 60 patients underwent isolated coronary artery bypass grafting using bilateral skeletonized internal mammary artery harvested by ultrasonic scalpel in Juntendo University Hospital. Results The number of distal anastomoses was （4. 1±1.5）. Major complications included severe arrhythmia in 2 patients, cerebral infarction complieated with sepsis in 1 , diffuse intravescular coagulopathy complicated with multiple organ failure in 1 patient, aud pneumonia in 2 patients. There were 2 patients dead in-hospital. The mean follow-up period was （ 15.6±3.2） months. There was no late death or cardiac-related events during the follow-up periods. Conclusion It is simple and safe to skeletonize the internal mammary artery using the ultrasonic scalpel. The early effect of bilateral skeletonized internal mammary artery grafting was satisfactory.