复合移植血管桥在冠脉外科中的应用现状

Current Clinical Application of Composite Grafting Techniques in Coronary Artery Bypass Grafting

复合移植血管桥技术已成为冠状动脉旁路移植术(CABG)的常用移植策略之一,尤其适合于高龄患者、术中遇到突发情况及需要全动脉化冠状动脉旁路移植术的患者。它不仅解决了移植桥血管材料短缺的突发情况,尽可能达到完全再血管化,而且减少了因升主动脉操作而导致的脑血管意外发生,并且取得了良好的短期及中期临床效果。现就各种复合移植血管桥手术方式及其改进、临床效果、目前存在的争议进行综述。

Composite grafting techniques is a commonly used strategy in coronary artery bypass grafting, especially suits elderly patients. It is an attractive myocardial revascularization strategy when the grafts are not sufficient to achieve complete myocardial revascularization. Furthermore, composite grafting in the presence of a diseased aortic wall seems a rational approach to reduce the incidene of postoperative neurological deficit or stroke by avoiding the manipulation of atherosclerotic aorta. Also,it gained excellent short- and mid-term results. This review provides an overview of the various surgical techniques, outcomes, concerns and controversies associated with composite grafting.