冠状动脉傍路移植术17例

AORTOCORONARY BYPASS GRAFTING:A REPORT OF 17 CASES

17例主动脉-冠状动脉傍路移植术(搭桥术)全部存活。全组均有心绞痛史。选择性冠状动脉及左心室电影造影示1支冠状动脉狭窄者2例,2支狭窄者3例,3支狭窄者10例,4支狭窄者2例;左心室射血分数(EF)均在0.30以上。17例共搭桥25根,其中直接搭桥12根,序贯式搭桥13根。共作46支冠状动脉远端吻合口,平均每位病人作2.7支。术后心绞痛均消失。高龄病人并非作为搭桥术的严格限制条件。术前选择EF在0.30以上;术中血运重建满意;木后有Swan-Ganz导管的血液动力学监护,均能取得良好的结果。本文并介绍蛇形搭桥的优点和适应症。

Seventeen patients underwent coronary artery bypassgrafiting (CABG) whithout mortality. All cases had a history of angina pectoris preope- ratively. A selected coronary artery and left ventricular cineangiocardiography was performed in each patient. A single-vessel stenosis of coronary artery was present in 2 patients, a double-vessel stenosis in 3 patients, a triple- vessel stenosis in 10 patients and a double-vessel stenosis in 2 patients. The left ventricular ejectioh fraction was more than 0.30 in whole group. Twenty five bridges were done in 17 cases. Twelve of them were single graftings and 13 bridges were sequential graftings. There were 46 distal anastomoses in all. On an average, 2.7 coronary arteries per case were bypassed. The angina of each case disappeared post-operatively. The high-aged patient is not the rigorously restricted indication for CABG. CABG will get successful if we select the EF over 0.3O preoperatively, myocardial revascula-rization is satisfactory during operation and the hemodynamics is monitored by Swan-Ganz catheter postope- ratively. This article also introduced the advantage and indication of sequential grafting.