严重左心室功能不全冠心病的外科手术治疗

Surgical treatment in patients suffering from coronary artery disease with left ventriculcar dysfunction

目的总结严重左心室功能不全（LVEF≤35％）冠心病患者行冠状动脉旁路移植术（CABG）的临床经验。方法回顾性研究分析23例有严重左心室功能不全冠心病患者行CABG的临床资料，其中合并左主干病变18例，合并室壁瘤6例，合并室间隔穿孔1例；16例采取非体外循环下冠状动脉旁路移植术，7例在体外循环下行冠状动脉旁路移植术。结果死亡2例，21例患者治愈出院。随诊6～36个月，无死亡．2例患者有心绞痛发作。结论CABG术对有严重左心室功能不全的冠心病是有效的治疗方法，手术效果取决于存活心肌的多少和可再血管化血管的数量。

Objective To summarize with severe left ventricular dysfunction in patients with coronary artery disease （LVEF≤35%） undergoing coronary artery bypass grafting clinical experience. Methods A retrospective analysis in 23 patients with severe left ventrieular dysfunction in patients with coronary heart disease undergoing coronary artery bypass grafting clinical data. With left main coronary artery disease 18 eases, 6 cases of ventrieular aneurysm, ventricular septal perforation 1 cases. 16 cases were undergone off-pump coronary artery bypass grafting, 7 patients in eardiopulmonary bypass coronary artery bypass grafting. Results 2 cases died, 21 cases were cured and discharged. Followed up for 6 to 36 months, no death, there were two cases of patients with angina attack. Conclusion CABG surgery for severe left ventricular dysfunction in patients with coronary artery disease is an effective treatment＂ method, operation effect depends on how much can be viable myocardium, revascularization vascular volume.