Enclose Ⅱ在148例非体外循环冠脉旁路移植术中的临床应用分析

Clinical Analysis of 148 Cases with Enclose Ⅱ proximal anastomosis device in off-pump coronary artery bypass

目的 总结冠脉搭桥近端吻合辅助器（Enclose Ⅱ）在不停跳冠状动脉脉旁路移植术（OPCAB）中应用的临床经验和体会.方法 自2009年8月至2013年5月我们对148例冠心病患者在施行OPCAB手术时应用Enclose Ⅱ行主动脉近端吻合,男性109例,女性39例,年龄51～83（60.1±3.2）岁.结果 应用Enclose Ⅱ完成近端吻合口298个,其中大隐静脉与升主动脉近端吻合263个,桡动脉35个,平均（2.01±0.80）个吻合口/例.围术期无死亡,无心肌梗死和脑卒中,术中未出现升主动脉破裂和急性主动脉夹层.结论 OPCAB术中应用EncloeⅡ完成近端吻合口,减少和减轻了对升主动脉的操作和损伤,尤其对主动脉钙化严重的患者,能有效避免因主动脉操作而引起主动脉破裂和急性主动脉夹层的发生,降低因斑块脱落引起的围术期心肌梗死和脑卒中的发生.

Objective The objective of this study was to review the experience and understanding of a new proximal anastomotic device- Enclose II during off-pump coronary artery bypass grafting surgery. Methods From August,2009 to May,2013,a total of 148 patients（109 males and 39 females,mean age,60.1± 3.2 years）underwent proximal anastomosis with the Enclose II proximal anastomotic device in off-pump coro- nary artery bypass graft （OPCAB）. Results A total of 298 proximal anastomoses were performed with this technique,average 2.01 ±0.80 per patient,without technical problem or failure. There was no perioperative death, acute myocardial infarction and stroke, meanwhile there was no aortic dissection and repture in all pa- tients. Conclusion The Enclose I1 could be used for proximal anastomosis in OPCAB, and it may minimiz the aortic operation and injury, especially for the patients with severe aortic calcification, which could prevent acute aortic dissection and repturc, meanwhile it could reduce the perioperative acute myocardial infarction and stroke because of plaque off.