不停跳冠状动脉旁路移植术中紧急建立体外循环的实施体会

Implementation strategies of emergency cardiopulmonary bypass in off- pump coronary artery bypass grafting surgery

目的总结不停跳冠状动脉旁路移植术(OPCAB)体外循环的准备及术中紧急转机完成手术的体会。方法本院自2004年1月至2014年7月共完成冠状动脉旁路移植术243例,其中OPCAB 197例,干备12例,湿备16例,常备169例。因术中病情突变,药物无法控制或除颤无效紧急转机13例。结果 13例紧急体外循环,平均体外循环时间(144.40±61.97)min,平均住院(17.38±7.16)d治愈出院,1例术后第三天死于严重低心排。结论 OPCAB术中预先的紧急体外循环的应对策略是必要的。

Objective To summarize the experience of preparation and emergency foundation of cardiopulmonary bypass（ CPB） in off-pump coronary artery bypass grafting（ OPCAB） surgery. Methods Of 243 cases of coronary artery bypass grafting（ CABG） surgery were completed in our hospital from January 2004 to July 2014. 197 were OPCAB. CPB circuits were preparedin all cases including 12 with dry preparation,16 with wet preparation,and 169 of them with normal preparation. A total of 13 OPCAB were converted to CPB because of lack of response to drugs or electric defibrillation. Results The average CPB time and hospital stays were144. 4±61. 97 minutes and 17. 38±7. 16 days,respectively. 1 of the 13 patients died of low cardiac output syndrome. Conclusion The implementation strategy of emergency cardiopulmonary bypass in OPCAB is feasible.