分站式杂交技术在多支冠状动脉血运重建中的应用

Application of staged hybrid in revascularization of multiple coronary artery

目的总结胸腔镜下左侧胸壁小切口冠状动脉旁路移植术联合经皮冠状动脉支架植入术治疗冠心病多支病变的临床经验。方法回顾性分析东风总医院心胸大血管外科2014年4月至2015年1月采用分站式杂交技术进行冠状动脉血运重建的10例多支冠状动脉病变患者的临床资料。结果 10例患者手术全部顺利完成,未出现围手术期死亡。后期介入治疗前行冠状动脉造影提示患者冠状动脉吻合口通畅。围术期并发症:肺部感染1例,切口脂肪液化1例。随访3~23个月,平均(14.0±8.8)个月,患者恢复正常工作及生活。结论胸腔镜辅助下分站式杂交技术治疗冠状动脉多支血管病变的近、中期疗效满意,长期的治疗效果有待于进一步随访。

Objective To summarize the clinical experience of video-assisted minimally invasive direct coronary artery bypass （VA-MIDCAB） combined with percutaneous transluminal coronary intervention （PTCI） in treatment of multiple coronary atherosclerotic cardiopathy （CHD）. Methods The clinical data of ten patients with multiple CHD who underwent revascularization of coronary artery by staged hybrid in General Hospital of Dongfeng Motor Corporation Affil- iated to Hubei University of Medicine from April 2014 to January 2015 were retrospectively reviewed. Results The op- eration of the ten patients was successful, and there was no perioperative death. Coronary artery angiography showed coronary anastomosis patency before the late intervention treatment. There were 1 case of pulmonary infection and 1 case of fat liquefaction of incision during the perioperative period. The patients were followed up for 3 to 23 months, （14±8.8） months in average, and the patients returned to normal work and life. Conclusion The short- and mid-term effect of staged hybrid under thoracoscope in the treatment of CHD is satisfactory, but long-term effect needs further fol- low-up for confirmation.