桡动脉-大隐静脉组合V形桥在冠状动脉旁路移植术中的应用

V-composite grafting with the saphenous vein and radial artery in coronary artery bypass grafting

目的:对桡动脉-大隐静脉组合V形桥新术式的安全性和近期移植血管通畅率进行初步探讨。方法:选自2015年4月至2016年3月,我院共完成29例桡动脉-大隐静脉组合V形桥冠状动脉旁路移植(CABG)术。平均年龄(65.3±8.2)岁,女性4例(16%)。将大隐静脉与升主动脉做近端吻合,桡动脉与该大隐静脉端侧吻合,吻合口距升主动脉的距离≤0.5 cm。对术后30 d死亡率,桡动脉-大隐静脉组合V形桥吻合口以及远端吻合口的近期通畅性(术后6个月)进行影像学评价。结果:术后30 d死亡率为零;术后6个月对桡动脉-大隐静脉组合V形桥吻合口及远端吻合口的通畅性应用冠状动脉CTA进行评价,通畅率均为100%。结论:桡动脉-大隐静脉组合V形桥CABG术是一种安全有效的新术式,临床效果满意,近期通畅率高。

Objective:The saphenous vein and radial artery are often harvested as grafting conduit in a population of patients who underwent coronary artery bypass grafting(CABG).In this study,the aim of this pilot study was to describe and assess the safety of V-composite grafting(de ned as a distance between the proximal anastomosis of the V-composite grafting and the ascending aorta of≤0.5 cm)using the radial artery anastomosed to aortocoronary(A-C)bypass grafts.Methods:Between April 2015 and March 2016,29 patients underwent CABG with V-composite grafting using the radial artery and the A-C bypass graft[saphenous vein graft(SVG)]at our institution.The mean age was(65.34±8.2)years and 4(16%)were female.The clinical outcomes and patency rates of distal anastomoses and anastomoses of the V-composite grafting were retrospectively evaluated.Results:The 30-day mortality rate was zero(0/29).The overall patency rate of distal anastomoses of the composite V-composite grafting follow-up(at 6 month)underwent non-invasive cardiac computed tomography angiography(CTA)was 100 and 100%,respectively.Conclusions:V-composite grafting with the saphenous vein and radial artery provides excellent clinical outcomes with satisfactory patency 6 month rates.