Symmetry主动脉吻合器在心脏不停跳冠状动脉旁路移植术中的应用

Application of Symmetry aortic connector in off-pump coronary artery bypass grafting

目的 总结非体外循环心脏不停跳冠状动脉旁路移植术 (Off-pumpcoronaryarterybypassgrafting ,OPCAB)中使用Symmetry主动脉吻合器的近期效果。 方法 2 0 0 2年 9月～ 2 0 0 3年 6月 ,2 0 4例冠心病行OPCAB ,其中 16 7例使用大隐静脉移植物 ,应用Symmetry主动脉吻合器 10 0例。 结果 使用吻合器 14 2个 ,吻合失败弃用 2个 ,3个吻合口漏血需手工修补 ,成功率 96 5 % (137 14 2 ) ,近端吻合口 (1 4± 0 5 )个 例 ,远端吻合口 (3 5± 0 8)个 例。近端吻合口血流量 (46 5± 2 2 3)ml min。吻合器安装时间 (4 0± 1 1)min ,吻合口完成时间均在 10s以内 ,手术时间 (3 2± 0 4 )h。手术死亡率 1% (1 10 0 ) ,无围手术期心肌梗塞、脑卒中等并发症 ,出血二次开胸 1例 ,但非吻合口出血。术后引流量 (5 4 1± 2 74 )ml,输血率 36 0 % (36 10 0 )。术后住院 (7 8± 1 6 )天。 结论 Symmetry主动脉吻合器可安全有效地应用于CABG术 ,近期临床效果满意 ,可缩短吻合时间和手术时间 ,避免主动脉钳夹 。

ObjectiveTo summarize the short-term effects o f Symmetry aortic co nnector in off-pump coronary artery bypass grafting (OPCAB) operation. MethodsTwo hundreds and four patients suffering from coronary artery d isease underwent OPCAB from September 2002 to June 2003. Among the 204 patients, saphenous vein grafts were used in 167 patients and Symmetry aortic connectors were adopted in 100 of them.ResultsOf 142 connectors used, 2 connectors fai led and manual r epairs were required in 3 cases because of anastomotic leakage, the success rate being 96 5% (137 of 142). The number of proximal anastomosis was (1 4±0 5) per case and the number of distal anastomosis (3 5±0 8) per case. The proximal a na stomotic blood flow was (46 5±22 3) ml/min. The fitting time for connectors w as (4 0±1 1) min, and anastomoses were all accomplished within 10 seconds. The op eration time was (3 2±0 4) hours. The operative death rate was 1% (1 of 100). R e-operation of thoracotomy was required in 1 case because of bleeding but not an astomotic bleeding. No myocardial infarction or stroke occurred in the peri-oper ative period. The postoperative drainage amount was (547±247) ml. The blood tra nsfusion rate was 36 0% (36 of 100). The postoperative hospital stay was (7 8 ±1 6) days.ConclusionsSymmetry aortic connector can be saf ely and effectively used in coronary artery bypass grafting operations, with satisfactory short-term clinical effects. The procedure may shorten operation time, avoid aortic clampi ng, and lower the incidence of stroke.