冠状动脉搭桥6例体会

Experiences in Six Cases of Coronary Bypass

本文报告1985年7月至1991年4月施行的6例冠状动脉旁路血管移植术。男5例,女1例,平均年龄60岁。全部有心绞痛史,陈旧性心肌梗塞4例。手术采用体外循环合并中低温,用自体大隐静脉在主动脉和冠状动脉之间架血管桥,解除因冠状动脉堵塞造成的心肌缺血。全组共搭桥19根,同时行室留瘤切除1例,血管内膜剥离1例。5例存活,1例死亡。诊断清楚、吻合满意、血运重建充分是手术成功的关键。良好的心肌保护,恰当的吻合秩序和应用蛇形桥有助于手术成功。

Six cases of Coronary-Aortic Bypass Graft (CABG), performed from June, 1985 toApril, 1991, were reported, including 5 males and 1 female with the mean-age of 60years. All had angina pectoris, 4 previous myocardial infarction. Autologous saphen-ous vein grafts between aorta and coronary artery were put, with cardiopulmonary by-pass and hypothermia, to release myocardial ischemia caused by coronary occlusion.There were 19 grafts in the series, and one repair for ventricular aneurysm and oneendarterectomy. There resulted 5 survivals and 1 death. Clear diagnosis, perfect anas-tomosis, and full revascularization were the keys of successful surgery. Good myo-cardial protection, proper anastomotic order and using sequential graft techniquewould help the surgery.