非体外循环冠状动脉搭桥术的初步经验

Experience of off-pump coronary artery bypass surgery

目的 :初步探讨非体外循环下冠状动脉搭桥手术的安全性和早期效果。方法 :12例病人在非体外循环下进行搭桥手术 ,手术均在全身麻醉 ,胸骨正中切口心脏跳动下 ,用MedtronicOctopusⅡ固定器辅助下进行。结果 :本组病人均安全顺利地施行了手术 ,平均搭桥 2 .7支 ,术后无严重并发症发生 ,呼吸机辅助时间、住院时间均大大缩短 ,早期随访所有患者均无心绞痛发作。结论 :初步表明非体外循环下冠状动脉搭桥术早期效果满意 ,但考虑远期血管桥的通畅率问题 。

Objective: To explore the feasibility, safety and early outcomes of off-pump coronary artery bypass surgery (OPCAB).Methodswelve patients operated without cardiopulmonary bypass (CPB) were enrolled in this study. All patients were operated with Medtronic Octopus stabilization system through medial sternotomy. Operative procedures, postoperative and early outcomes were analyzed. Results:No patients required conversion to CPB during OPCAB procedure. An average of 2.7 grafts per patient was completed. Besides the low complication rates, patients were extubated and discharged earlier. Early follow-up showed that no patients suffered angina pectoris.Conclusion:OPCAB may be used as a suitable and safe alternative to conventional CABG and has complete revascularization with comparable short-term results. However, considering the late graft patent rates, patients' selection and operation technique should be studied further.