非体外循环冠状动脉搭桥术中冠状窦血流频谱的经食管超声心动图研究

Use of coronary sinus flow measured by transesophageal echocardiography during off-pump coronary artery bypass

目的 探讨经食管超声 (TEE)探测冠状窦血流频谱的变化在非体外循环冠脉搭桥术(OPCAB)中的应用价值。方法 选取 3 0例行OPCAB的患者 ,根据术后即刻左心室射血分数 (LVEF)提高≥5%和 <5%分为两组 ,对各组用TEE检测其术前、术后即刻冠状窦血流频谱。结果 LVEF提高≥ 5%组冠状窦血流速度峰值 (PV)和血流速度时间积分 (VTI)较术前有显著增加 (P <0 .0 1～ 0 .0 5) ,LVEF提高 <5%组冠状窦PV和VTI也增加 ,但差异无显著性意义 (P >0 .0 5)。结论 TEE在OPCAB术中可清楚显示冠状窦血流频谱 。

ObjectiveTo measure coronary sinus(CS) blo od flow during off-pump coronary artery bypass using transesophageal echocardiography(TEE). MethodsCS blood flow velocity and left ventricular ejection fraction (LVEF) of 30 patients who accepted off-pump coronary bypass(OPCAB) were measured during the operation using TEE and divided the patients into two groups according to the elevation of LVEF≥ or < 5% right after OPCAB. The peak velocity and velocity time integral (VTI) of CS blood flow were compared between before and right after OPCAB in each group. ResultsThe peak velocity and VTI of CS blood flow were improved significantly right after OPCAB compared with pre-OPCAB in the group of LVEF increasing more than 5%(P< 0.01 ～ 0.05 ),but in the other group the difference between pre- and post-OPCAB had no statistical significance (P> 0.05 ). ConclusionsThe CS blood flow can be measured clearly and easily using TEE during OPCAB. It′s feasible to evaluate OPCAB intraoperatively with CS blood flow performed by TEE.