自体桡动脉作为非体外循环冠状动脉旁路移植材料的评估

回顾性分析25例2005-01/2007-01在昆明医学院第一附属医院应用乳内动脉和桡动脉进行全动脉化冠状动脉旁路移植患者的临床资料。全组取左乳内动脉25例;左侧桡动脉15例,右侧桡动脉6例,双侧桡动脉4例;人均重建旁路3.14(2～4)支。出院后1,3,6个月门诊随访,以后每半年1次,术后随访11～35个月,血管通畅率良好,取桡动脉侧无前臂运动障碍及缺血并发症。结果说明自体桡动脉是冠状动脉搭桥理想的第2种动脉移植物,重建血管后通畅率高。

阿托伐他汀对移植动脉硬化抑制作用的实验研究

目的研究阿托伐他汀(atorvastatin)对大鼠移植动脉硬化的抑制作用。方法建立大鼠腹主动脉移植模型。动物分为3组:(1)异系移植对照组;(2)异系移植实验组;(3)同系移植对照组。6 0 d后对移植动脉行病理组织学检测,观察移植动脉内膜增生程度,并行免疫组织化学染色(SP法)检测移植动脉增殖细胞核抗原(PCNA)和平滑肌肌动蛋白(α-SMA)的表达情况。结果异系移植实验组血管内膜增厚程度显著低于异系移植对照组,(1),(2),(3)组移植动脉内膜增厚面积比分别为(3 5.2 0±6.3 5)%,(1 2.4 0±2.6 5)%,(1.2±1.1 0)%,差异均有统计学意义(P<0.05)。PCNA在异系移植实验组表达明显低于异系移植对照组和高于同系移植对照组,(1),(2),(3)组分别为(1 7.2 0±1.6 5)%,(5.4 0±0.8 0)%,(1.1 0±0.2 5)%,差异有统计学意义(P<0.05)。结论阿托伐他汀可抑制大鼠移植动脉硬化,PCNA基因表达的下调可能是阿托伐他汀抑制移植动脉硬化的机制之一。

大鼠胸主动脉腹腔移植模型的建立及改进

目的:移植物慢性排斥反应最重要的特征是移植体动脉硬化,大鼠大动脉移植模型的血管改变非常类似于人类的移植体动脉硬化,但此模型的制作多采用显微外科血管缝合方法,既费时又需精巧的显微外科技术。采用套管技术建立大鼠胸主动脉腹腔移植模型,验证其作为慢性排斥反应简化动物模型的可行性。方法:实验于2005-03/2006-03在卫生部器官移植重点实验室完成,动物实验方法符合动物伦理学要求。①实验材料:选用纯系Wistar大鼠120只和SD大鼠40只,按随机数字表法分为两组:异系移植组(SD→Wistar)40对次,同系移植组(Wistar→Wistar)40对次。②实验方法:采用自制聚乙烯套管(内径1.5mm,长度3mm)将供体胸主动脉与受体腹主动脉连接,建立胸主动脉腹腔移植模型。③实验评估:分别于移植术后14,28,42,56d取移植动脉标本,采用病理图像定量分析及电镜等检测手段,观察移植动脉病理变化。结果:同、异系胸主动脉移植模型共成功72只,成功率为90%。①手术时间40～45min,其中移植胸主动脉冷缺血时间10～15min,腹主动脉阻断时间4～7min。②异系移植组动脉硬化具有血管中层细胞坏死迁移、内膜增生及炎性细胞浸润的特点,与人类慢性排斥反应动脉硬化的改变类似,最早出现在术后28d。③同系移植组无明显内膜增生,与受者自身的正常动脉差异不明显;异系移植组术后14d内膜出现细胞增生层,术后28d内膜出现半月形增生,增生程度直到术后56d仍呈上升趋势。结论:采用套管技术建立大鼠胸主动脉腹腔移植模型简单易行,避免了显微血管缝合,明显缩短了腹主动脉阻断时间和移植胸主动脉的冷缺血时间,成功率高,移植后的血管改变类似于人类慢性排斥反应移植体动脉硬化,可作为分析慢性移植排斥反应的简化模型。

应用深低温处理同种异体动脉修复下肢血管伤

目的探讨同种异体动脉修复下肢大血管伤的疗效。方法应用经深低温处理的同种异体动脉12条移植修复腘动脉损伤2例、股动脉缺损10例,6h内重建10例,6～12h重建2例。移植血管长度6～22(10±4.9)cm。术后予以监护及显微外科常规治疗。结果12例术后均无排异反应,伤口2～4周内全部愈合,愈合后2～3周超声多谱勒检测血管通畅率为100%。12例均获随访,时间1～5年,肢体功能恢复良好,无迟发排异反应。结论同种异体动脉经深低温处理后为修复下肢大血管伤提供了较为理想的生物性材料。

胃网膜右动脉在猪全动脉化冠状动脉搭桥中的实验研究

目的评价胃网膜右动脉(right gastroepiploic artery,RGEA)在冠脉旁路移植术中可行性。方法选取实验用猪80例,随机分为实验组(40例)和对照组(40例),两组均行心脏不停跳搭桥术,实验组采用乳内动脉-前降支、RGEA-后降支的方式搭桥,对照组采用乳内动脉-前降支、大隐静脉-后降支的方式搭桥。记录并比较两组手术时间、术中出血量,桥血管流量和搏动指数、术后24 h内心包纵隔引流管引流量和术后总机械通气时间。结果实验组的手术时间和术后总机械通气时间较对照组增加(P<0.01),实验组与对照组的术中出血量,桥血管流量和搏动指数、术后24 h内心包纵隔引流管引流量与对照组差异无统计学意义(P>0.05)。结论胃网膜右动脉是可供选择的动脉移植物之一,在冠脉外科有良好的可行性和应用前景。

超声引导下连续臂丛神经阻滞对肱动脉-贵要静脉人工血管移植内瘘血流的影响

目的观察超声引导下连续臂丛神经阻滞对肱动脉-贵要静脉人工血管内瘘血流的影响。方法选择拟行上臂肱动脉-贵要静脉人工血管内瘘成形术患者共78例，采用随机数字表法分为单次臂丛神经阻滞组（SBB组）和连续臂丛神经阻滞组（CBB组），每组39例，操作均在超声引导下进行，CBB组术后接神经阻滞镇痛泵自控镇痛（PCNA），比较两组术前（T0）动脉直径及术后4h（T1）、24h（T2）、7d（T3）、3个月（T4）的动脉直径、内瘘血流量及手术成功率；比较两组术后48h的镇痛药补救次数、镇痛满意度及麻醉相关并发症。结果CBB组T2、T3、T4的动脉直径[（4．2±0．3）mm、（4．6±0．3）mm、（5．2±0．3）mm]及内瘘血流量[（325±15．2）ml／min、（625±32．5）ml／min、（1125±90．2）ml／min]均较SBB组[（3．8±0．2）mm、（4．1±0．2）mm、（4．7±0．3）mm，（162±9．8）ml／min、（442±20．3）ml／min、（778±40．2）ml／min]明显增加（P〈0．05）；CBB组较SBB组术后48h的镇痛药补救次数减少，镇痛满意度升高（P〈0．05）。结论与单次臂丛神经阻滞相比，连续臂丛神经阻滞可显著减轻肱动脉．贵要静脉人工血管移植内瘘术后疼痛，增加动脉直径及内瘘血流量。

Sevoflurane Versus Propofol for Myocardial Protection in Patients Undergoing Coronary Artery Bypass Grafting Surgery: a Meta-analysis of Randomized Controlled Trials

Objective To systematically review randomized controlled trials to compare myocardial protection profiles of sevoflurane with propofol in patients undergoing coronary artery bypass grafting （CABG） surgery. Methods Electronic databases were searched to identify all randomized controlled trials comparing sevoflurane with propofol for protecting myocardium in adult patients undergoing CABG surgery. Two authors independently extracted patients＇ perioperative data, including patients＇ baseline characteristics, surgical variables, and outcome data. For continuous variables, treatment effects were calculated as weighted mean difference （WMD） and 95% confidential interval （C/）. For dichotomous data, treatment effects were calculated as odds ratio （OR） and 95% CI. Each outcome was tested for heterogeneity, and randomized-effects or fixed-effects model was used in the presence or absence of significant heterogeneity （Q test P〈0.05）. Sensitivity analyses were done by examining the influence of statistical model on estimated treatment effects. Publication bias was explored through visual inspection of funnel plots of the outcomes. Statistical significance was defined as P〈0.05. Results Our search yielded 13 studies including 696 patients, and 402 patients were allocated into sevoflurane group and 294 into propofol group. There was no significant difference in postoperative mechanical ventilation time, inotropic support, mortality, myocardial infarction, and atrial fibrillation between the two groups （all P〉0.05）. Patients randomized into sevoflurane group had higher post-bypass cardiac index （WMD=0.39, 95% CI： 0.18 to 0.60, P=0.0003）, lower troponin I level （WMD=-0.82, 95% CI：-0.87 to -0.85, P=0.0002）, lower incidence of myocardial ischemia （OR=0.37, 95% CI： 0.16 to 0.83, P=0.02）, shorter ICU and hospital stay length （WMD=-10.99, 95% CI： -12.97 to -9.01, P〈0.00001; WMD=-0.78, 95% CI： -1.00 to -0.56, P〈0.00001, respectively）. Conclusion This meta-analysis has found some evidence showing that sevoflurane has better myocardial protection than propofol in CABG surgery.

Treatment modalities for hypersplenism in liver transplant recipients with recurrent hepatitis C

Hepatitis C is the most common indication for orthotopic liver transplantation in the United States. Unfortunately, hepatitis C recurs universally in the transplanted liver and is the major cause of decreased graft and patient survival. The combination therapy of interferon and ribavirin has been shown to be the most effective therapy for recurrent hepatitis C. However, pre-and post-transplant hypersplenism often precludes patients from receiving the antiviral therapy. Splenectomy and partial splenic embolization are the two invasive modalities that can correct the cytopenia associated with hypersplenism. In this report we review the two treatment options, their associated outcomes and complications.

Coronary artery bypass grafting in the octogenarians： should we intervene, or leave them be？

Objective Coronary artery bypass grafting （CABG） is gradually increasing in the elderly population. We aimed to investigate the risk factors and the results of CABG along with the long term survival in patients at an age of 80 and older. Methods Between Januaa-y 2002 and December 201 I, a total of i01 consecutive patients at an age of S0 and older who underwent CABG in our hospital were included in the study. The patients were followed and the long-term survival was estimated. Results The mean age of the patients was 82.98 ~ 2.27 years. Sixty-four （63.4%） were males and 37 （36.6%） were females. Emergency surgery, duration of cardiopulmonary bypass, the intensive care unit （ICU） stay, inotropic support, intra aortic balloon pulsation application, amount oferythrocyte transfusion and flesh frozen plasma transfusion and ventilation period were significantly higher in the patients who died in the hospital. The duration of cardiopulmonary bypass （CPB） was found to be an inde- pendent predictor of mortality （OR： 1.18, 95% CI 1.01-1.38, P = 0.034）. The in-hospital mortality was 16.8%. Kaplan-Meier analyses revealed a survival ratio of 91.3% at one year, 82.9% at three years and 69.0% at five years. Conclusions Patients at the age of 80 and older can be candidates for the CABG procedure bearing in mind that they may have a longer ventilation period and intensive care unit stay. The morbidity and mortality of this age group is considered within an acceptable range. Approaches to minimize CPB, or the choice of off-pump surgery, may be a preventive method to lower the incidence of mortality. Hence, CABG may be performed in this age group with a satisfactory survival ratio.

Revascularization for Iliac-femoral Artery Pseudoaneurysm with Greater Saphenous Vein

Objective To investigate the role of revascularization procedures with autologous greater saphenous vein in surgical management of iliac-femoral artery pseudoaneurysm in parenteral drug abusers. Methods Twenty-one patients with iliac-femoral artery pseudoaneurysm caused by parenteral drug abuse from 2004 to 2007 were enrolled. Among them,15 patients were male and 6 were female; their average age was 31.3 years. The size of pseudoaneurysms ranged from 3.0 cm to 7.5 cm. Common femoral artery and distal external iliac artery were often involved. We performed arterial reconstruction on these patients with autologous greater saphenous vein as a graft after excising iliac-femoral artery pseudoaneurysm through a single curved inguinal incision. All patients were followed up,and the complications were recorded. Results The surgical procedures were finished without intraoperative mortality or perioperative complications. All patients were free of claudication symptoms after the surgery except one case with preoperative popliteal artery stenosis. One case of infection and wound tissue fistula was found later. One case had inguinal incisional hematoma and another complained of numbness in thigh skin. Conclusions The use of autologous greater saphenous venous grafts for arterial reconstruction after pseudoaneurysm excision in drug abusers is safe and effective. This technique offers more advantages than arterial ligation alone without revascularization. An optimal greater saphenous venous graft is a prerequisite for revascularization.

Retrospective analysis of exercise capacity in patients with coronary artery disease after percutaneous coronary intervention or coronary artery bypass graft

Objectives:To describe the current state of exercise capacity as well as to identify its predictors in patients with coronary artery disease (CAD) following percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in the mainland of China.Methods:A retrospective study design was employed.We evaluated 230 CAD patients following PCI or CABG in a cardiac rehabilitation center from January 2019 to October 2019.The patients were referred to undergo incremental cardiopulmonary exercise testing with a cycle ergometer.The Zung Self-Rating Anxiety Scale and the Zung Self-Rating Depression Scale were used to evaluate patients' mental health.Statistical analysis was performed using the chi-square test,Fisher's exact test,t-test,Mann-Whitney U test,and binary logistic regression.Results:Among the 230 patients,223 patients demonstrated reduced exercise capacity.Resutlts of the logistic regression analysis showed that anxiety (OR =1.13,95% CI 1.01-1.32,P =0.029) was an independent risk factor for reduced exercise capacity in patients following the PCI or CABG.Conclusions:Exercise capacity of Chinese CAD patients after PCI or CABG was relatively poor.Alleviating symptoms of anxiety and making exercise prescriptions according to the results of the cardiopulmonary exercise test should be considered during the intervention to improve CAD patients' exercise capacity.

Long term outcomes of saphaneous vein graft intervention in elderly patients with prior coronary artery bypass graft

Objectives To investigate the procedure characteristics and long term follow-up ofpercutaneous coronary intervention （PCI） for sa phaneous vein graft （SVG） lesions in the elderly patients. Methods From December 2005 to December 201 l, 84 graft lesions were treated percumneously. Seventeen were located at proximal anastomosis, 48 were located at SVG body, 19 were located at distal anastomosis. Pri mary endpoint was defined as major adverse cardiovascular events （MACE, composite of cardiac death, target vessel revascularization, acute myocardial infarction）. Results The graft age was 6.7 i 4.0 years. Most anastomosis lesions （80.0%） presented within one year post coro-nary artery bypass grafting （CABG）. Proximal anastomosis lesion had the lowest successful rate for PCI compared with graft body and distal anastomosis lesions （70.6% vs. 91.7%, 79.0%, P 〈 0.05）. The distal embolic protection device was used in 19.1% of patients, most frequently used in body graft PCI （29.2%, P 〈 0.01）. The diameter of the stent was smallest in distal anastomosis group （2.9 ±0.4 mm, P 〈 0.05）. The highest post dilatation pressure was required in the proximal anastomosis （17.8 ± 2.7 atm, P 〈 0.05）. The patients were followed up for 24.3 ±16.9 months. MACE occurred in 18.57% of patients. Incidence of MACE was highest among proximal anastomosis PCI （47.1% vs. body graft PCI 16.7%, distal anastomosis PCI 21.1%; P 〈 0.05）. Old myocardial infarction was the predictive factor for the poor clinical outcomes （P〈 0.04）. Conclusions PCI of SVG lesions is feasible with lower success rate. PCI of ostial graft anastomosis lesions had the lowest procedure success rate and highest MACE rate compared with graft body and distal anastomosis lesions. Old myocardial infarction was a predictive factor of poor outcomes.

Portal venous arterialization resulting in increased portal inflow and portal vein wall thickness in rats

AIM： To explore the influence of portal vein hemodynamic changes after portal venous arterialization （PVA） on peribiliary vascular plexus （PVP） morphological structure and hepatic pathology, and to establish a theoretical basis for the clinical application of PVA. METHODS： Sprague-Dawley rats were randomly divided into control and PVA groups. After PVA, hemodynamic changes of the portal vein and morphological structure of hepatohilar PVP were observed using Doppler ultrasound, liver function tests, ink perfusion transparency management and three-dimensional reconstruction of computer microvisualization, and pathological examination was performed on tissue from the bile duct wall and the liver. RESULTS： After PVA, the cross-sectional area and blood flow of the portal vein were increased, and the increase became more significant over time, in a certain range. If the measure to limit the flow in PVA was not adopted, the high blood flow would lead to dilatation of intrahepatic portal vein and its branches, increase in collagen and fiber degeneration in tunica intima. Except glutamic pyruvic transaminase （GPT）, other liver function tests were normal. CONCLUSION： Blood with a certain flow and oxygen content is important for filling the PVP and meeting the oxygen requirement of the bile duct wall. After PVA, It is the anatomic basis to maintain normal morphology of hepatohilar bile duct wall that the blood with high oxygen content and high flow in arterialized portal vein may fill PVP by collateral vessel reflux. A adequate measure to limit blood flow is necessary in PVA.

Off-pump coronary artery bypass grafting versus on-pump coronary artery bypass grafting： which is better in patients with chronic obstructive pulmonary disease？

To evaluate the clinic outcome of off-pump coronary bypass grafting (OPCABG) of patients with coronary heart disease and chronic obstructive pulmonary disease, we collected and analyzed 1998-2002 data on 28 patients with these two diseases who had received off-pump coronary bypass operation in our hospital, and compared with data on those who also had the same two diseases but received on-pump coronary artery bypass at same time. There were no operation-related death;one died of respiratory failure 14 days after operation while staying in hospital; there were more respiratory complications in the conventional coronary artery bypass grafting group (CCABG) than in the OPCABG group; and the PaO2/FiO2 in the CCABG group was higher than that in the OPCABG group during operation because of CPB, but lower than that in the OPCABG group 6-12 hours after operation. OPCABG seemed more suitable than CCABG for coronary artery disease patients with chronic obstructive pulmonary disease due to less damage to their oxygen-exchange capability and the fewer respiratory complications.

Off-pump coronary artery bypass grafting using a bilateral internal mammary artery Y graft

Objective To evaluate the outcome of off-pump coronary artery bypass grafting （OPCABG） using a bilateral internal mammary artery （BIMA） Y configuration graft to achieve total arterial myocardial revascularization. Methods From October 2002 to December 2008, 208 patients （196 males and 12 females） underwent OPCABG using a BIMA Y configuration graft. The average age of the patients was 56.5 ± 11.3 years, with an age range of 33-78 years. A total of 167 （80.2%） cases had triple-vessel disease. Left main stem disease was found in 33 （15.9%） cases, and double-vessel disease was found in 8 （3.9%） cases. The semi-skeletonization technique was used to harvest the two internal mammary arteries （IMAs）, and then the free right internal mammary artery was connected end-to-side to the left internal mammary artery （LIMA） in situ to complete the Y configuration graft. Off-pump and sequential anastomosis methods were used to perform coronary artery bypass surgery in all patients. Graft patency was assessed intm-operatively with the HT311 transit time flowmeter. Results A total of 728 distal anastomoses were performed in 208 patients, with the average being 3.5± 1.3 per person. No one died or experienced recurrent angina within 30 days after the operation. Conclusions OPCABG using the BIMA Y graft was safe and effective to achieve total arterial revascularization. This method avoids surgical operation on the ascending aorta and other incisions.

Intraoperative pulmonary hypertension occurred in an asymptomatic patient with pre-existent liver cirrhotic and portal hypertension

Portopulmonary hypertension(PPH) is clinically defined as the development of pulmonary arterial hypertension complicated by portal hypertension,with or without advanced hepatic disease.Physical signs may be absent in mild to moderate PPH and only appear in a hyperdynamic circulatory state.Similar signs of advanced liver disease can be observed in severe PPH,with ascites and lower extremity edema.Pulmonary hypertension is usually diagnosed after anesthetic induction during liver transplantation(LT).We present intraoperative pulmonary hypertension in a 41-year-old male patient with hepatic cirrhosis.Since this patient had no preoperation laboratory data supporting the diagnosises of pulmonary hypertension and was asymptomatic for a number of years,it was necessary to send him to the intensive care unit after operation.Further study should be focued on the diagnosis and treatment of pulmonary arterial hypertension in order to reduce its mortality.

Establishment of a pig model with enteric and portal venous drainage of pancreatoduodenal transplantation

AIM： To establish the pig model of pancreatoduodena transplantation with enteric drainage （ED） and porta venous drainage （PVD）. METHODS： Forty-six hybrid Landrace pigs were divided into two groups （donors and recipients） randomly, and pancreatoduodenal allotransplantation was performed. Donors were perfused via abdominal aorta without clamping the portal venous outflow with UW solution at 80-100 cm H2O after heparinization. Whole pancreatoduodenal grafts were harvested with segments of abdominal aorta and portal vein, and shaped under 4℃ UW solution. Then, end-to-end anastomosis was performed with the donor iliac artery bifurcation Y graft to the recipient superior mesenteric artery and celiac artery. Furthermore, type I diabetes model was made by removal of the recipient pancreas. The venous anastomosis was reconstructed between the donor portal vein and the recipient superior mesentery vein. Meanwhile, end-toside anastomosis was performed with the donor common iliac artery bifurcation Y graft to the recipient abdominal aorta, and side-to-side intestinal anastomosis was performed between the donor duodenum and the recipient jejunum. External jugular vein was intubated for transfusion. Levels of plasma glucose, insulin and glucagon were measured during the operation and on the 1^st 3^rd 5^th and 7^th d after operation. RESULTS： Pancreatoduodenal allotransplantation was performed on 23 pigs of which 1 died of complication of anesthesia. The success rate of operation was 95.6%. Complications of operation occurred in two cases in which one was phlebothrombosis with an incidence of 4.6%, and the other was duodenojejunal anastomotic leak with an incidence of 4.6%. The level of plasma glucose decreased within 30 min, after removal of pancreas and recovered on the 2^nd after operation. The level of plasmainsulin and glucagon increased within 30 min after removal of pancreas and recovered on the 2^nd d after operation. Rejection occurred on the 1^st and reached the worst level on the 7^th d after transplantation, without change of plasma insulin and glucagon or clinical symptoms of rejection. CONCLUSION： Pancreatoduodenal transplantation in pigs can treat type I diabetes. ED and PVD can keep the function of endocrine in normal. The technique of pancreatoduodenal transplantation with ED and PVD may pave the way for the further application of pancreas transplantation in clinic.

Patients without hepatocellular carcinoma progression after transarterial chemoembolization benefit from liver transplantation

AIM： To assess the outcome of patients, who underwent transarterial chemoembolization （TACE） for hepatocellular carcinoma （HCC） and subsequently liver transplantation （OLT） irrespective of tumor size when no tumor progression was observed. METHODS： Records, imaging studies and pathology of 84 patients with HCC were reviewed. Ten patients were not treated at all, 67 patients had TACE and 35 of them were listed for OLT. Tumor progression was monitored by ultrasound and AFP level every 6 wk. Fifteen patients showed signs of tumor progression without transplantation. The remaining 20 patients underwent OLT. Further records of 7 patients with HCC seen in histological examination after OLT were included. RESULTS： The patients after TACE without tumor progression underwent transplantation and had a median survival of 92.3 too. Patients, who did not qualify for liver transplantation or had signs of tumor progression had a median survival of 8.4 mo. The patients without treatment had a median survival of 3.8 mo. Independent of International Union Against Cancer （UICC） stages, the patients without tumor progression and subsequent OLT had longer median survival. No significant difference was seen in the OLT treated patients if they did not fulfill the Milan criteria. CONCLUSION： Selection of patients for OLT based on tumor progression results in good survival. The evaluation of HCC patients should not only be based on tumor size and number of foci but also on tumor progression and growth behavior under therapy.

Predictors of atrial fibrillation after coronary artery bypass graft： a meta-analysis

Objectives Postoperative atrial fibrillation （AF） has been associated with less favorable outcomes in patients undergoing coronary artery bypass graft surgery （CABG） and may result in increased post-operative morbidity and mortality. A systematic review and meta-analysis of published studies was conducted to examine the risk factors of occurrence AF after CABG. Methods Using the Medline database, the Cochrane clinical trials database and online clinical trial databases, we reviewed all randomized controlled trials （RCTs） and observational studies examining the risk factors of occurrence of AF after CABG. We searched for literature published April 2009 or earlier. Results Our review identified 8 studies （observational studies）, involving 14548 patients, that examined the risk factors of occurrence of AF after CABG. Although studies provide conflicting results, the overall outcomes suggests that advanced age, previous hypertension, numbers of bridge vessels may increase the occurrence of AF after CABG, while no significant difference of diabetes, preoperative myocardial infarction, and preoperative medication of 13 -Blocker have been observed between the AF patients and no-AF patiens. Conclusions Patients with advanced age, previous hypertension and more numbers of bridge vessels had higher risk for the occurrence of AF after CABG, and perioperative medication and care must be intensified to decrease the postoperative occurrence ofAF（J Geriatr Cardio12009; 6：162-167）.