With the experience of over 250 beating hear operations since Feb 1995 westarted minimally invasive revascularization of the LAD(MIDCAB).SinceFeb.1996 we operated upon 182 patients with this procedure Since June1996 w...With the experience of over 250 beating hear operations since Feb 1995 westarted minimally invasive revascularization of the LAD(MIDCAB).SinceFeb.1996 we operated upon 182 patients with this procedure Since June1996 we treated 40 patients with multivessel discase with a Hybridproccdurc(PTCA plus MIDCAB)The age of the patients ranged between 68 and 79 years.29 patients waremaic.28 patiens suffered from a double vessel discase.12 patients fromtriple vessel discase.The left ventricular ejeetion fraction was loss then 40%in 8 cases 2 patients underwent a reoperativc procedure.Further risk factorswere COLD(n=9).recent MI(n=6),renal insufliciency(n=13).Diabeiesinellitus(n-12).The left mammary was prepared in the usual manner.As access wechese a partial inferior sternotomy(n=4)or a lateral minithoracotomy(n=36).The anastomosis was performed on the beating heart.In all patients we conneeted the LIMA to the LAD.All patients survived andcould be discharged on the 6th postoperative day(mean).In two patients arevision due to bleeding became necessary.Two patients reccived a bloodtransfusions.Postoperatively 15 patients reccived a PTCA of the RCX.4 astentimplantation to the Rex.16 a PTCA of the RCA.5 a stentimplantationto the RCA and 3 patients a PTCA of a D1.3 patients developed a falscaneurysm after the cathcter intervention.By performing the nunimally invasive proeedure the trauma caused bycxtracorporeal circulation can be avoided.Through the combination withPTCA a less invasive therapy of coronary multivessel discase becomespossible in select patients.Postoperative complications and hospital stay canbe teduced.展开更多
文摘With the experience of over 250 beating hear operations since Feb 1995 westarted minimally invasive revascularization of the LAD(MIDCAB).SinceFeb.1996 we operated upon 182 patients with this procedure Since June1996 we treated 40 patients with multivessel discase with a Hybridproccdurc(PTCA plus MIDCAB)The age of the patients ranged between 68 and 79 years.29 patients waremaic.28 patiens suffered from a double vessel discase.12 patients fromtriple vessel discase.The left ventricular ejeetion fraction was loss then 40%in 8 cases 2 patients underwent a reoperativc procedure.Further risk factorswere COLD(n=9).recent MI(n=6),renal insufliciency(n=13).Diabeiesinellitus(n-12).The left mammary was prepared in the usual manner.As access wechese a partial inferior sternotomy(n=4)or a lateral minithoracotomy(n=36).The anastomosis was performed on the beating heart.In all patients we conneeted the LIMA to the LAD.All patients survived andcould be discharged on the 6th postoperative day(mean).In two patients arevision due to bleeding became necessary.Two patients reccived a bloodtransfusions.Postoperatively 15 patients reccived a PTCA of the RCX.4 astentimplantation to the Rex.16 a PTCA of the RCA.5 a stentimplantationto the RCA and 3 patients a PTCA of a D1.3 patients developed a falscaneurysm after the cathcter intervention.By performing the nunimally invasive proeedure the trauma caused bycxtracorporeal circulation can be avoided.Through the combination withPTCA a less invasive therapy of coronary multivessel discase becomespossible in select patients.Postoperative complications and hospital stay canbe teduced.
