体外循环辅助心脏不停跳冠状动脉旁路移植术在左主干严重病变患者中的应用价值
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摘要
目的探讨体外循环辅助心脏不停跳冠状动脉旁路移植术在左主干严重病变患者中的应用价值。方法回顾性分析35例择期行体外循环辅助心脏不停跳冠状动脉旁路移植术的左主干严重病变患者的临床资料。结果 35例患者均顺利完成手术,体外循环时间30～75min,左乳内动脉-前降支桥30个,远端吻合口数2～5个;术前植入主动脉球囊反搏1例,术中及术后植入主动脉球囊反搏2例;术后死亡2例;随访6个月～2a,失访3例,死亡2例,余患者均恢复良好。结论体外循环辅助心脏不停跳冠状动脉旁路移植术对左主干严重病变患者是一种安全有效的治疗方法。
Objective To investigate the application of on-pump beating-heart coronary artery bypass grafting in patients with severe left main disease.Methods The clinical data of 35 patients with severe left main disease undergoing on-pump beating-heart coronary artery bypass grafting were retrospectively analyzed.Results The operations were completed smoothly in all patients with the average cardiopulmonary bypass time of 30～75 min.Thirty left internal mammary artery-anterior descending bridges were performed,with the average distal anastomosis of 2～5.Intra-aortic balloon pump was performed in 1 case preoperatively and 2 cases intraoperatively or postoperatively.Two patients died after operation.The follow-up for 6 months to 2 years showed 3 cases were lost,2 died,and the others recovered well.Conclusion On-pump beating-heart coronary artery bypass grafting is safe and effective for patients with severe left main disease.
Objective To investigate the application of on-pump beating-heart coronary artery bypass grafting in patients with severe left main disease.Methods The clinical data of 35 patients with severe left main disease undergoing on-pump beating-heart coronary artery bypass grafting were retrospectively analyzed.Results The operations were completed smoothly in all patients with the average cardiopulmonary bypass time of 30～75 min.Thirty left internal mammary artery-anterior descending bridges were performed,with the average distal anastomosis of 2～5.Intra-aortic balloon pump was performed in 1 case preoperatively and 2 cases intraoperatively or postoperatively.Two patients died after operation.The follow-up for 6 months to 2 years showed 3 cases were lost,2 died,and the others recovered well.Conclusion On-pump beating-heart coronary artery bypass grafting is safe and effective for patients with severe left main disease.
引文
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[2]韩雅玲.2016中国经皮冠状动脉介入治疗指南解读[J].临床军医杂志,2016,44(5):441-443.
[3]吴清玉,许建屏,高长青,等.冠状动脉旁路移植术技术指南[J].中华外科杂志,2006,44(22):1517-1524.
[4]贺文帅,赵兴胜,吴云,等.心肌缺血再灌注损伤小鼠E1A激活基因阻遏子基因表达及其对心肌的保护作用[J].中华实用诊断与治疗杂志,2018,32(6):525-528.
[5]马计,杨颖,肖娟.脑钠肽对高血脂大鼠缺血再灌注心肌的保护作用[J].中华实用诊断与治疗杂志,2017,31(9):836-838.
[6]王现强,袁昕,武恒朝,等.主动脉内球囊反搏在左室室壁瘤手术患者中的应用效果[J].中国循证心血管医学杂志,2018,10(2):221-223.