经左前外侧小切口获取双乳内动脉结合“分站式”杂交技术治疗冠状动脉多支病变65例

吴松; 凌云鹏; 傅元豪; 郭丽君; 高炜; 万峰

doi:10.13201/j.issn.1001-1439.2018.04.012

经左前外侧小切口获取双乳内动脉结合“分站式”杂交技术治疗冠状动脉多支病变65例

- 1 北京大学第三医院心脏外科(北京, 100191);
- 2 北京大学第三医院心脏内科

详细信息

通讯作者: 凌云鹏,E-mail:yunpengling@sohu.com

中图分类号: R6954.3

收稿日期: 2017-09-13

2-staged hybrid coronary revascularization using a bilateral internal thoracic artery Y graft for 65 patients with multivessel coronary artery disease

- 1 Department of Cardiac Surgery;
- 2 Department of Cardiology, Peking University Third Hospital, Beijing, 100191, China

More Information

Corresponding author: LING Yunpeng, E-mail: yunpengling@sohu.com

Received Date: 13 September 2017

摘要

摘要: 目的:探讨应用双乳内动脉 (BITA) 经左前外侧小切口实施"分站式"冠状动脉 (冠脉) 血运杂交重建术 (HCR) 治疗冠脉多支血管病变的可行性及安全性。方法:回顾性分析2014-05-2017-05我院应用BITA经左前外侧小切口实施HCR治疗的65例冠脉多支病变患者临床资料。分析患者手术情况及随访结果。结果:65例患者均顺利应用BITA经左前外侧小切口实施"分站式"HCR, 全组无手术死亡。小切口冠脉旁路移植术 (MIDCAB) 的外科手术时间为 (204.6±28.7) min, 冠脉搭桥数 (2.6±0.5) 支, 术后总引流量 (520.1±120.3) ml, 输红细胞5例 (7.7%), 机械通气时间 (10.5±5.0) h, MIDCAB与PCI间隔时间 (6.0±1.37) d。PCI前复查冠脉造影未见桥血管吻合口狭窄、闭塞情况, PCI植入支架 (1.90±0.67) 枚。术后平均随访1个月, 65例患者无死亡、心绞痛、心肌梗死和脑卒中发生。结论:应用BITA经左前外侧小切口实施"分站式"HCR技术治疗多支冠脉病变早期临床结果显示可行性和安全性满意, 远期疗效尚待进一步观察。
- 双乳内动脉 /
- 分站式杂交 /
- 小切口冠状动脉旁路移植术
Abstract: Objective: To observe early clinical outcomes of 2-staged hybrid coronary revascularization (HCR) using bilateral internal thoracic artery (BITA) for the treatment of multivessel coronary artery disease.Method: A total of 65 patients who underwent 2-staged HCR using BITAs in our hospital because of coronary multivessel lesions from May 2014 to May 2017 were included.The operation data and follow-up results were analyzed.Result: BITA operations were successfully harvested in 65 cases, and the mean operative time of minimally invasive direct coronary artery bypass (MIDCAB) were (204.6±28.7) min.The average number of grafts was (2.2±0.5).The duration of mechanical ventilation and length of stay in ICU was (10.5±5.0) h and (16.4±6.4) h respectively.The average number of stent was 1.90±0.67, and 24-hours drainage during hospitalization was (520.1±120.3) ml.No occlusion of anastomosis was found, and no death, angina or myocardial infarction occurred in all 65 patients during the 1-month follow-up period.Conclusion: The 2-staged hybrid procedure using BITAs is safe and feasible for performing the multiple coronary artery revascularization in the short term, the long-term effect remains to be further observed.
- bilateral internal thoracic artery /
- 2-staged hybrid coronary artery revacularization /
- minimally invasive direct coronary artery bypass

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