高危患者主动脉内球囊反搏辅助下不停跳冠脉搭桥体会  

Severe triple coronary artery disease operated by OPCAB is safe with preoperative insertion of IABP

作　　者：钱松屹[1] 王凤林[1] 刘鹏[1] 王非[1] 林凡[1] 曹德生[1] 曹永彤[1] 叶志东[1] 杨煜光[1] 周明[1] 

机构地区：[1]中日友好医院心脏.血管外科,北京100029

出　　处：《临床外科杂志》2008年第8期538-540,共3页Journal of Clinical Surgery

摘　　要：目的探讨严重冠状动脉三支血管病变（狭窄〉75％）的高危患者在主动脉内球囊反搏（IABP）辅助下行非体外循环下冠脉搭桥术的安全性。方法回顾2002年1月至2007年12月间27例高危冠心病患者，在IABP支持下行非体外循环下冠脉搭桥术临床资料。结果本组患者冠状动脉造影均提示严重三支血管病变，15例合并左主干病变（狭窄〉75％），均属高危（EuroSeore〉6分），无术中死亡、术后死亡1例，搭桥2～7支、平均（3．2±1．1）支。结论对于冠脉严重三支血管病变高危病例，在预先置入IABP的辅助下可以安全地施行非体外循环下的冠脉搭桥术。Objective To study the safety of the patients with triple coronary artery disease （stenosis rate 〉 75% ） undergone by OPCAB with preoperative insertion of IABP. Method To review the results of 27 patients, mean age 64.8 years, sex m/f 19/8, operated by OPCAB with preoperative insertion of IABP between 2001 to 2007. The indications for preoperative insertion of IABP was severe triple coronary artery disease with severe unstable angina and/or acute myocardial infarction. Most of these patients （15/27） were also with severe LMA stenosis （ 〉 75% ）. Results Postoperatively there was one patient died in the group because of renal failure, There were grafts per patient （ 3.2 ± 1.1 ）. No one needs conversion from OPCAB to ONCAB and there was no any IABP related complications in the Group. Conclusion Severe three vessel disease can be operated safely by OPCAB with preoperative insertion of IABP,which can certainly avoid the potential complications of CPB and avoid high risk of emergency conversion from OPCAB to ONCAB for the high risk patients.

关 键 词：冠状动脉旁路移植术 非体外循环 主动脉内球囊反搏 高危手术 

分 类 号：R654.2[医药卫生—外科学]