杂交技术在治疗冠心病多支病变中的应用  

Application of hybrid revascularization in multivessel coronary artery disease

作　　者：何伟[1] 刘志勇[1] 蒋杰[1] 周建明[1] 陆启同[1] 

机构地区：[1]东南大学附属中大医院心胸外科,江苏省210009

出　　处：《江苏医药》2012年第15期1776-1778,共3页Jiangsu Medical Journal

摘　　要：目的探讨胸骨下段小切口非体外循环下冠状动脉旁路移植术联合经皮冠状动脉支架植入术(杂交技术)在治疗冠心病多支病变中的临床价值。方法 21例冠心病患者中,两支冠脉血管病变4例,三支冠脉血管病变17例;均采用杂交技术进行心肌再血管化。采用胸骨下段小切口,在非体外循环下行左乳内动脉至前降支吻合;其余狭窄冠脉血管行药物涂层支架植入。结果 21例患者共植入支架38个,平均每例心肌再血管化2.6支,手术均成功,无围术期心肌梗死及手术死亡。患者术后平均ICU观察时间为26.2h,术后平均住院时间9d。随访2-16个月,所有患者均无心绞痛症状发作。结论杂交技术治疗冠心病多支病变近、中期疗效确切。Objective To evaluate the safety and feasibility of a hybrid coronary revascularization strategy that combines minimally invasive left internal thoracic artery to left anterior descending coronary artery anastomosis with drug-eluting stent implantation to non-left anterior descending coronary artery lesions. Methods Twenty-one consecutive patients with multivessel coronary artery disease underwent minimally invasive direct coronary artery bypass and percutaneous coronary intervention. Anastomoses were constructed under direct vision through a lower half ministernotomy incision with beating heart. Non-left anterior descending coronary artery lesions were then treated percutaneously using drug-eluting stents. Results A total of 38 drug-eluting stents was implanted in non-left anterior descending coronary artery coronary lesions among 21 cases. The mean number of revascularization was 2.6 perpatient. There were no surgery-related deaths and myocardial infarctions. The median postoperative ICU stay was 26.2 hours and total hospital stay was 9 days. The patients were symptoms free during follow-up of 2 to 16 months. Conclusion Hybrid approach in multivessel coronary artery disease is a feasible option accomplished with acceptable early and midterm clinical outcomes.

关 键 词：冠心病 杂交技术 微创冠状动脉旁路移植术 

分 类 号：R645[医药卫生—外科学]