左胸小切口非体外循环冠状动脉旁路移植术70例  

Minimally Invasive Direct Coronary Artery Bypass via Let Anterior Small Thoracotomy

作　　者：凌云鹏[1] 鲍黎明[1] 杨威[1] 陈彧[1] 

机构地区：[1]北京大学人民医院心脏外科,北京100044

出　　处：《中国胸心血管外科临床杂志》2015年第6期550-553,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的评价采用新型悬吊式乳内动脉牵开系统完成左胸小切口冠状动脉旁路移植术（MIDCAB）的安全性和可行性。方法回顾性分析2012年5月至2013年8月北京大学人民医院心脏外科完成左胸前外侧MIDCAB术70例患者的临床资料,使用悬吊式乳内动脉牵开系统（FEHLING）直视下获取左乳内动脉,然后完成乳内动脉-前降支吻合。其中男60例、女10例,年龄44～76（56.8±9.2）岁;单支病变42例（60.0%）,左主干或多支病变28例（40.0%）。结果 70例手术均顺利完成,围术期无死亡、心肌梗死、脑卒中、肾功能衰竭等严重并发症。呼吸机治疗时间4～16（9.7±5.2）h,术后住ICU时间10～24（20.8±10.8）h。术后复查冠状动脉脉造影17例均提示左乳内动脉桥通畅性良好。随访1～14个月,无死亡,无心肌梗死或心绞痛发生。结论使用新型悬吊式乳内动脉牵开系统行MIDCAB手术安全可行。Objective To evaluate the safety of a less traumatic surgical approach in minimally invasive direct coronary artery bypass （MIDCAB）. Methods We retrospectively analyzed the clinical data of 70 patients underwent MIDCAB via left anterior small thoracotomy between May 2012 and August 2013. There were 60 male and 10 female patients with a mean age of 56.8±9.2 years （ranged 44-76 years）, with single vessd disease （left anterior descending artery） in 42 patients, and double or three vessels disease in 28 patients （ include left main vessel disease）. Results The procedure were successfully completed in all 70 patients. No operation-related death or complication occurred. The extubation time was 4-16 （9.7±5.2） hours. The ICU time was 10-24 （20.8±10.8）hours. They were followed up for 1-14 months. No deaths or angina or myocardial infarct/on occurred. Postoperative coronary angiography in 17 patients found no restenosis. Conclusion MIDCAB via left anterior small thoracotomy can be performed safely by using the new left internal mammary artery （LIMA） harvesting system.

关 键 词：冠状动脉旁路移植术 非体外循环 小切口手术 

分 类 号：R654.2[医药卫生—外科学]