大隐静脉序贯桥+乳内动脉单支桥在非体外循环冠状动脉旁路移植术中的应用  

Application of sequential bridge of sequential Bridge of saphenous vein of great saphenous vein in off-pump coronary artery bypass grafting

作　　者：赵昌学[1] ZHAO Chang-xue(Heze Municipal Hospital Cardiovascular surgery,Heze 274000,China)

机构地区：[1]菏泽市立医院心脏血管外科

出　　处：《泰山医学院学报》2019年第7期545-547,共3页Journal of Taishan Medical College

摘　　要：目的总结大隐静脉序贯桥+乳内动脉单支桥非体外循环冠状动脉旁路移植手术的有效性及安全性,分析手术要点,探讨手术方法及临床疗效。方法于2014年4月至2018年2月共完成大隐静脉序贯桥+乳内动脉单支桥非体外循环冠状动脉旁路移植手术53例,男38例,女15例。所有病例均心脏跳动非体外循环下进行,先行带蒂左乳内动脉与前降支端侧吻合,再以大隐静脉为移植材料完成升主动脉与冠状动脉靶血管的序贯吻合。结果本组53例患者手术全部成功,住院期间无死亡患者,无术后心肌梗死及脑卒中发生。1年后随访,桥血管及吻合口通畅率满意。结论大隐静脉序贯桥+乳内动脉单支桥冠状动脉旁路移植手术临床效果满意,术中桥血管流量快,远期桥血管及吻合口通畅率高;手术时间短,对升主动脉损伤小,是一种快捷、安全的手术方式。Objective:To summarize the efficacy and safety of sequential bridge of the great saphenous vein for off-pump coronary artery bypass grafting of the internal mammary artery.Methods:From April 2014 to February 2018,53 cases of non extracorporeal bypass coronary artery grafting for the single branch of the large saphenous vein were completed in 38 men and 15 women.All cases were performed under the heart beating and non extracorporeal circulation.The left internal mammary artery and the anterior descending branch were anastomosed,and the great saphenous vein was used as the transplantation material to complete the sequential anastomosis of the ascending aorta and the target vessels of the coronary arteries.Results:All of the 53 patients were successful in operation,with no death during hospitalization or post-operative myocardial infarction and stroke.After 1 year follow-up,the patency rate of the bridge vessel and anastomotic stoma was satisfactory.Conclusion:The coronary artery bypass grafting of the single branch of the internal artery of the large saphenous vein is satisfactory,the flow of the bridge is fast,the rate of the vessel and the anastomosis of the bridge is high,the operation time is short,and the injury of the ascending aorta is small,which is a quick and safe operation.

关 键 词：冠状动脉旁路移植术 序贯桥 非体外循环 大隐静脉 

分 类 号：R654[医药卫生—外科学]