微创冠状动脉搭桥术(附23例报告)  

Off-pump coronary artery bypass grafting (A report of 23 cases)

作　　者：李小波[1] 单根法[1] 张辅贤[1] 隆桂麟[1] 杜奇容[1] 李国庆[1] 钟竑[1] 戚晓敏[1] 耿隽超[1] 

机构地区：[1]上海第二医科大学附属新华医院心胸外科,上海200092

出　　处：《中国微创外科杂志》2002年第5期295-296,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探索冠状动脉搭桥术的微创治疗方法。　方法 1999年 1月至 2 0 0 0年 8月 ,用Octo pus方法给 2 3位冠状动脉狭窄的患者行冠状动脉搭桥术。搭桥数 1根 1例 ,2根 3例 ,3根以 19例。移植部位 :前降支 2 3例 ,对角支 8例 ,回旋 15例 ,右冠 14例 ,后降支 8例。移植血管 :左乳内动脉 2 0根 ,大隐静脉 4 8根。　结果　无手术死亡 ,无中转体外循环 ,术后心绞痛消失 ,MRI提示桥血管通畅。　结论　非体外循环下冠状动脉搭桥术适用于多支血管病变 ,包括回旋支和后降支。桥血管通畅率与常规冠状动脉搭桥术相同。并发症少 ,费用低 ,是一种安全、经济的微创手术方法。Objective To study a minimally invasive surgical procedure for coronary artery bypass grafting (GABG). Methods 23 patients, aged from 45 to 73 years old, undervent off-pump coronary artery bypass grafting (OPCABG) according to Octopus procedure from December 1999 to Auguest 2001. In the present study , more than 3 vessels were involved in 19 patients; 2 vessels involved in 3 cases and 1 vessel involved in one case. The grafted arteries included left anterior descending branch (LAD)(23); circumflex(CX)(15); right coronary artery(RCA)(14); ramus intermedius(RUM)(8); and posterior descending artery(PDA) (8). The types of grafts were left internal mammary artery (LIMA)(20) and saphenous vein grafts(SVG)(48). Results None of the patients was managed by means of cardiopulmonary bypass. All survived without angina pectoris. MRI showed that all the conduits were patent postoperatively. Conclusions OPCABG by Octopus procedure can be used in multiple vessel coronary bypass including CX and PDA. The patency rate is similar to that of the conventional technique. The mortality rate and occurrence of complications is low compared with those of the conventional technique . In addition, medical cost is lower. So This procedure is both safe and cost-effective, and is of value in clinical practice.

关 键 词：微创冠状动脉搭桥术 治疗 冠状动脉狭窄 非体外循环 

分 类 号：R654.2[医药卫生—外科学]