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非體外循環(huán)冠狀動脈搭橋術在低射血分數(shù)病人中的應用
[關鍵詞] 冠狀動脈搭橋術,非體外循環(huán),左室功能低下,射血分數(shù)
目的:總結分析25例射血分數(shù)小于30%的冠心病患者進行的非體外循環(huán)冠狀動脈搭橋術。
方法:2000年2月至2001年4月進行的選擇性OPCAB手術25例,全部經(jīng)左心室造影測定射血分數(shù)在6-30%之間,平均25.6±5.6%。合并心梗史19例,急性心肌梗塞后1個月內6例,不穩(wěn)定心絞痛12例。心功能II級9例,III級12例,IV級4例。冠狀動脈造影提示兩支病變3例,三支病變22例,左主干7例。
結果:全部病例均完成OPCAB手術,平均遠端吻合口數(shù)目為3.9±0.8個,使用主動脈內球囊反搏14例,其中10例均在手術中安放。手術死亡1例,于術后2月死于多器官功能衰竭。有2例術后出現(xiàn)急性左心衰,安放主動脈內球囊反搏后保守治療好轉。其中2例為室顫,均復蘇成功。
結論:低射血分數(shù)患者實施OPCAB手術有良好的可行性和近期效果,而長期結果仍有待進一步觀察。
Off -Pump Coronary Artery Bypass Grafting
in Patients with Low Ejection Fraction
Wan Feng. Chen Yu, Wang Jingsheng, Wang Xinsheng, Chen Shenglong
Abstract
Objective: To analyze 25-case off-pump coronary artery bypass grafting (OPCAB) in patients with low left ventricular ejection fraction.
Method:25 case selective off pump coronary artery bypass grafting from February of 2000 to April of 2001 were analyzed, whose mean left ventricular ejection fraction by ventricular angiography was 25.6±5.6%。There were 19 cases with history of myocardial infarction, 12 case with unstable angina pectoris, 22 cases with triple vessels defect and 7 cases with left main coronary defect.
Results:OPCAB surgery were performed in all the cases. The mean number of distal anastamose was 3.9±0.8. Intra-aortic balloon pump was used in 14 cases, of which 10 cases we
[1] [2] [3] [4] [5]
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