一站式杂交手术治疗冠状动脉三支血管病变近期疗效观察

摘要

Objective:To evaluate the safety and effectiveness of one-stop hybrid therapy for triple-vessel coronary disease.Methods:Totally 34 patients with triple vessel coronary disease were treated by off-pump coronary artery bypass graft (OPCAB)combined with percutaneous coronary intervention(PCI)from Jan.2011 to Jun.2014.All 34 patients received PCI firstly,46 stents implanted in coronary arteries,and then OPCAB were performed,41 distal anastomosis were completed. Results:The one-stop hybrid procedure was successful in all patients.Selective coronary angiography immediately after one-stop hybrid procedure showed that grafts and stents were unobstructed.There was no death during the operation and perioperative period,no episodes of angina attack,no cardio-cerebrovascular events,no bleeding postoperatively and second exploratory thoracotomy.All patients remained free from angina,cardiac function improved significantly and no patient need medical intervention during the(36 ± 8)months follow-up period.Conclusions:One-stop hybrid cardiac surgery provides a reasonable,feasible,and safe alternative for treating patients with coronary artery triple-vessel lesions,and it has good prognosis.%目的:探讨一站式杂交手术治疗冠状动脉三支血管病变的安全性及有效性.方法:2011年1月至2014年6月, 34例冠状动脉三支血管病变患者接受非体外循环冠脉旁路移植术(off-pump coronary artery bypass graft,OPCAB)联合经皮冠脉介入治疗术(percutaneous coronary intervention,PCI),观察患者近期疗效及并发症发生情况.结果:34例患者均成功完成手术,无术中死亡,OPCAB共完成41处远心端吻合,同期PCI植入冠脉支架46枚.术后即刻DSA造影示移植物及支架内无闭塞发生.患者术后恢复可,无心绞痛发作,无围术期死亡,无心脑血管事件发生,无二次开胸探查.术后平均随访(36 ± 8)个月,患者无再发心绞痛,未再接受医疗干预.结论:一站式杂交手术治疗冠状动脉三支血管病变安全、有效,近期预后良好.