Akiyama K, Ogasawara K, Inoue T, Shindou S, Okumura H, Negishi N, Sezai Y
Second Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo 173-0032.
Ann Thorac Cardiovasc Surg. 1999 Feb;5(1):31-5.
We have treated 7 myocardial revascularization cases with operative risk factors, using the beating heart technique without cardiopulmonary bypass. Operative risk factors included left ventricular dysfunction, calcified aorta, chronic renal failure, cerebrovascular accident, immunosupressive state and old age. The 6 males and 1 female ranged in age from 54 to 84 years (mean age 70 years). The mean number of grafts was 1.3 per patient. All were extubated within 3 hours of arrival at the intensive care unit. Inotropic catecholamin support was not necessary on postoperative days. None of our patients had perioperative myocardial infarction. Postoperative angiography showed that all grafts were patent. We have found, based on our experiences, that selected patients can safely undergo CABG without cardiopulmonary support.
我们采用非体外循环心脏跳动技术治疗了7例具有手术危险因素的心肌血运重建病例。手术危险因素包括左心室功能障碍、主动脉钙化、慢性肾功能衰竭、脑血管意外、免疫抑制状态和高龄。6例男性和1例女性，年龄在54至84岁之间（平均年龄70岁）。每位患者平均移植血管数量为1.3根。所有患者在进入重症监护病房后3小时内均拔除气管插管。术后无需使用儿茶酚胺类正性肌力药物支持。我们的患者均未发生围手术期心肌梗死。术后血管造影显示所有移植血管均通畅。基于我们的经验，我们发现，经过挑选的患者可以在无体外循环支持的情况下安全地进行冠状动脉旁路移植术。
