标准冠状动脉旁路移植术与微创直接冠状动脉旁路移植术的比较。早期和中期结果。

Comparison of standard coronary artery bypass grafting and minimary invasive direct coronary artery bypass grafting. Early and mid-term result.

作者信息

Okawa Y, Baba H, Hashimoto M, Tanaka T, Toyama M, Matsumoto K, Azuma K

机构信息

Department of Cardiovascular Surgery, Toyohashi Heart Center, 21 Gobudori, Oyamacho, 441-8071 Toyohashi, Japan.

出版信息

Jpn J Thorac Cardiovasc Surg. 2000 Nov;48(11):725-9. doi: 10.1007/BF03218240.

DOI:10.1007/BF03218240

PMID:11144093

Abstract

OBJECTIVES

We studied indications and problems involved in minimally invasive coronary artery bypass grafting (MIDCAB).

METHODS

We compared patients profiles, graft patency, stenosis severity, morbidity, mortality, long-term survival and freedom from cardiac accidents in 174 patients undergoing elective standard coronary artery bypass grafting (CABG) and 128 undergoing between January 1996 and March 1999.

RESULTS

No statistically difference was seen in gender, diabetes mellitus, renal failure, cerebrovascular accident, multi-vessel disease ratios, or left main trunk stenosis between 2 groups. Internal thoracic artery graft patency was 97% (114/118) and the rate of anastomotic stenosis (> 50%) was 9% (10/118) compared to 96% (213/221) in the MIDCAB group. The 3-year survival rate was 91% in the MIDCAB group and 92% in the CABG group and freedom from cardiac accidents, most involving pericutaneus transluminal coronary angioplasty retreatment, was 66% in the MIDCAB group and 88% in the CABG group.

CONCLUSION

Although patency and stenosis incidence did not differ between 2 groups, freedom from cardiac accidents was lower in the MIDCAB group.

摘要

目的

我们研究了微创冠状动脉旁路移植术（MIDCAB）的适应症及相关问题。

方法

我们比较了1996年1月至1999年3月期间接受择期标准冠状动脉旁路移植术（CABG）的174例患者和接受MIDCAB的128例患者的病例资料、移植血管通畅情况、狭窄严重程度、发病率、死亡率、长期生存率以及无心脏意外情况。

结果

两组在性别、糖尿病、肾功能衰竭、脑血管意外、多支血管病变比例或左主干狭窄方面无统计学差异。MIDCAB组胸廓内动脉移植血管通畅率为97%（114/118），吻合口狭窄率（>50%）为9%（10/118），而CABG组分别为96%（213/221）。MIDCAB组3年生存率为91%，CABG组为92%；MIDCAB组无心脏意外情况（大多数涉及经皮腔内冠状动脉成形术再治疗）的比例为66%，CABG组为88%。