Yamazaki T, Sakurai K, Hagiwara H, Yoshikawa M, Ito T, Akita T, Yano Y, Abe T
Department of Cardiovascular Surgery, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
Kyobu Geka. 2002 Jul;55(7):529-33; discussion 533-6.
Right heart bypass (RHB) yields more stable hemodynamics by increasing left ventricular preload and collapse right ventricular chamber during the displacement of the heart on beating heart coronary artery bypass grafting (CABG). Recently beating heart CABG gaining popularity, and the indications for CABG have increasingly expanded to elderly person. Using RHB while exposing posterior branches by displacing the beating heart, we have attempted to make total revascularization in beating heart CABG. We performed beating heart CABG with RHB in 3 cases of octogenarian. All patients had left main trunk lesion and needed revascularization of posterior vessels. Introduction of RHB enabled us to approach to posterior target vessels in better exposure and under greater hemodynamic stability. All three patients had no complications postoperatively. Strictly speaking CABG with RHB is not off-pump CABG, but RHB system does not include either artificial lung or manipulation of the aorta. Therefore we think it is very effective support system which enables multiple coronary revascularization for elderly person.
在跳动心脏冠状动脉搭桥术（CABG）中，通过增加左心室前负荷并在心脏移位过程中使右心室腔塌陷，右心旁路（RHB）可产生更稳定的血流动力学。近来，跳动心脏CABG越来越受欢迎，且CABG的适应症已日益扩大至老年人。在通过移位跳动心脏暴露后支血管时使用RHB，我们已尝试在跳动心脏CABG中实现完全血运重建。我们对3例八旬老人实施了采用RHB的跳动心脏CABG。所有患者均有左主干病变且需要后血管的血运重建。RHB的应用使我们能够在更好的暴露和更大的血流动力学稳定性下接近后目标血管。所有3例患者术后均无并发症。严格来讲，采用RHB的CABG并非非体外循环CABG，但RHB系统既不包括人工肺也不涉及主动脉操作。因此，我们认为它是一种非常有效的支持系统，能够为老年人实现多条冠状动脉的血运重建。
