Collison Sathiakar Paul, Agarwal Anil, Trehan Naresh
Escorts Heart Institute and Research Centre, New Delhi, India.
Ann Thorac Surg. 2006 Oct;82(4):1559-66. doi: 10.1016/j.athoracsur.2006.05.019.
Technical advances have made the performance of multivessel off-pump coronary artery bypass feasible. Snaring and intraluminal shunts are the techniques used for vascular control. Snaring provides a bloodless surgical field, is usually well tolerated by the patient, and is supported by years of clinical experience. Intraluminal shunts aim to achieve hemostasis at the arteriotomy site and to allow antegrade flow to provide myocardial protection. There are unresolved issues regarding whether shunts have a clinical benefit, do provide adequate flow to provide myocardial protection, and whether they cause significant endothelial damage. In this article, we have reviewed the literature to lend perspective to these issues.
技术进步已使多支血管非体外循环冠状动脉搭桥手术成为可能。套扎和腔内分流术是用于血管控制的技术。套扎可提供无血的手术视野，患者通常耐受性良好，且有多年临床经验支持。腔内分流术旨在实现动脉切开部位的止血，并允许顺行血流以提供心肌保护。关于分流术是否具有临床益处、是否能提供足够的血流以提供心肌保护以及是否会造成显著的内皮损伤，仍存在未解决的问题。在本文中，我们回顾了相关文献，以对这些问题提供见解。
