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胸廓成形术后不停跳冠状动脉搭桥术

[On/off-pump beating coronary artery bypass grafting after thoracoplasty].

作者信息

Yashiki Noriyoshi, Saito H, Kiuchi R, Tomita S, Watanabe G

机构信息

Department of Thoracic Surgery, Koseiren Takaoka Hospital, Takaoka, Japan.

出版信息

Kyobu Geka. 2008 Feb;61(2):109-12.

Abstract

Off-pump coronary artery bypass grafting (CABG) [OPCAB] or on-pump beating CABG (conventional CABG) was performed in 3 post-thoracoplasty patients. Considering their poor respiratory function after thoracoplasty, OPCAB is considered more suitable than conventional CABG with cardio-pulmonary bypass in such cases with severe coronary lesions. However, because the sternum inclines or the pleural cavity may be polluted in these patients, special care is necessary for the operation. In such cases, it may be impossible to bypass to the circumflex artery in OPCAB, and is necessary to consider the use of percutaneous cardiopulmonary support (PCPS), cardio-pulmonary bypass or hybrid therapy before the operation.

摘要

3例胸廓成形术后患者接受了非体外循环冠状动脉旁路移植术(CABG)[OPCAB]或体外循环心脏不停跳CABG(传统CABG)。考虑到胸廓成形术后患者呼吸功能较差,在这类冠状动脉病变严重的病例中,OPCAB被认为比采用体外循环的传统CABG更合适。然而,由于这些患者胸骨倾斜或胸腔可能被污染,手术时需要特别小心。在这种情况下,OPCAB可能无法绕过回旋支动脉,术前有必要考虑使用经皮心肺支持(PCPS)、体外循环或杂交治疗。

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