Yu Yang, Gu Cheng-xiong, Wei Hua, Li Qin, Wang Chuan
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Zhonghua Wai Ke Za Zhi. 2010 Dec 15;48(24):1864-7.
To evaluate the early and medium-term curative effect of water sac blocking used in the proximal anastomosis during off-pump coronary artery bypass (OPCAB) in the patients with serious calcified ascending aorta.
Thirty-one patients with serious calcified ascending aorta who underwent OPCAB were enrolled in this study from January 2005 to May 2009 as experimental group in which the water sac blocking was used in the proximal anastomosis during OPCAB. There were 23 male and 8 female patients with the age of (69±8) years. Sixty-three patients without calcified ascending aorta who underwent OPCAB at the corresponding period were selected randomly as control group in which lateral-mural clamp on ascending aorta was used in the proximal anastomosis during OPCAB. There were 39 male and 24 female patients with the age of (60±9) years. Preoperative and postoperative heart functional indexes were compared in 3 months and the short and the mid-term outcomes were followed up.
No deaths happened in the two groups. Postoperative incidence rate of cerebral stroke in control group was relatively higher than experimental group, but there was no significant difference between the two groups (P<0.05). All the patients had no symptoms 3 months after operation. Heart function and ejection fraction were increased significantly (P<0.05), meanwhile left ventricular end-diastolic diameter were decreased notably (P<0.05). The follow-up rate was 91.5% and the survival rate was 96.0% and left ventricular function decreased slightly (P<0.05) up to the end of November 2009. Seven patients more than two years after operation received coronary angiography which showed proximal anastomotic stoma was patent.
For patients with serious calcified ascending aorta, the short and medium-term result of water sac blocking used in proximal anastomosis was simple, effective and safe.
评估水囊阻断技术在严重钙化升主动脉患者非体外循环冠状动脉旁路移植术（OPCAB）近端吻合术中的早期及中期疗效。
选取2005年1月至2009年5月期间行OPCAB的31例严重钙化升主动脉患者作为实验组，该组患者在OPCAB近端吻合术中采用水囊阻断技术。其中男性23例，女性8例，年龄（69±8）岁。同期随机选取63例无升主动脉钙化行OPCAB的患者作为对照组，该组患者在OPCAB近端吻合术中采用升主动脉侧壁钳夹技术。其中男性39例，女性24例，年龄（60±9）岁。比较两组患者术后3个月的心功能指标，并对其近期及中期结局进行随访。
两组均无死亡病例。对照组术后脑卒中发生率略高于实验组，但两组间差异无统计学意义（P<0.05）。所有患者术后3个月均无不适症状。心功能及射血分数显著提高（P<0.05），同时左心室舒张末期内径显著减小（P<0.05）。截至2009年11月底，随访率为91.5%，生存率为96.0%，左心室功能略有下降（P<0.05）。7例术后两年以上患者接受冠状动脉造影显示近端吻合口通畅。
对于严重钙化升主动脉患者，近端吻合术中采用水囊阻断技术的近期及中期效果简单、有效且安全。
