Van Meter C H
Chief, Division of Cardiothoracic Surgery and Transplantation, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, LA.
Ochsner J. 2000 Jul;2(3):172-4.
In the hope of decreasing patient trauma and morbidity, cardiothoracic surgeons at the Ochsner Clinic are currently investigating techniques of performing coronary bypass surgery without the use of the cardiopulmonary bypass machine, which can cause complications following surgery in patients with certain coexisting conditions (such as renovascular, cerebrovascular, or pulmonary disease), particularly elderly patients. The initial 15 at-risk patients who underwent off-pump coronary artery bypass have demonstrated extremely encouraging results in reducing previously expected complication rates. Operative and intermediate survival was 100%. Eighty percent (80%) of procedures were accomplished without red blood cell transfusion, 100% were extubated within 24 hours of surgery, and (with the exception of two out-layers who had prolonged stays due to non-cardiac causes) the average length of stay was 5 days with only 18% demonstrating postoperative atrial arrhythmia. We are evaluating our technique to conform to multicenter protocols in the hope of identifying precisely which groups of patients will receive the maximal benefit from this procedure.
为了减少患者的创伤和发病率，奥施纳诊所的心胸外科医生目前正在研究不使用体外循环机进行冠状动脉搭桥手术的技术。体外循环机在某些合并症（如肾血管、脑血管或肺部疾病）患者，尤其是老年患者术后可能会引发并发症。最初接受非体外循环冠状动脉搭桥手术的15名高危患者在降低先前预期的并发症发生率方面取得了极其令人鼓舞的结果。手术和中期生存率为100%。80%的手术无需输注红细胞，100%的患者在术后24小时内拔管，（除两名因非心脏原因住院时间延长的患者外）平均住院时间为5天，只有18%的患者术后出现房性心律失常。我们正在评估我们的技术以符合多中心方案，希望准确确定哪些患者群体将从该手术中获得最大益处。
