Macmanus Q, Grunkemeier G, Lambert L, Diethl C, Starr A
Br Heart J. 1978 Jun;40(6):608-11. doi: 10.1136/hrt.40.6.608.
Forty-nine patients have undergone combined aortic valve replacement and aortocoronary saphenous vein bypass graft surgery using a technique of distal coronary perfusion. Vein grafts are placed before replacement of the aortic valve, and continuously perfused by siting the proximal anastomoses high on the aortic root or individually perfusing the grafts before proximal anastomosis. Continuous coronary ostial perfusion is used as well during aortic valve replacement. There were 3 (6.1%) operative deaths and 1 (2%) perioperative myocardial infarction. A comparison of this technique with other reported results suggests that attention to myocardial perfusion distal to significant coronary artery stenosis may decrease the incidence of perioperative myocardial infarction in patients requiring both aortic valve replacement and coronary bypass graft operation.
49例患者接受了主动脉瓣置换术联合主动脉-冠状动脉大隐静脉旁路移植术，采用了远端冠状动脉灌注技术。静脉移植物在主动脉瓣置换术前放置，并通过将近端吻合口置于主动脉根部较高位置或在近端吻合术前单独灌注移植物来持续灌注。在主动脉瓣置换期间也采用持续冠状动脉开口灌注。有3例（6.1%）手术死亡和1例（2%）围手术期心肌梗死。将该技术与其他报道结果进行比较表明，关注严重冠状动脉狭窄远端的心肌灌注可能会降低同时需要进行主动脉瓣置换和冠状动脉旁路移植手术的患者围手术期心肌梗死的发生率。
