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非体外循环冠状动脉旁路移植术后免接触式连续静脉桥取栓的扩张。

The expansion of no-touch harvesting sequential vein graft after off-pump coronary artery bypass grafting.

机构信息

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

出版信息

J Card Surg. 2021 Jul;36(7):2381-2388. doi: 10.1111/jocs.15577. Epub 2021 May 7.

Abstract

BACKGROUND AND AIM OF THE STUDY

Many studies support that the no-touch (NT) procedure can improve the patency rate of vein grafts. However, it is not clear that the sequential vein graft early expansion in the NT technique during off-pump coronary artery bypass grafting (CABG). This study will explore this issue.

METHODS

This was a prospective single-center randomized controlled clinical trial. A total of 100 patients undergoing off-pump CABG with the sequential saphenous graft were randomly assigned to two groups: the NT and conventional (CON) groups. Perioperative and postoperative data were collected during the hospital stay. The mean diameter of sequential grafts was measured using cardiac computed tomography angiography 3 months after the operation.

RESULTS

There was a significant difference in the average diameter of sequential grafts between the two groups (NT: [2.98 ± 0.42], CON: [3.26 ± 0.51], p = .005). There was no difference in occlusion of sequential venous grafts between the two groups (NT: 4/48 [8.3%], CON: 5/49 [10.2%], p = 1.000). There were differences in surgery time between the two groups (NT: 220 [188,240], CON: 190 [175,230], p = .009).

CONCLUSIONS

The sequential graft early expansion in the NT technique is not as pronounced as that in the conventional technique, which may have a long-term protective effect on the grafts.

摘要

背景与研究目的

许多研究表明,非接触(NT)技术可以提高静脉移植物的通畅率。然而,在非体外循环冠状动脉旁路移植术(CABG)中,NT 技术中连续静脉移植物早期扩张的效果尚不清楚。本研究将对此进行探讨。

方法

这是一项前瞻性单中心随机对照临床试验。共纳入 100 例行非体外循环 CABG 且采用序贯隐静脉移植物的患者,随机分为 NT 组和常规(CON)组。收集围手术期和住院期间的相关数据。术后 3 个月,采用心脏计算机断层血管造影术测量序贯移植物的平均直径。

结果

两组序贯移植物的平均直径存在显著差异(NT 组:[2.98±0.42]mm,CON 组:[3.26±0.51]mm,p=0.005)。两组序贯静脉移植物闭塞率无差异(NT 组:4/48[8.3%],CON 组:5/49[10.2%],p=1.000)。两组手术时间存在差异(NT 组:220[188,240]min,CON 组:190[175,230]min,p=0.009)。

结论

NT 技术中序贯移植物早期扩张不明显,可能对移植物有长期保护作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59d8/8252464/a0e72796bf63/JOCS-36-2381-g002.jpg

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