Kilic Yasin, Jalalzai Izatullah, Sonmez Ebubekir, Erkut Bilgehan
Department of Cardiovascular Surgery, Medical Faculty, Atatürk University, 25030 Erzurum, Turkey.
Heart Surg Forum. 2023 Dec 27;26(6):E808-E816. doi: 10.59958/hsf.6923.
When acute coronary syndrome patients necessitate immediate revascularization, heart-on-pump coronary artery bypass grafting may be regarded as a viable substitute for conventional on-pump surgery. Our clinical experience and initial outcomes of heart-on-pump coronary surgery in patients with acute coronary syndrome are detailed in this article.
This research endeavor was a retrospective analysis that spanned the years March 2011 to August 2023. The sample size comprised 2816 patients who had undergone coronary artery surgery. During this period, the same surgical team performed coronary artery bypass surgery on 411 of these patients, who underwent beating heart surgery while on cardiopulmonary bypass support and without cardioplegic arrest; this was done under emergency conditions.
9.3 ± 2.2 hours elapsed between the initiation of acute myocardial infarction and the commencement of coronary artery bypass grafting (CABG). A mean of 4.0 grafts was applied (2.2 ± 1.1). Mortality in hospitals was calculated for sixteen patients. Following surgery, twenty-six patients developed an inadequate cardiac output syndrome. Despite having renal dysfunction, none of the eight individuals needed hemodialysis. The mean duration of stay in intensive care was 3.2 (2.2 ± 1.1) days, while the mean length of hospitalization was 9.2 (4.3 ± 2.4) days.
We believe that for high-risk patients with multivascular coronary artery disease who require an emergency coronary artery bypass graft, on-pump beating heart revascularization could be a viable option.
当急性冠状动脉综合征患者需要立即进行血运重建时，非体外循环冠状动脉搭桥术可被视为传统体外循环手术的一种可行替代方案。本文详细介绍了我们在急性冠状动脉综合征患者中进行非体外循环冠状动脉手术的临床经验和初步结果。
本研究为回顾性分析，时间跨度为2011年3月至2023年8月。样本量包括2816例接受冠状动脉手术的患者。在此期间，同一手术团队对其中411例患者进行了冠状动脉搭桥手术，这些患者在体外循环支持下进行不停跳心脏手术，且未进行心脏停搏；这是在紧急情况下完成的。
急性心肌梗死发作至冠状动脉搭桥术（CABG）开始之间经过了9.3±2.2小时。平均应用了4.0根移植血管（2.2±1.1）。计算出16例患者的医院死亡率。术后，26例患者出现心输出量不足综合征。尽管存在肾功能不全，但8例患者中无人需要血液透析。重症监护的平均住院时间为3.2（2.2±1.1）天，而平均住院时间为9.2（4.3±2.4）天。
我们认为，对于需要紧急冠状动脉搭桥的高危多支冠状动脉疾病患者，体外循环不停跳心脏血运重建可能是一种可行的选择。
