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微创直接冠状动脉旁路移植术(MIDCAB)的短期临床结果

Short-Term Clinical Results of Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) Procedure.

作者信息

Alaj Eissa, Seidiramool Vahid, Ciobanu Veaceslav, Bakhtiary Farhad, Monsefi Nadejda

机构信息

Department of Cardiac Surgery, University Hospital Bonn, 53127 Bonn, Germany.

出版信息

J Clin Med. 2024 May 26;13(11):3124. doi: 10.3390/jcm13113124.

Abstract

Minimally invasive direct coronary artery bypass (MIDCAB) is an alternative for revascularisation of the isolated left anterior descending (LAD) artery or as a multi-vessel (MV) procedure for the diagonal branch (RD) or the left circumflex coronary artery (LCX) region. From 2021 to 2022, 91 patients underwent MIDCAB or multi-vessel MIDCAB procedures in our heart center. The left internal mammary artery (LIMA) was anastomosed to the left anterior descending artery via the left minithoracotomy approach in all patients. Of the patients, a total of 86.8% were male. Eighty percent of the patients had two- or three-vessel coronary artery disease. The mean age was 65.1 ± 10.1 years. The mean operation time was 2.6 ± 0.8 h. The 30-day mortality was 0. The mean required packed red blood cells (pRBC) was 0.4 ± 1.2 unit. The mean intensive care unit stay (ICU) was 1.5 ± 1.6 days. The mean follow-up time was 1.5 ± 0.5 years. One patient received percutaneous coronary intervention due to de novo stenosis of the RCA. Late mortality was 2.2%. The Kaplan-Meier survival rate was 98.8% at 1 and 2 years. The postoperative complication rate of our MIDCAB cohort is low, and the short-term survival is favorable. Our postoperative and short-term clinical results demonstrate that this procedure is safe and feasible.

摘要

微创直接冠状动脉旁路移植术(MIDCAB)是孤立性左前降支(LAD)动脉血运重建的一种替代方法,也可作为对角支(RD)或左旋支冠状动脉(LCX)区域的多支血管(MV)手术。2021年至2022年,91例患者在我们的心脏中心接受了MIDCAB或多支血管MIDCAB手术。所有患者均通过左胸小切口将左乳内动脉(LIMA)吻合至左前降支动脉。患者中,共有86.8%为男性。80%的患者患有双支或三支冠状动脉疾病。平均年龄为65.1±10.1岁。平均手术时间为2.6±0.8小时。30天死亡率为0。平均所需浓缩红细胞(pRBC)为0.4±1.2单位。平均重症监护病房停留时间(ICU)为1.5±1.6天。平均随访时间为1.5±0.5年。1例患者因右冠状动脉(RCA)新发狭窄接受了经皮冠状动脉介入治疗。晚期死亡率为2.2%。1年和2年时的Kaplan-Meier生存率为98.8%。我们的MIDCAB队列术后并发症发生率低,短期生存率良好。我们的术后及短期临床结果表明该手术安全可行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b8c/11173179/1c3724f519f1/jcm-13-03124-g001.jpg

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