Salerno T A
Ann Thorac Surg. 1982 May;33(5):518-20. doi: 10.1016/s0003-4975(10)60798-9.
Using hypothermic cardiopulmonary bypass and a single cross-clamping period under multidose infusions of hypothermic cardioplegia, both distal and proximal anastomoses were performed in 87 consecutive patients undergoing coronary artery operation. This method allows for precise surgical technique, avoids the need for multiple clampings of the ascending aorta, and appears to avoid the threat of aortic tear. When the clamp is released, the heart has been totally revascularized. This is in contrast to more conventional methods, where an exclusion clamp is applied to the ascending aorta and where the combination of coronary stenosis, low perfusion pressure during bypass, and narrowing of the ascending aorta by the exclusion clamp may be more hazardous than a single cross-clamp period for construction of all anastomoses. This is particularly applicable to patients with severe stenosis of the left main coronary artery.
在低温体外循环和多剂量低温心脏停搏液输注下的单次主动脉阻断期间，对87例连续接受冠状动脉手术的患者进行了远端和近端吻合。这种方法允许采用精确的手术技术，避免了对升主动脉进行多次钳夹的需要，并且似乎避免了主动脉撕裂的风险。当松开钳夹时，心脏已完全实现血运重建。这与更传统的方法形成对比，在传统方法中，需对升主动脉应用阻断钳，而冠状动脉狭窄、体外循环期间的低灌注压力以及阻断钳导致的升主动脉狭窄相结合，对于构建所有吻合口而言，可能比单次主动脉阻断期更具危险性。这尤其适用于左主干冠状动脉严重狭窄的患者。
