Buffolo E, de Andrade C S, Branco J N, Teles C A, Aguiar L F, Gomes W J
Escola Paulista de Medicina, Hospital São Paulo, Disciplina de Cirurgia Cardiovascular, São Paulo, Brazil.
Ann Thorac Surg. 1996 Jan;61(1):63-6. doi: 10.1016/0003-4975(95)00840-3.
Coronary artery bypass grafting without cardiopulmonary bypass is now an accepted technique of myocardial revascularization. We herein report our total experience with this procedure.
In a consecutive series of 8,751 patients operated on in our institution for coronary artery disease from 1981 to 1994, 1,274 patients received coronary artery bypass grafting without cardiopulmonary bypass.
Results indicate that the operation can be performed with an acceptable mortality (2.5%), and that all types of arterial conduits can be used. Most commonly the left anterior descending and right coronary arteries were bypassed. The incidence of arrhythmias and of pulmonary and neurologic complications were significantly lower in this group of patients compared with patients receiving coronary artery bypass grafting with cardiopulmonary bypass. Most importantly, there was decreased cost when the procedure was used because no extracorporeal circulation, cardioplegia sets, or other cannulas were used.
We conclude that the continuing use of coronary artery bypass grafting without cardiopulmonary bypass is justified and that, with proper selection of patients, the procedure is safe and cost-effective.
非体外循环冠状动脉搭桥术现已成为一种公认的心肌血运重建技术。我们在此报告我们在该手术方面的总体经验。
在1981年至1994年间在我们机构接受冠心病手术的连续8751例患者中，1274例患者接受了非体外循环冠状动脉搭桥术。
结果表明，该手术可在可接受的死亡率（2.5%）下进行，并且所有类型的动脉血管均可使用。最常进行搭桥的是左前降支和右冠状动脉。与接受体外循环冠状动脉搭桥术的患者相比，该组患者心律失常、肺部和神经系统并发症的发生率显著更低。最重要的是，使用该手术时成本降低，因为无需使用体外循环、心脏停搏液装置或其他插管。
我们得出结论，持续使用非体外循环冠状动脉搭桥术是合理的，并且在适当选择患者的情况下，该手术安全且具有成本效益。
