Kondo K, Minohara S, Sawada Y, Irie H, Okamoto K, Kinugasa S, Nakao M, Sasaki S
Department of Thoracic Surgery, Osaka Medical College, Japan.
Surg Today. 1997;27(3):202-6. doi: 10.1007/BF00941645.
As an alternative method of myocardial protection and to obviate the inherent risks of cardiopulmonary bypass (CPB), we have been performing coronary artery bypass grafting (CABG) without CPB in carefully selected patients. Since the first such operation was successfully performed in January 1995 on a patient with angina pectoris and lung cancer, four other patients have subsequently undergone this technique. This series of 5 patients, being 1 man and 4 women ranging in age from 68 to 80 years, is presented in this report. The reasons for the selection of this procedure were concomitant diseases including lung cancer, a calcified aorta, and myocardial infarction. The mean time of ischemia for each anastomosis was 15.3 +/- 5.3 min, and the maximum cardiac muscle creatine phosphokinase (CPK-MB) was less than 14 unit/l postoperatively. None of the patients required ventilatory support for longer than 24 h postoperatively, and oral intake was started within 24 h after extubation in all patients. Postoperative angiography confirmed graft patency and none of the patients developed any ischemic symptoms. All the patients were discharged between 1 and 2 months postoperatively. Thus, the off-pump technique is useful when concomitant diseases are present and will become an alternative method of treatment for coronary artery disease in selected patients.
作为一种心肌保护的替代方法，并为了避免体外循环（CPB）的固有风险，我们一直在精心挑选的患者中进行非体外循环冠状动脉搭桥术（CABG）。自1995年1月首次成功地为一名患有心绞痛和肺癌的患者实施此类手术以来，随后又有其他4名患者接受了该技术治疗。本报告介绍了这组共5例患者，其中1例男性，4例女性，年龄在68至80岁之间。选择该手术方法的原因是存在包括肺癌、主动脉钙化和心肌梗死在内的合并症。每次吻合的平均缺血时间为15.3±5.3分钟，术后心肌肌酸磷酸激酶（CPK-MB）最高值低于14单位/升。所有患者术后需要通气支持的时间均不超过24小时，所有患者在拔管后24小时内开始经口进食。术后血管造影证实移植血管通畅，所有患者均未出现任何缺血症状。所有患者均在术后1至2个月出院。因此，非体外循环技术在存在合并症时是有用的，并将成为特定患者冠状动脉疾病的一种替代治疗方法。
