非体外循环冠状动脉搭桥术在低射血分数病人中的应用
[关键词] 冠状动脉搭桥术,非体外循环,左室功能低下,射血分数目的:总结分析25例射血分数小于30%的冠心病患者进行的非体外循环冠状动脉搭桥术。
方法:2000年2月至2001年4月进行的选择性OPCAB手术25例,全部经左心室造影测定射血分数在6-30%之间,平均25.6±5.6%。合并心梗史19例,急性心肌梗塞后1个月内6例,不稳定心绞痛12例。心功能II级9例,III级12例,IV级4例。冠状动脉造影提示两支病变3例,三支病变22例,左主干7例。
结果:全部病例均完成OPCAB手术,平均远端吻合口数目为3.9±0.8个,使用主动脉内球囊反搏14例,其中10例均在手术中安放。手术死亡1例,于术后2月死于多器官功能衰竭。有2例术后出现急性左心衰,安放主动脉内球囊反搏后保守治疗好转。其中2例为室颤,均复苏成功。
结论:低射血分数患者实施OPCAB手术有良好的可行性和近期效果,而长期结果仍有待进一步观察。
Off -Pump Coronary Artery Bypass Grafting
in Patients with Low Ejection Fraction
Wan Feng. Chen Yu, Wang Jingsheng, Wang Xinsheng, Chen Shenglong
Abstract
Objective: To analyze 25-case off-pump coronary artery bypass grafting (OPCAB) in patients with low left ventricular ejection fraction.
Method:25 case selective off pump coronary artery bypass grafting from February of 2000 to April of 2001 were analyzed, whose mean left ventricular ejection fraction by ventricular angiography was 25.6±5.6%。There were 19 cases with history of myocardial infarction, 12 case with unstable angina pectoris, 22 cases with triple vessels defect and 7 cases with left main coronary defect. ......
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