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非体外循环冠状动脉旁路移植术中2种近端吻合方式的临床对照研究

Comparison of two aortic proximal anastomotic strategies during off-pump coronary artery bypass grafting

  • 摘要:
    目的 探讨Heartsting近端吻合装置和部分阻断法这2种近端吻合方式在非体外循环冠状动脉旁路移植术中的临床疗效。
    方法 回顾性分析2018年5月至2021年5月复旦大学附属中山医院心脏外科收治的非体外循环冠状动脉旁路移植术258例患者的临床资料,其中男性220例,女性38例,平均年龄(68.6±8.2)岁。根据近端吻合方式分为Heartstring近端吻合装置组(HS组,n=86)和部分阻断组(PC组,n=172)。
    结果 术后死亡2例(0.78%),HS组与PC组各1例,差异无统计学意义。术后脑卒中7例(2.13%),HS组1例,PC组6例,差异无统计学意义。
    结论 Heartstring近端吻合装置可减少主动脉操作,对于高危患者应用此装置可获得良好的近期效果。

     

    Abstract:
    Objective To explore the clinical efficacy of two different aortic proximal anastomotic strategies: Heartstring device (HS) and partial clamping (PC) during off-pump coronary artery bypass grafting (OPCAB).
    Methods Clinical data of 258 patients who underwent OPCAB procedure at the Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University from May 2018 to May 2021 were retrospectively analyzed, including 220 males and 38 females, with a mean age of 68.6±8.2 years. Patients were grouped according to different intraoperative aortic manipulation strategies: Heartstring clampless facilitating device group (HS, n=86) and partial clamp group (PC, n=172).
    Results There were two cases of postoperative death (0.78%, one case in each group), and there were 7 cases of postoperative stroke 7 (2.13%; 1 in the HS group and 6 in the PC group, P=0.430).
    Conclusions The Heartstring proximal anastomosis device can reduce aortic operation, and good short-term effects can be obtained for high-risk patients.

     

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