Coronary artery bypass grafting without cardiopulmonary bypass
Coronary artery bypass grafting without cardiopulmonary bypass
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DOI：
10.1016/0003-4975(95)00840-3
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发表时间：
1996-01-01
影响因子：
4.6
通讯作者：
Gomes, WJ
中科院分区：
文献类型：
--
作者：
Buffolo, E;deAndrade, JCS;Gomes, WJ
背景。不经体外循环的冠状动脉旁路移植术是目前公认的心肌血运重建术。我们在此报告我们使用此方法的全部经验。1981年至1994年，本院连续8751例冠心病患者行冠状动脉旁路移植术，其中1274例患者行冠状动脉旁路移植术。结果表明，手术死亡率（2.5%）可接受，所有类型的动脉导管均可使用。最常见的是左前降支和右冠状动脉旁路。与行冠状动脉旁路移植术合并体外循环的患者相比，该组患者心律失常、肺部和神经系统并发症的发生率明显降低。最重要的是，由于不使用体外循环、心脏截瘫装置或其他插管，使用该方法降低了成本。我们的结论是，继续使用冠状动脉旁路移植术而不进行体外循环是合理的，并且通过正确选择患者，该手术是安全且具有成本效益的。
Background. Coronary artery bypass grafting without cardiopulmonary bypass is now an accepted technique of myocardial revascularization. We herein report our total experience with this procedure.Methods. 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. 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.Conclusions. 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.