| 不停跳冠脉搭桥心肌保护技术在瓣膜疾病合并冠心病手术中的应用 |
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| 引用本文： | 董桂福,王宇航,葛建军. 不停跳冠脉搭桥心肌保护技术在瓣膜疾病合并冠心病手术中的应用[J]. 中华全科医学, 2021, 19(10): 1650-1653. DOI: 10.16766/j.cnki.issn.1674-4152.002133 |
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| 作者姓名： | 董桂福 王宇航 葛建军 |
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| 作者单位： | 1.中国科学技术大学附属第一医院(安徽省立医院)心脏大血管外科,安徽 合肥 230001 |
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| 基金项目： | 安徽省科技重大专项项目18030801132 |
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| 摘 要： | 目的 介绍不停跳冠脉搭桥心肌保护技术在瓣膜疾病合并冠心病手术中的应用.方法 观察2017年1月-2020年7月就诊于中国科学技术大学附属第一医院心脏外科的瓣膜病合并冠心病的149例患者,应用不停跳冠脉搭桥心肌保护技术行瓣膜置换合并冠脉搭桥术的手术效果和相关并发症.对于搭桥+主动脉瓣膜/双瓣膜置换术,经左、右冠状动脉开口...
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| 关 键 词： | 冠心病合并瓣膜病 不停跳冠脉搭桥心肌保护技术 瓣膜置换 冠脉搭桥 术后住院死亡 |
| 收稿时间： | 2021-04-20 |
Application analysis of myocardial protection technique for off-pump coronary artery bypass grafting in the operation of valve disease combined with coronary heart disease |
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| Affiliation: | Department of Cardiac Surgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China |
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| Abstract: | Objective To introduce the application of myocardial protection technique for off-pump coronary artery bypass grafting (OPCABG) in the operation of valve disease complicated with coronary heart disease. Methods The effect and related complications of valve replacement combined with coronary artery bypass grafting using myocardial protection technique for OPCABG in patients with valvular disease complicated with coronary heart disease treated in the Department of Cardiac Surgery of the First Affiliated Hospital of China University of science and technology from January 2017 to July 2020. For bypass surgery+aortic valve replacement surgery, the direct perfusion through the left and right coronary artery orifices and transvenous graft perfusion were firstly performed, and then heart valve replacement surgery was taken and the anastomosis of aortic incision and vascular graft was sutured. For bypass surgery+mitral valve replacement surgery, the vascular graft was anastomosed with the pathological target vessel under the circulatory beating heart, and the vascular graft was anastomosed with the aorta. After the aorta was cooled and blocked, the aortic root perfusion and the mitral valve replacement were performed. Results Among the 149 patients, 49 patients taken aortic valve replacement+bypass surgery, 83 taken mitral valve replacement+bypass surgery, 17 taken double valves replacement+bypass surgery, 54 had a single pathological branch of coronary artery which required bypass surgery, 55 had two pathological branches of coronary artery which required bypass surgery, and 40 had three pathological branches of coronary artery requiring bypass surgery. Ten patients died during postoperative hospitalization, 4 suffered permanent stroke after surgery, 28 suffered acute renal insufficiency and required dialysis treatment, and 18 taken mechanical ventilation for more than 24 hours. Conclusion For patients with coronary heart disease combined with valvular diseases, the myocardial protection technique for OPCABG in coronary artery bypass surgery combined with valve surgery is easy to operate, causing less postoperative complications and bringing satisfactory surgical results and clinical effects. |
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