不横断胸骨微创不停跳冠状动脉旁路移植术临床总结

目的  总结胸骨下段小切口且不横断胸骨，施行微创不停跳冠状动脉旁路移植术的临床体会。方法  选取2013年5月-2016年6月施行胸骨下段小切口且不横断胸骨微创不停跳冠状动脉旁路移植术（MIDCAB）共9例（含1例杂交手术）。男8例，女1例；年龄48～91岁，平均（66.8±13.51）岁；均为冠状动脉粥样硬化性心脏病（冠心病），其中2例合并冠状动脉心肌桥，均采用左乳内动脉旁路移植于前降支。结果  全组患者无死亡，无并发症，术后均顺利出院，随访时间为1个月～3年，心绞痛症状消失，恢复正常工作及生活。结论  不横断胸骨微创不停跳冠状动脉旁路移植术具有切口小、创伤小、围术期合并症少、恢复快等优点，临床疗效可靠。

Clinical application of minimally invasive direct coronary artery bypass graft without sternal division

Objective To summarize the clinical experience of minimally invasive direct coronary artery bypass graft (MIDCAB) without sternal division. Methods MIDCAB (including 1 case of hybrid operation) were performed in 9 cases from May 2013 to June 2016. There were 8 males and 1 female aged 48-91 years with the average age of (66.8 ± 13.51) years. All the patients had coronary heart diseases, of which 2 had coronary artery myocardial bridge. All the patients received MIDCAB of left internal mammary artery to left anterior descending artery. Results There was neither death nor complication, and all the patients were discharged smoothly. After follow-up of 1 month to 3 years, the angina pectoris symptom disappeared and the patients returned to normal work and life. Conclusions The minimally invasive direct coronary artery bypass graft without sternal division has the advantages of small incision, little trauma, few perioperative complications, and fast recovery.