CT血管造影分析体外循环与非体外循环冠状动脉旁路移植后的桥血管通畅率

背景：近年来，非体外循环冠状动脉旁路移植后桥血管通畅率是否与传统的体外循环冠状动脉旁路移植相同存在争议。 目的：探讨体外循环与非体外循环冠状动脉旁路移植后桥血管时间通畅率的差异性。 方法：选取同一操作者行体外循环冠状动脉旁路移植患者100例，按其临床特征及桥血管病变危险因素匹配抽取非体外循环冠状动脉旁路移植患者137例。采用64排多螺旋CT血管造影分析冠脉搭桥后1个月，1年，2年，3年，4年的桥血管通畅情况。 结果与结论：共对641条桥血管进行评价，两组中左侧乳内动脉桥血管时间通畅率均高于大隐静脉桥，两组左侧乳内动脉桥和大隐静脉桥血管时间通畅率比较差异均无显著性意义。说明非体外循环与体外循环冠状动脉旁路移植后患者桥血管时间通畅率相似，对于某些适当的患者来说，非体外循环冠状动脉旁路移植不失为一个良好的选择。

Analysis on graft patency after off-pump and conventional coronary arterial bypass grafting by computed tomography angiography

BACKGROUND:Off-pump coronary artery bypass graft surgery (OPCAB) has been performed for many years and its use is increasing frequently, but it remains an open question whether OPCAB provides similar patency to conventional coronary artery bypass graft (CCABG) surgery with cardiopulmonary bypass. OBJECTIVE:To assess the graft patency in patients that had coronary arterial bypass grafting (CABG) performed on-pump and off-pump. METHODS:A total of 237 patients with CABG performed by a single surgeon were retrospectively studied, in which 100 patients underwent CCABG and 137 patients underwent OPCAB; the two groups were well matched according to relative factors and no significant differences were found in both groups. Postoperatively, systematic assessment on the graft patency of all patients was conducted with 64-slice multidetector spiral computed tomography angiography at 1 month, 1 year, 2 years, 3 years and 4 years, respectively, to provide 641 grafts for analysis. RESULTS AND CONCLUSION: Patency of left internal mammary artery was higher than that of saphenous vein in both groups; no significant difference was observed in left internal mammary artery patency and saphenous vein patency in both groups. Results of 64-slice multidetector spiral computed tomography angiography indicate that OPCAB provides similar patency to CCABG surgery with CPB.