双源CT评价冠状动脉搭桥术后桥血管通畅率的临床研究

目的比较非体外循环下冠状动脉旁路移植术（OPCABG）与常规冠状动脉旁路移植术（常规CABG）术后5年血管桥的通畅率。方法2006年1月至2008年1月间40例单独行冠状动脉旁路移植术（CABG）的患者资料回顾性地被分为OPCABG组和常规CABG组。OPCABG组通过胸骨正中切口，在非体外循环心脏不停跳下完成CABG；常规CABG组建立常规体外循环心脏停搏下完成CABG。两组术前的一般情况无明显差异。利用双源CT造影检查及CT图像后处理，研究两种术式各条血管桥的通畅情况。结果常规CABG组及OPCABG组左乳内动脉（uMA）到前降支（LAD）的通畅率都达到100％，静脉桥的通畅率分别为93．87％和94．23％，组间比较差异均无统计学意义。结论OPCABG旁路血管桥的3~5年通畅率可以和常规CABG相媲美。OPCAB治疗冠心病的初期结果显示可以减少术后并发症，减少患者术后呼吸机辅助时间、ICU留观时间和住院时间，降低住院费用。

Dual source CT estimate to grafts patency after coronary artery bypass surgeries

Objective To compare the grafts patency rate after off-pump coronary artery bypass grafting （OPCABG） and conventional coronary artery bypass grafting at 5 years follow-up. Methods Between January 2006 and January 2008 patients with coronary artery disease underwent coronary artery bypass grafting by one sur- geon were enrolled. They were divided into two groups, OPCABG group： 20 cases underwent CABG with off- pump and beating heart, conventional CABG group： 20 cases underwent conventional CABG with extra corporeal circulation. The grafts patency rate between two groups was studied by multislice spiral CT （MSCT）. Results The grafts patency rate of OPCABG group and conventional CABG group were 100% in grafts linked LIMA to LAD. The great saphenous vein grafts patency rate was 93.87%, 94.23%. Conclusion The grafts patency rate of OP- CABG has almost the same excellent result with which of conventional CABG. Patients with coronary disease un- derwent OPCABG have less operative morbidity, assisted respiratory time, ICU stay, hospitalization stay and hos- pitalization cost than those of conventional CABG. The pervasion of OPCAB is on the way.