全胸腔镜非体外循环下冠状动脉旁路移植术的动物实验研究

目的研究全胸腔镜非体外循环下冠状动脉旁路移植术的可行性。方法家猪8头,体重35⁴5kg,在双侧胸壁打孔,取双侧乳内动脉。将左侧乳内动脉旁路移植至前降支,右侧乳内动脉旁路移植至右冠状动脉。结果 8头实验猪全部成活,总共成功游离左侧乳内动脉8条,右侧乳内动脉8条。共行吻合口16个。左侧乳内动脉与前降支的吻合时间为2545kg,在双侧胸壁打孔,取双侧乳内动脉。将左侧乳内动脉旁路移植至前降支,右侧乳内动脉旁路移植至右冠状动脉。结果 8头实验猪全部成活,总共成功游离左侧乳内动脉8条,右侧乳内动脉8条。共行吻合口16个。左侧乳内动脉与前降支的吻合时间为25⁴2 min,平均(37±15)min。右侧乳内动脉与右冠状动脉的吻合时间为3642 min,平均(37±15)min。右侧乳内动脉与右冠状动脉的吻合时间为36⁵2 min,平均(44±9)min。术后除1例右侧乳内动脉与右冠状动脉吻合口狭窄外,其余吻合口通畅情况均良好。结论全胸腔镜非体外循环下行左右冠状动脉旁路移植术是可行的,家猪是良好的合适的动物训练模型。

ANIMAL EXPERIMENT OF VIDEO-ASSISTED CORONARY ARTERY BYPASS GRAFT

Objective To study the feasibility of totally thoracoscopic coronary artery bypass. Methods Eight pigs, weighed 35 -45 kg, were used in this study. Their left and right internal mammary arteries were harvested through the ports on the chest wall. The left internal mammary artery was sutured to the left anterior descending coronary artery and the right in- ternal mammary artery to the right coronary artery. Results All the eight experimental pigs survived. The eight left internal thoracic arteries and eight right internal mammary arteries were harvested. Totally 16 anastomotic stomas were completed. The anastomosis time for the left internal mammary artery with the left anterior descending artery was 25 -42 min, averaged （37 ± 15 ） min and the anastomosis time for right internal mammary artery with the right coronary artery was 36 - 52 min, averaged （44 ± 9） min. With one exception of anastomotic stenosis at the right internal mammary artery and the right coronary artery, the rest stomas were good. Conclusion Totally thoracoscopic off - pump coronary artery bypass grafting is feasible. Pigs age is suitable as a training model.