升主动脉钙化冠心病合并心肌桥12例临床分析

目的：分析升主动脉钙化冠心病合并心肌桥的外科治疗效果。方法：对12例升主动脉钙化冠心病合并心肌桥患者施行冠状动脉旁路移植术和心肌切开术,12例患者均存在不同程度的升主动脉钙化,术中将血管桥近端吻合在降主动脉上,对于较浅的心肌桥在非体外循环下行心肌切开术,而对于走形于心肌深部的肌桥,采用体外循环下冠状动脉旁路移植术;血管段同时合并狭窄及肌桥时,在心肌桥远侧的部位进行冠状动脉旁路移植术。结果：所有患者均手术顺利,无严重并发症,术后随访未出现心脏不良反应。结论：升主动脉钙化冠心病合并心肌桥者选择适当的手术方式可取得令人满意的近期效果,其远期疗效还有待于进一步观察。

Combined coronary artery bypass grafting and myotomy in the treatment of coronary artery disease with myocardial bridging

Objective To investigate the clinical effect of combined coronary artery bypass grafting and myotomy in the treatment of coronary artery disease with myocardial bridging.Method From April 2004 to July 2007,12 patients with coronary artery disease and myocardial bridging received myotomy and /or coronary artery bypass grafting(CABG).Results The acute clinical success rate was 100% with no death or other major inhospital complications.All patients survived the operation and recovered uneventfully.All patients were followed up clinically with the follow up rate of 100%.During follow-up,no patient had adverse cardiac events.Conclusion Surgical myotomy or CABG should be performed in coronary artery disease associated with myocardial bridging patients requiring surgical treatment.Surgical relief of myocardial ischemia due to systolic compression of intramyocardial coronary arteries can be accomplished with low operative risk and excellent middle and long term results.