70岁以上女性冠心病患者非体外循环冠状动脉旁路移植术

目的　分析总结 5 2例 70岁以上女性冠心病患者非体外循环冠状动脉旁路移植术。方法　 2 0 0 0年 8月至2 0 0 3年 9月共完成 5 2例 70岁以上女性冠心病患者非体外循环冠状动脉旁路移植术 ,平均年龄 (71.4± 1.7)岁。本组病例 ,不稳定型心绞痛 2 7例 ,1个月内急性心肌梗死 7例。冠状动脉 3支血管病变 4 7例 ,左主干病变 10例。 9例左心室射血分数低于 30 % ,10例左心室舒张期末内径大于 6 0 mm。结果　完成非体外循环冠状动脉旁路移植术 5 0例 ,包括急症手术 3例。 2例改为体外循环冠状动脉旁路移植术。平均远端血管吻合数 (2 .9± 1.2 )例。 4例使用主动脉气囊反搏。 1例术后 3周死于胸骨后感染所致多脏器功能衰竭。结论　非体外循环冠状动脉旁路移植术对 70岁以上女性患者是安全可行的。

Off-pump coronary artery bypass in female patients aged 70 or more

Objective To analyze 52-case off-pump coronary artery bypass graft (OPCAB)in female patients aged 70 or more. Methods 52 female patients of OPCAB from August 2000 to September 2003 were performed, whose mean age was (71.4±1.7) years. Among them, 27 cases had unstable angina pectoris, and 7 cases had acute myocardial infaction in one month. 47 cases with triple vessels defect, and 10 cases with left main coronary defect. 9 cases with left ventricular ejection fraction below 30%, and 10 cases with left ventricular end-diastolic diameter over 60mm.Results: OPCAB surgery were performed in 50 cases, including 3 cases emergency operation. Conversion to conventional coronary artery bypass graft was required in 2 cases. The mean number of grafts was (2.9±1.2)patient. The intra-aortic ballon pump was used in 4 cases. There was 1 death due to multiple organ function failture resulted from deep wound infection 3 weeks after operation.Conclution OPCAB is safe and feasibility to female patients aged 70 or more.