内窥镜游离与全程切开法静脉桥血管通畅率的初步研究

目的 比较冠状动脉旁路移植术(CABG)中内窥镜与全程切开法采集大隐静脉后静脉桥血管近、中期通畅率,分析影响静脉桥血管通畅率的危险因素.方法 回顾性分析解放军总医院2006年5月至2009年5月择期行CABG中采用内窥镜游离法制备大隐静脉60例(EVH组)的临床资料,其中男34例,女26例；年龄66.6±9.2岁.同期...

Comparative Study of Vein Graft Patency Between Endoscopic and Open Saphenous Vein Harvesting in Coronary Artery Bypass Grafting

Objective To compare vein graft patency after endoscopic great saphenous vein harvesting （EVH） and conventional open saphenous vein harvesting （OVH） in coronary artery bypass grafting （CABG）, and to identify risk factors for vein graft stenosis. Methods The great saphenous vein was harvested using an EVH method in 60 patients, 34 males and 26 females, who underwent CABG in the General Hospital of PLA between May 2006 and May 2009. The mean patient age was 66.6--4-_9.2 years in the EVH group. The OVH group had 60 patients （40 males and 20 females with a mean age of 65.7±10.6 years）, chosen to match the clinical characteristics of the EVH group. 64 multi slice computed tomography （64 MSCT） was used to evaluate vein graft patency at six months and two years postoperatively. We also collected and analyzed data on possible risk factors for vein graft stenosis. Results The harvesting time was longer in the EVH group than in the OVH group （52.54±13.3 minutes vs. 36.14±18.0 minutes, t=2.13, P（0.05）. The EVH group required a greater number of repairs to veins than did the OVH group （2.2±1.3 vs. 0. 94-0. 6,t=2. 60, P〈0.05）. There were no statistically significant differences in vein length, number of vein grafts, or vein graft flow between the two groups. There was also no significant difference in vein graft patency between the EVH and OVH groups at six months postoperatively （96.2 % vs. 94.5%） or at two years postoperatively （90.2% vs. 91. 5%）. The average of vein graft blood flow was a risk factor for vein graft stenosis（t=2.61, P= 0.01）. Conclusion The EVH vein graft had a good patency rate at six months and two years after the surgery.