心血管手术同期施行冠状动脉搭桥

为提高心血管手术同期施行冠状动脉搭桥（ＣＡＢＧ）的疗效,降低手术死亡率,作者于１９８４年１１月至１９９６年７月施行此类手术５１例,其中瓣膜手术４５例,室间隔穿孔和室壁瘤切除４例,左房粘液瘤摘除术和腹主动脉瘤切除术各１例。术后早期死亡３例,死亡率５．８８％（１９９０年以后为４．１７％）,晚期死亡３例。作者认为：５０岁以上或有心绞痛症状和心电图缺血依据的心血管外科患者,应常规行冠状动脉造影。对狭窄程度＞５０％的主要分支,在纠正其他心血管病变同时,须行ＣＡＢＧ。术中充分再血管化,注意心肌保护,尽量减少升主动脉阻断时间。

Simultaneous coronary artery bypass grafting with other cardiovascular surgical procedures

To improve the effect and reduce the mortality of the simultaneous coronary artery bypass grafting (CABG) with other cardiovascular surgical procedures, from Nov,1984 to July,1996,51 patients underwent such operation. Among them 45 patients had valvular heart diseases, 4 postinfarction ventricular septal defect and ventricular aneurysm,and 1 myxoma of left atrium and abdominal aortal aneurysm.The operative mortality was 5 85% (3/51), and 3 patients died.Cardiovascular surgical patients of over 50 years or with angina pectorsi and ECG confirmed myocardiac ischemia should undergo coronary angiography routinely. If main coronary artery branches stenosis occupied over 50%, CABG must be performed.During the operation revasculariztion should be made as full as possible to enhance myocardiac protection and reduce the ascending aortic cross clamping time.