Enclose Ⅱ主动脉近端吻合器在非体外循环冠状动脉搭桥术中的应用

目的:总结600例Enclose Ⅱ主动脉近端吻合器在非体外循环冠状动脉搭桥术中的使用经验和体会。方法:自2006年1月至2009年12月,全组病例600例,平均年龄(63.2±9.1)岁。肝素1mg/kg抗凝下,于升主动脉置入Enclose Ⅱ主动脉近端吻合器使吻合器内膜和动脉壁之间形成无血环境,以6-0prolene缝线吻合大隐静脉于升主动脉上。结果:全组患者死亡2例,3例于术后恢复期下地活动后出现突发脑梗死,对症治疗恢复良好。5例因置入点出血行二次开胸止血术,其余患者均于术后7～14d痊愈出院。结论:Enclose Ⅱ主动脉近端吻合器,在非体外循环冠状动脉搭桥术中的应用具有良好的安全性和稳定性,明显降低术后脑血管并发症发生率。

The application of Enclose Ⅱ proximal anastomosis device in off-pump coronary artery bypass grafting

Objective：The objective of this study was to review the experience and understanding of a new proximal anastomotic device-Novare Enclose Ⅱ device during off-pump coronary artery bypass grafting surgery in 600 cases.Methods：From January,2006 to December,2009,a total of 600 patients（420 males and 180 females;mean age,63.2 ± 9.1 years） underwent proximal anastomoses with the Enclose Ⅱproximal anastomotic device in OPCAB.Results：There were 2 hospital death due to left heart failure.The postoperative complications included cerebral infarction after cardiac surgery in 3 cases and postoperation bleeding in 5.Conclusion：The Novare Enclose Ⅱproximal anastomotic device appears to be safe and effective as a tool for proximal anastomosis in OPCAB.Use of the Enclose Ⅱ may represent an important strategy for minimizing cerebral injury during proximal aortic anastomoses