冠状动脉支架植入术后行冠脉旁路移植术

目的:总结15例冠状动脉支架植入术后行冠状动脉旁路移植术的临床经验。方法:回顾分析行冠状动脉支架植入术后行冠状动脉旁路移植术15例患者的资料,男10例,女5例,平均年龄(61±5)岁。行冠状动脉支架植入术后再行冠状动脉旁路移植术时间间隔(24±4)月,冠状动脉内置入支架3-6枚,左室射血分数为43%-64%,其中50%为3例。全组行体外循环下冠状动脉旁路移植术3例,行非体外循环心脏跳动下冠状动脉旁路移植术12例。结果:全组共行动脉桥吻合13支,静脉桥33支;围术期并发低心排综合征3例,肺部感染4例,胸腔内出血行胸腔闭式引流术2例,本组患者无死亡病例。术后平均住院日(13±4)天。结论:对冠状动脉内支架植入术后再狭窄或(和)冠状动脉再血管化不足的病例进行冠状动脉旁路移植治疗,可使冠状动脉达到充分再血管化,提高冠心病患者生活质量及预后。

Coronary Artery Bypass Grafting Following Percutaneous Coronary Stenting

Objective: To review the clinical experience in 15 patients undergone coronary artery bypass grafting (CABG) after percutaneous coronary intervention (PCI). Methods: 15 patients underwent CABG were reviewed. Of 10 males and 5 females with a mean age of (61± 5). The mean periods between CABG and PCI were (24± 4) months. Left ventricle ejection fraction (EF) was 43% -64%, and there was 3 cases with EF<50%. Among them, 3 cases performed with CABG under cardiopulmonary bypass (CPB), and 12 cases with off pump coronary artery bypass grafting (OPCAB). Results: The numbers of arterial grafts and venous grafts were 13 and 33 respectively. There were 3 cases with low output syndrome, 4 cases with pulmonary infection and 2 cases with Pleural effusion undergoing closed thoracic drainage. There were no deaths after CABG, and the average postoperative length of stay was 13± 4 days. Conclusion: CABG surgery is safe and effective in patients with coronary artery diseases who underwent PCI to improve myocardial blood flow.