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 offpump 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.