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Clinical experience of simultaneous aortic operation and coronary artery bypass grafting
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF SURGERY
- Issue:
- 2
- DOI:
- 10.3760/j.issn.0529-5815.2006.02.002
- Key Word:
- 动脉瘤,夹层;主动脉瘤,胸;冠状动脉分流术
Abstract： 目的总结行主动脉手术同期行冠状动脉旁路移植术的临床经验.方法回顾分析1997年11月至2004年8月,36例同期行主动脉手术和冠状动脉旁路移植术患者的临床资料.36例中,主动脉夹层19例,主动脉瘤17例.年龄(57±12)岁.其中急性A型主动脉夹层10例,术中探查见冠状动脉开口受累7例,冠状动脉为索条状2例,1例在外院行冠状动脉造影检查发现;慢性A型主动脉夹层7例,术中发现冠状动脉开口受累2例,冠状动脉呈索条状3例,术前造影检查发现冠状动脉病变2例;B型主动脉夹层2例;真性主动脉瘤均为术前冠状动脉造影检查发现冠状动脉病变.移植血管共57支,其中动脉6支,静脉51支.结果平均体外循环时间(157±54) min,心肌阻断时间(98±31) min.围手术期死亡5例(均为A型主动脉夹层),分别为低心排血量综合征、心源性休克并发多脏器功能衰竭3例,脑疝1例,内脏缺血坏死1例.术后发生并发症2例,发生率为6%,分别为二次开胸止血和呼吸功能衰竭气管切开.结论主动脉夹层累及冠状动脉和冠状动脉本身的病变严重影响预后.对年龄>50岁的主动脉瘤患者,于术前常规行冠状动脉造影检查,行单纯主动脉瘤手术并同期行冠状动脉旁路移植手术安全、可靠.
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