Strategy of coronary bypass grafting for patients with anterior wall calcification of ascending aorta_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

張仁騰 , 姜輝 ,  王輝山

沈陽軍區總醫院心血管外科（沈陽 110016）;

Corresponding?author：

王輝山, Email: huishanwang@hotmail.com

Keywords：

冠狀動脈旁路移植; 升主動脈鈣化; 腦梗塞

DOI：

10.7507/1007-4848.201511027

Video：

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Abstract Full text Figures/Tables Video References Cited by

目的探討合并彌漫性升主動脈前壁鈣化的冠心病患者冠狀動脈旁路移植術策略。方法回顧性分析 2011 年 9 月至 2012 年 6 月 30 例升主動脈前壁彌漫鈣化的冠心病患者的冠狀動脈旁路移植手術策略，男 21 例、女 9 例，年齡 60～75 歲。所有患者均行非體外循環冠狀動脈旁路移植術（OPCAB）。結果術后住院時間（8.7±3.2）d，圍術期無死亡，無心腦血管意外，無傷口及縱隔感染。圍術期主要并發癥為心房顫動，發生率 23.3%。術后 30 d 常規復查所有患者心絞痛癥狀均消失或改善，心功能改善。結論對于升主動脈前壁有彌漫鈣化的冠心病患者，采用 OPCAB 方式，多種方法聯合應用，可盡量避免或減少升主動脈前壁的刺激，減少手術風險，實現最大限度的目標冠狀動脈再血管化。

Citation： 張仁騰, 姜輝, 王輝山. Strategy of coronary bypass grafting for patients with anterior wall calcification of ascending aorta. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(4): 315-317. doi: 10.7507/1007-4848.201511027 Copy

1.	?Bamer HB. Operative treatment of coronary atheroselerosis. Ann Thorac Surg, 2008, 85 (4): 1473-1482.
2.	Lev-Ran O, Loberman D, Matsa M, et al. Reduced strokes in the elderly: the benefits of untouched aorta off-pomp coronary surgery. Ann Thorac Surg, 2004, 77 (1): 102-107.
3.	Lev-Ran O, Braunstein R, Sharony R, et al. No-touch aorta off-pump coronary surgery: the effect on stroke. J Thorac Cardiovase Surg, 2005, 129(2): 307-313.
4.	Mishra M, Malhotra R, Kalrekar A, et al. Propensity case-matched analysis of off-pump versus on-pump coronary artery bypass grafting in patients with atheromatous aorta. Ann Thorac Surg, 2006, 82 (7): 608-614.
5.	Rosenberger P, Shernan SK, Loffler M, et al. The influence of epiaortic ultrasonography on intraoperative surgical management in 6 051 cardiac surgical patients. Ann Thorac Surg, 2008, 85(2): 548-553.
6.	Goto T, Maekawa K. Cerebral dysfunction after coronary artery bypass surgery. J Anesth, 2014, 28(2): 242-248.
7.	Johnson WM, Smith JM, Woods SE, et al. Cardiac surgery in octogenarians: does age alone influence outcomes? Arch Surg, 2005, 140(11): 1089-1093.
8.	Al-Ruzzeh S, George S, Bustami M, et al. Effect of of-pump coronary artery bypass surgery on clinical, angiographic, neurocognitive, and quality of life outcomes: randomised controlled tria1. BMI, 2006, 332(7554): 1365-1370.
9.	Motallebzadeh R, Bland JM, Markus HS, et al. Neurocognitive function and cerebral emboli: Randomized study off on-pump versus off-pump coronary artery bypass surgery. Ann Thorac Surg, 2007, 83 (3): 475-482.
10.	Stamou SC, Jablonski KA, Pfister AJ, et al. Stroke after conventional versus minimally invasive coronary artery bypass. Ann Thorac Surg, 2002, 74 (2): 301-305.
11.	Kieser TM. Bilateral internal mammary artery grafting in CABG surgery: an extra 20 minutes for an extra 20 years. EuroIntervention, 2013, 9(8): 899-901.
12.	Itagaki S, Cavallaro P, Adams DH, et al. Bilateral internal mammary artery grafts, mortality and morbidity: an analysis of 1526360 coronary bypass operations. Heart, 2013, 99(12): 849-853.
13.	Odayan MK, Paterson HS. Myocardial revascularization with the left internal thoracic artery Y graft configuration. Ann Thorac Surg, 1999, 67(5): s1359-1361.
14.	Gwozdziewicz M, Nemec P, Simek M, et al. Sequential bypass grafting on the beating heart: blood flow characteristics. Ann Thorac Surg, 2006, 82(2): 620-623.
15.	Tagusari O, Kobayashi J, Bando K, et al. Total arterial off-pump coronary artery bypass grafting for revascularization of the total coronary system: clinical outcome and angiographic evaluation. Ann Thorac Surg, 2004, 78(4): 1304-1311.
16.	高杰, 蘇丕雄, 劉巖, 等. 非體外循環下冠狀動脈旁路移植術中升主動脈鈣化的處理. 中國胸心血管外科臨床雜志, 2008, 15(6): 415-417.

1. ?Bamer HB. Operative treatment of coronary atheroselerosis. Ann Thorac Surg, 2008, 85 (4): 1473-1482.
2. Lev-Ran O, Loberman D, Matsa M, et al. Reduced strokes in the elderly: the benefits of untouched aorta off-pomp coronary surgery. Ann Thorac Surg, 2004, 77 (1): 102-107.
3. Lev-Ran O, Braunstein R, Sharony R, et al. No-touch aorta off-pump coronary surgery: the effect on stroke. J Thorac Cardiovase Surg, 2005, 129(2): 307-313.
4. Mishra M, Malhotra R, Kalrekar A, et al. Propensity case-matched analysis of off-pump versus on-pump coronary artery bypass grafting in patients with atheromatous aorta. Ann Thorac Surg, 2006, 82 (7): 608-614.
5. Rosenberger P, Shernan SK, Loffler M, et al. The influence of epiaortic ultrasonography on intraoperative surgical management in 6 051 cardiac surgical patients. Ann Thorac Surg, 2008, 85(2): 548-553.
6. Goto T, Maekawa K. Cerebral dysfunction after coronary artery bypass surgery. J Anesth, 2014, 28(2): 242-248.
7. Johnson WM, Smith JM, Woods SE, et al. Cardiac surgery in octogenarians: does age alone influence outcomes? Arch Surg, 2005, 140(11): 1089-1093.
8. Al-Ruzzeh S, George S, Bustami M, et al. Effect of of-pump coronary artery bypass surgery on clinical, angiographic, neurocognitive, and quality of life outcomes: randomised controlled tria1. BMI, 2006, 332(7554): 1365-1370.
9. Motallebzadeh R, Bland JM, Markus HS, et al. Neurocognitive function and cerebral emboli: Randomized study off on-pump versus off-pump coronary artery bypass surgery. Ann Thorac Surg, 2007, 83 (3): 475-482.
10. Stamou SC, Jablonski KA, Pfister AJ, et al. Stroke after conventional versus minimally invasive coronary artery bypass. Ann Thorac Surg, 2002, 74 (2): 301-305.
11. Kieser TM. Bilateral internal mammary artery grafting in CABG surgery: an extra 20 minutes for an extra 20 years. EuroIntervention, 2013, 9(8): 899-901.
12. Itagaki S, Cavallaro P, Adams DH, et al. Bilateral internal mammary artery grafts, mortality and morbidity: an analysis of 1526360 coronary bypass operations. Heart, 2013, 99(12): 849-853.
13. Odayan MK, Paterson HS. Myocardial revascularization with the left internal thoracic artery Y graft configuration. Ann Thorac Surg, 1999, 67(5): s1359-1361.
14. Gwozdziewicz M, Nemec P, Simek M, et al. Sequential bypass grafting on the beating heart: blood flow characteristics. Ann Thorac Surg, 2006, 82(2): 620-623.
15. Tagusari O, Kobayashi J, Bando K, et al. Total arterial off-pump coronary artery bypass grafting for revascularization of the total coronary system: clinical outcome and angiographic evaluation. Ann Thorac Surg, 2004, 78(4): 1304-1311.
16. 高杰, 蘇丕雄, 劉巖, 等. 非體外循環下冠狀動脈旁路移植術中升主動脈鈣化的處理. 中國胸心血管外科臨床雜志, 2008, 15(6): 415-417.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Strategy of coronary bypass grafting for patients with anterior wall calcification of ascending aorta

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