Mid-term Outcomes of“2-staged”Hybrid Coronary Revascularization in Treating 73 Patients With Multi-vessel Coronary Artery Disease
10.3969/j.issn.1000-3614.2017.01.005
- VernacularTitle:“分站式”杂交冠状动脉血运重建术治疗73例冠状动脉多支血管病变临床中期随访结果分析
- Author:
Song WU
;
Yunpeng LING
;
Yuanhao FU
;
Lufeng ZHANG
;
Hang YANG
;
Lijun GUO
;
Guisong WANG
;
Ming CUI
;
Jie NIU
;
Wei GAO
;
Feng WAN
- Keywords:
Coronary artery disease;
Angioplasty,transluminal,percutaneous coronary;
Coronary artery bypass grafting
- From:
Chinese Circulation Journal
2017;32(1):17-20
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To observe the midterm outcomes of“2-staged”hybrid coronary revascularization (HCR) for treating the patients with multi-vessel coronary artery disease (CAD) and to evaluate the feasibility, safety and effcacy of“2-staged”HCR.
Methods: A total of 73 relevant patients received elective “2-staged” HCR in our hospital from 2012-01 to 2014-06 were studied. There were 50 (68.5%) male and 23 (31.5%) female at the age of (61.1±10.7) years and all patients had multi coronary artery lesions including left anterior descending (LAD) artery. The key points of“2-staged”HCR were as follows:double-chamber intubation with general anesthesia, small incision between 4-5 ribs of left front thorax, take left internal mammary artery (LIMA) by direct view and make anastomosis of LIMA and LAD with heartbeat. At (3-5) days post-minimally invasive direct coronary artery bypass (MIDCAB), coronary angiography (CAG) was conducted to confirm that LIMA-LAD bypass vessel was unobstructed; then percutaneous coronary intervention (PCI) was performed in non-LAD coronary artery for stent implantation. Post-operative echocardiography, chest X-ray and ECG were examined in each year;coronary CTA or CAG would be taken if the patients with myocardial ischemia.
Results: All patients finished“2-staged”HCR smoothly and no operative death occurred. The average surgical time was (152.9±43.8) min and (2.6±0.5) coronary branches were treated, total post-operative drainage volume was (558.6±441.3) ml, red blood cell transfusion was (0.8±1.9) U, mechanical ventilation time was (10.5±13.0) h. The interval between MIDCAB and PCI was (5.3±2) days and (1.6±0.7) stents was implanted. During post-operative follow-up period, there 1 (1.4%) patient died, 3 (4.1%) with recurrent myocardial ischemia, 1 (1.4%) with in-stent restenosis and received PCI again, 4 (5.5%) with MACCE.
Conclusion: “2-staged”HCR is a safe and feasible operation with satisfactory peri-operative and mid-term outcomes;it is suitable for the patients with multi-vessel CAD including severe LAD lesions.
