Discussion on the influencing factors of beating heart coronary artery bypass grafting
10.7507/1007-4848.201804044
- VernacularTitle:影响不停跳冠状动脉旁路移植术效果的因素探讨
- Author:
LIU Yun
1
;
PIAO Hulin
1
;
LI Bo
1
;
WANG Yong
1
;
XIE Chulong
1
;
WEI Shibo
1
;
XU Jian
1
;
GAO Xinghao
1
;
DU Yu
1
;
LIU Kexiang
1
Author Information
1. Department of Cardiac Surgery, The Second Affiliated Hospital of Jilin University, Changchun, 130041, P. R. China
- Publication Type:Journal Article
- Keywords:
Off-pump coronary artery bypass grafting;
on-pump beating heart coronary artery bypass grafting;
coronary artery bypass grafting;
coronary heart disease
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(1):73-77
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the factors affecting the operation of coronary artery bypass grafting with heart beating and improve the effect of the operation. Methods From January 2012 to June 2016, 898 patients with coronary heart disease who received cardiovascular surgery in the Second Affiliated Hospital of Jilin University were analyzed retrospectively. All patients only underwent coronary artery bypass grafting with beating heart. Among them, 797 patients underwent the off-pump coronary artery bypass grafting (an OPCABG group, 592 males and 205 females, with an average age of 60.5±8.4 years); another 101 patients received on-pump beating heart coronary artery bypass grafting (an OPBH group, 77 males and 24 females, with an average age of 61.5±8.2 years). Results The average number of grafts in the OPCABG group was 3.36±0.74, and in the OPBH group was 3.71±0.69 (P<0.05). The postoperative ventilation time (10.8±9.5 hvs. 20.6±12.3 h), ICU stay (28.8±15.5 h vs. 37.4±30.8 h), hospital stay (10.9±4.8 d vs. 14.8±8.6 d), mortality (1.1% vs. 3.0%), the utilization rate of intra-aortic balloon pump (2.4% vs. 8.9%) and extracorporeal membrane oxygenation (0.5% vs. 5.0%) were significantly different between the OPCABG group and OPBH group (all P<0.05). Twelve patients died after surgery, and the total bloodless operation ratio was 91.3%. Conclusion The results show that most patients can achieve good results with the help of apical fixation and myocardial fixator, improved surgical techniques and methods, good anesthesia management as well as flexible and accurate use of vasoactive drugs. But extracorporeal circulation is necessary in the patients with large left ventricle, low ejection fraction and hemodynamic instability after intraoperatively moving the heart.
