Clinical practice and discovery of selective coronary venous bypass grafting in the treatment of diffuse coronary artery disease
10.3760/cma.j.issn.1001-4497.2019.04.006
- VernacularTitle:弥漫性冠心病行选择性心中静脉动脉化的临床实践探索
- Author:
Tian TANG
1
;
Danni QI
;
Mingxin GAO
;
Wenyuan YU
;
Pengcheng WANG
;
Hui HU
;
Yang YU
Author Information
1. 首都医科大学附属北京安贞医院心脏外科 100029
- Keywords:
Coronary artery bypass grafting,off-pump;
Selective coronary venous bypass grafting;
Diffuse coronary artery disease
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2019;35(4):218-222
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical features of patients with diffuse coronary artey diseases,and evaluate the clinical efficacy of off-pump coronary artery bypass grafting(OPCABG) combined with selective coronary venous bypass grafting (SCVBG).Methods Retrospectively analyzed the clinical data of 61 patients with diffuse right coronary stenosis undergoing operation of OPCABG + SCVBG from January 2007 to December 2013,and couducted the comparative study of the patients who underwent OPCABG during the same period based on propensity score.Patients were divided into SCVBG group(61 cases,underwent OPCABG + SCVBG) and control group(60 cases,matched by propensity score and underwent OPCABG without SCVBG).Results Compared with control group,the rate of myocardial infarction in SCVBG group was higher (67.2％ vs.46.7c％,P ＜0.05),the heart rate was faster[(69.92 ± 15.82) bpm vs.(64.48 ± 13.72) bpm,P ＜ 0.05],the low density lipoprotcin and triglyceride were higher[(2.67 ± 0.78) mmol/L vs.(2.37 ± 0.78) mmol/L (1.84 ± 0.79) mmol/L vs.(1.36 ± 0.60) mmol/L,both P ＜ 0.05] and the troponin I was higher in the first postoperative day [0.85 (0.29,3.15)μg/L vs.5.09 (2.02,13.03)μg/L,P ＜ 0.05].The perioperative(postoperative) mortality(1.6％ vs.0) and the long-term survival curve difference had no statistically significance(P ＞0.05).Conclusion Patients with coronary artery disease should pay more attention to the control of heart rate and blood lipids,poorly controlled heart rate and high blood lipids are the important factors for the development of coronary heart disease.The exact efficacv of selective coronary vein arterialization for diffuse coronary artery disease is confirmed through the small sample comparative study.
