Application of off-pump coronary artery bypass grafting surgery in coronary artery disease patients with dilated left ventricle
- VernacularTitle:不停跳冠状动脉旁路移植术在大左室冠状动脉粥样硬化性心脏病患者中的应用
- Author:
Yongyi WANG
1
;
Song XUE
1
;
Genxing XU
1
;
Ritai HUANG
1
;
Feng LIAN
1
;
Wei LI
1
Author Information
1. Department of Cardiovascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, P.R.China
- Publication Type:Journal Article
- Keywords:
Dilated left ventricle;
coronary artery disease;
off-pump coronary artery bypass grafting surgery;
surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(05):544-547
- CountryChina
- Language:Chinese
-
Abstract:
Objective To describe our experiences of application of off-pump coronary artery bypass grafting surgery (OPCABG) in coronary artery disease (CAD) patients with dilated left ventricle. Methods A retrospective analysis of 303 patients with dilated left ventricle [left ventricular end-diastolic diameter (LVEDD)> 60 mm] who underwent OPCABG from January 2008 to December 2018 at a single center was conducted. There were 205 males and 98 females at age of 45-87 (66.9±9.3) years. Results The mean pulmonary artery pressure in 90 patients was more than 25 mm Hg. Sixteen patients underwent OPCABG with emergent transition of extracorporeal circulation (CPB). Twenty-one patients underwent OPCABG with CPB at the beginning of CABG. Thirty-five patients underwent intra-aortic balloon counterpulsation (IABP). Four patients died during in-hospital time with the experience of emergent transition of CPB. Six months after operation, LVEDD and left ventricular ejection fraction (LVEF) were improved. Conclusion OPCABG is a safe and effective alternative for CAD patients with dilated left ventricle. However, for patients with higher pulmonary pressure and a spherical left ventricle after cardiac reshaping, there is a high risk of emergent transition of CPB during OPCABG; for this kind of patients, it is necessary to start CPB at the beginning of OPCABG.
