Surgical treatment in patients with severe left main artery stenosis with severe three-vessel-disease
10.3760/cma.j.issn.1008-1372.2014.06.017
- VernacularTitle:左主干伴三支病变严重狭窄外科治疗体会
- Author:
Liming MA
;
Qianjin CHENG
;
Xiang LI
;
Gaoli LIU
;
Yongliang ZHAO
;
Liang ZONG
;
Qingchen LI
;
Qingquan WU
;
Bin LIU
;
Yanlin CHU
- Publication Type:Journal Article
- Keywords:
Coronary stenosis/surgery;
Coronary artery bypass,off-pump;
Coronary artery bypass/methods;
Counterpulsation
- From:
Journal of Chinese Physician
2014;(6):774-776
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the appropriately operative chance , method, and perioperative management of coronary arterybypass grafting (CABG) in the patients with severe left main artery (LMA) stenosis with three-vessel-disease.Methods A total of296 patients with severe LMA stenosis with three-vessel-disease who underwent CABG surgery was analyzed retrospectively from 2003through 2013.Of them, 276 patients underwent conventional coronary artery bypass surgery on pump ( CCABG)and 20 patients underwentoff-pump CABG( OPCAB); 172 Patients was over 60 years old (58.1%)and 246 patients (83.10%) had concomitant diseasesincluding valve lesion, hypertension, diabetes, myocardial infarction, left ventricular aneurysm with septal defect , stroke, renal failure,and cancer.Left internal mammary artery use was in 281 patients (95.1%); and 32 patients were implanted intra-aortic ballonpump(IABP) perioperatively.Results There were 7 cases(2.36 %) death of postoperative low cardiac output , ventricular fibrillation,cerebral infarction, renal failure, and multiple organ failure, respectively.Postoperative complications were low cardiac output ,respiratory failure , ventricular fibrillation, cereboembolism, cardiac tampomade, renal failure, stroke, and multiple organ failure.Afterfollow-up 2 to 84 months, there was 3 death in which 2 death of cardiac factors.Conclusions CCABG was a safe and effectivemethod in patients with severe LMA stenosis with severe three -vessel-disease.Preoperative insertion of IABP can certainly avoid the po -tential operative risk factor and significantly decrease the mortality and morbidity .
