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ORIGINAL ARTICLE
Year : 2018  |  Volume : 131  |  Issue : 18  |  Page : 2179-2184

Total Arterial Off-Pump Coronary Artery Bypass Grafting: A 10-Year Experience


Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China

Correspondence Address:
Prof. Biao Yuan
Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.240796

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Background: Arterial grafts had better mid-term and long-term patency than saphenous vein grafts in coronary artery bypass grafting (CABG). We summarized our experience with total arterial off-pump coronary artery bypass grafting (OPCAB) and assessed the early clinical results, surgical complications, and follow-up. Methods: From January 2007 to May 2017, 508 coronary artery disease patients undergoing total arterial OPCAB were enrolled. Clinical features, approaches, outcomes of surgical treatments, and follow-up data of these patients were studied retrospectively. A total of 122 patients underwent single left internal mammary artery (IMA)-left anterior descending artery grafts, whereas the other 386 patients underwent multiple vessel grafts. Results: The average distal anastomosis was 2.34 ± 0.97 (range: 1–4). All the patients were discharged from hospital except one died. A total of 457 (90.32%) patients were followed up. In the 4-, 7-, and 10-year follow-up groups, the rate of death from any cause was 1.19%, 6.47%, and 10.67%; rate of cardiac death was 0.60%, 2.88%, and 3.33%; rate of repeat revascularization was 0.00%, 3.60%, and 8.67%; rate of ischemic symptoms was 1.79%, 7.91%, and 11.33%; and incidence of stroke was 2.38%, 4.32%, and 6.67%, respectively. Poor medication adherence was observed in 9.38% of the follow-up population. Conclusions: Total arterial OPCAB with bilateral IMA, radial artery, and right gastroepiploic artery grafting yielded satisfactory early and midterm outcomes in this patient group, without a significant increase in early mortality or morbidity. Moreover, the long-term outcomes are also positive.

 

 Abstract in Chinese

全动脉化非体外循环冠状动脉旁路移植术10年经验

摘要

背景: 背景 冠状动脉旁路移植术中静脉桥中远期通畅率不理想催生了动脉桥的应用。总结全动脉化非体外循环冠状动脉旁路移植术(OPCAB)的临床应用经验,并观察早期临床结果、手术并发症及随访结果。

方法: 从2007年1月至2017年5月,共完成了508例全动脉化OPCAB,回顾总结这些患者的临床特点、手术方式、手术效果及随访资料。其中122例患者单纯行左乳内动脉-前降支搭桥,其余386例患者行多支血管吻合。

结果: 平均远端吻合口2.34±0.97 (1-4),院内死亡1例,其余患者均痊愈出院。随访457(90.32%)例患者,4,7,10年随访组全因死亡率分别为1.19%,6.47%及10.67%;心源性死亡率分别为0.60%,2.88%和3.33%;再血管化率分别为0.00%,3.60%和8.67%;再发缺血症状分别为1.79%,7.91%和11.33%;脑卒中发生率分别为2.38%,4.32%及6.67%。9.38%随访人群未正规服用冠心病二级预防药物。

结论: 应用双侧乳内动脉、桡动脉及胃网膜右动脉进行全动脉化搭桥的此组患者,在未增加早期死亡率及并发症的情况下,得到了满意的早期及中期结果,另外,也有令人满意的晚期结果。



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