Strategy of coronary bypass grafting for patients with anterior wall calcification of ascending aorta_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

张仁腾 , 姜辉 ,  王辉山

沈阳军区总医院心血管外科（沈阳 110016）;

Corresponding author：

王辉山, Email: huishanwang@hotmail.com

Keywords：

冠状动脉旁路移植; 升主动脉钙化; 脑梗塞

DOI：

10.7507/1007-4848.201511027

Video：

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Abstract Full text Figures/Tables Video References Cited by

目的探讨合并弥漫性升主动脉前壁钙化的冠心病患者冠状动脉旁路移植术策略。方法回顾性分析 2011 年 9 月至 2012 年 6 月 30 例升主动脉前壁弥漫钙化的冠心病患者的冠状动脉旁路移植手术策略，男 21 例、女 9 例，年龄 60～75 岁。所有患者均行非体外循环冠状动脉旁路移植术（OPCAB）。结果术后住院时间（8.7±3.2）d，围术期无死亡，无心脑血管意外，无伤口及纵隔感染。围术期主要并发症为心房颤动，发生率 23.3%。术后 30 d 常规复查所有患者心绞痛症状均消失或改善，心功能改善。结论对于升主动脉前壁有弥漫钙化的冠心病患者，采用 OPCAB 方式，多种方法联合应用，可尽量避免或减少升主动脉前壁的刺激，减少手术风险，实现最大限度的目标冠状动脉再血管化。

Citation： 张仁腾, 姜辉, 王辉山. Strategy of coronary bypass grafting for patients with anterior wall calcification of ascending aorta. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(4): 315-317. doi: 10.7507/1007-4848.201511027 Copy

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2.	Lev-Ran O, Loberman D, Matsa M, et al. Reduced strokes in the elderly: the benefits of untouched aorta off-pomp coronary surgery. Ann Thorac Surg, 2004, 77 (1): 102-107.
3.	Lev-Ran O, Braunstein R, Sharony R, et al. No-touch aorta off-pump coronary surgery: the effect on stroke. J Thorac Cardiovase Surg, 2005, 129(2): 307-313.
4.	Mishra M, Malhotra R, Kalrekar A, et al. Propensity case-matched analysis of off-pump versus on-pump coronary artery bypass grafting in patients with atheromatous aorta. Ann Thorac Surg, 2006, 82 (7): 608-614.
5.	Rosenberger P, Shernan SK, Loffler M, et al. The influence of epiaortic ultrasonography on intraoperative surgical management in 6 051 cardiac surgical patients. Ann Thorac Surg, 2008, 85(2): 548-553.
6.	Goto T, Maekawa K. Cerebral dysfunction after coronary artery bypass surgery. J Anesth, 2014, 28(2): 242-248.
7.	Johnson WM, Smith JM, Woods SE, et al. Cardiac surgery in octogenarians: does age alone influence outcomes? Arch Surg, 2005, 140(11): 1089-1093.
8.	Al-Ruzzeh S, George S, Bustami M, et al. Effect of of-pump coronary artery bypass surgery on clinical, angiographic, neurocognitive, and quality of life outcomes: randomised controlled tria1. BMI, 2006, 332(7554): 1365-1370.
9.	Motallebzadeh R, Bland JM, Markus HS, et al. Neurocognitive function and cerebral emboli: Randomized study off on-pump versus off-pump coronary artery bypass surgery. Ann Thorac Surg, 2007, 83 (3): 475-482.
10.	Stamou SC, Jablonski KA, Pfister AJ, et al. Stroke after conventional versus minimally invasive coronary artery bypass. Ann Thorac Surg, 2002, 74 (2): 301-305.
11.	Kieser TM. Bilateral internal mammary artery grafting in CABG surgery: an extra 20 minutes for an extra 20 years. EuroIntervention, 2013, 9(8): 899-901.
12.	Itagaki S, Cavallaro P, Adams DH, et al. Bilateral internal mammary artery grafts, mortality and morbidity: an analysis of 1526360 coronary bypass operations. Heart, 2013, 99(12): 849-853.
13.	Odayan MK, Paterson HS. Myocardial revascularization with the left internal thoracic artery Y graft configuration. Ann Thorac Surg, 1999, 67(5): s1359-1361.
14.	Gwozdziewicz M, Nemec P, Simek M, et al. Sequential bypass grafting on the beating heart: blood flow characteristics. Ann Thorac Surg, 2006, 82(2): 620-623.
15.	Tagusari O, Kobayashi J, Bando K, et al. Total arterial off-pump coronary artery bypass grafting for revascularization of the total coronary system: clinical outcome and angiographic evaluation. Ann Thorac Surg, 2004, 78(4): 1304-1311.
16.	高杰, 苏丕雄, 刘岩, 等. 非体外循环下冠状动脉旁路移植术中升主动脉钙化的处理. 中国胸心血管外科临床杂志, 2008, 15(6): 415-417.

1. Bamer HB. Operative treatment of coronary atheroselerosis. Ann Thorac Surg, 2008, 85 (4): 1473-1482.
2. Lev-Ran O, Loberman D, Matsa M, et al. Reduced strokes in the elderly: the benefits of untouched aorta off-pomp coronary surgery. Ann Thorac Surg, 2004, 77 (1): 102-107.
3. Lev-Ran O, Braunstein R, Sharony R, et al. No-touch aorta off-pump coronary surgery: the effect on stroke. J Thorac Cardiovase Surg, 2005, 129(2): 307-313.
4. Mishra M, Malhotra R, Kalrekar A, et al. Propensity case-matched analysis of off-pump versus on-pump coronary artery bypass grafting in patients with atheromatous aorta. Ann Thorac Surg, 2006, 82 (7): 608-614.
5. Rosenberger P, Shernan SK, Loffler M, et al. The influence of epiaortic ultrasonography on intraoperative surgical management in 6 051 cardiac surgical patients. Ann Thorac Surg, 2008, 85(2): 548-553.
6. Goto T, Maekawa K. Cerebral dysfunction after coronary artery bypass surgery. J Anesth, 2014, 28(2): 242-248.
7. Johnson WM, Smith JM, Woods SE, et al. Cardiac surgery in octogenarians: does age alone influence outcomes? Arch Surg, 2005, 140(11): 1089-1093.
8. Al-Ruzzeh S, George S, Bustami M, et al. Effect of of-pump coronary artery bypass surgery on clinical, angiographic, neurocognitive, and quality of life outcomes: randomised controlled tria1. BMI, 2006, 332(7554): 1365-1370.
9. Motallebzadeh R, Bland JM, Markus HS, et al. Neurocognitive function and cerebral emboli: Randomized study off on-pump versus off-pump coronary artery bypass surgery. Ann Thorac Surg, 2007, 83 (3): 475-482.
10. Stamou SC, Jablonski KA, Pfister AJ, et al. Stroke after conventional versus minimally invasive coronary artery bypass. Ann Thorac Surg, 2002, 74 (2): 301-305.
11. Kieser TM. Bilateral internal mammary artery grafting in CABG surgery: an extra 20 minutes for an extra 20 years. EuroIntervention, 2013, 9(8): 899-901.
12. Itagaki S, Cavallaro P, Adams DH, et al. Bilateral internal mammary artery grafts, mortality and morbidity: an analysis of 1526360 coronary bypass operations. Heart, 2013, 99(12): 849-853.
13. Odayan MK, Paterson HS. Myocardial revascularization with the left internal thoracic artery Y graft configuration. Ann Thorac Surg, 1999, 67(5): s1359-1361.
14. Gwozdziewicz M, Nemec P, Simek M, et al. Sequential bypass grafting on the beating heart: blood flow characteristics. Ann Thorac Surg, 2006, 82(2): 620-623.
15. Tagusari O, Kobayashi J, Bando K, et al. Total arterial off-pump coronary artery bypass grafting for revascularization of the total coronary system: clinical outcome and angiographic evaluation. Ann Thorac Surg, 2004, 78(4): 1304-1311.
16. 高杰, 苏丕雄, 刘岩, 等. 非体外循环下冠状动脉旁路移植术中升主动脉钙化的处理. 中国胸心血管外科临床杂志, 2008, 15(6): 415-417.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Strategy of coronary bypass grafting for patients with anterior wall calcification of ascending aorta

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