Volume 19 Issue 10
Oct.  2021
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(10): 1650-1653
DONG Gui-fu, WANG Yu-hang, GE Jian-jun. Application analysis of myocardial protection technique for off-pump coronary artery bypass grafting in the operation of valve disease combined with coronary heart disease[J]. Chinese Journal of General Practice, 2021, 19(10): 1650-1653. doi: 10.16766/j.cnki.issn.1674-4152.002133
Citation: DONG Gui-fu, WANG Yu-hang, GE Jian-jun. Application analysis of myocardial protection technique for off-pump coronary artery bypass grafting in the operation of valve disease combined with coronary heart disease[J]. Chinese Journal of General Practice, 2021, 19(10): 1650-1653. doi: 10.16766/j.cnki.issn.1674-4152.002133
shu

Application analysis of myocardial protection technique for off-pump coronary artery bypass grafting in the operation of valve disease combined with coronary heart disease

doi: 10.16766/j.cnki.issn.1674-4152.002133
  • 1.

    Department of Cardiac Surgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China

Funds:

 18030801132

  • Received Date: 2021-04-20
    Available Online: 2022-02-15
    Abstract
  •   Objective   To introduce the application of myocardial protection technique for off-pump coronary artery bypass grafting (OPCABG) in the operation of valve disease complicated with coronary heart disease.   Methods   The effect and related complications of valve replacement combined with coronary artery bypass grafting using myocardial protection technique for OPCABG in patients with valvular disease complicated with coronary heart disease treated in the Department of Cardiac Surgery of the First Affiliated Hospital of China University of science and technology from January 2017 to July 2020. For bypass surgery+aortic valve replacement surgery, the direct perfusion through the left and right coronary artery orifices and transvenous graft perfusion were firstly performed, and then heart valve replacement surgery was taken and the anastomosis of aortic incision and vascular graft was sutured. For bypass surgery+mitral valve replacement surgery, the vascular graft was anastomosed with the pathological target vessel under the circulatory beating heart, and the vascular graft was anastomosed with the aorta. After the aorta was cooled and blocked, the aortic root perfusion and the mitral valve replacement were performed.   Results   Among the 149 patients, 49 patients taken aortic valve replacement+bypass surgery, 83 taken mitral valve replacement+bypass surgery, 17 taken double valves replacement+bypass surgery, 54 had a single pathological branch of coronary artery which required bypass surgery, 55 had two pathological branches of coronary artery which required bypass surgery, and 40 had three pathological branches of coronary artery requiring bypass surgery. Ten patients died during postoperative hospitalization, 4 suffered permanent stroke after surgery, 28 suffered acute renal insufficiency and required dialysis treatment, and 18 taken mechanical ventilation for more than 24 hours.   Conclusion   For patients with coronary heart disease combined with valvular diseases, the myocardial protection technique for OPCABG in coronary artery bypass surgery combined with valve surgery is easy to operate, causing less postoperative complications and bringing satisfactory surgical results and clinical effects.

     

    • FullText(HTML)
  • loading
    • References(18)
  • [1]
    楚天舒, 葛建军, 赵智伟. 不停跳冠脉搭桥心肌保护技术在冠脉搭桥合并瓣膜手术中的应用[J]. 安徽医科大学学报, 2016, 51(6): 897-899. https://www.cnki.com.cn/Article/CJFDTOTAL-YIKE201606031.htm
    [2]
    殷恩智, 田伟臣, 李刚, 等. 同期行冠状动脉旁路移植和心脏瓣膜置换术治疗冠心病合并心脏瓣膜病的临床研究[J]. 现代生物医学进展, 2014, 14(10): 1890-1892. https://www.cnki.com.cn/Article/CJFDTOTAL-SWCX201410021.htm
    [3]
    王领, 刘学刚, 李海慧, 等. 单操作孔全胸腔镜心脏不停跳技术在心内直视手术中的应用[J]. 中华全科医学, 2021, 19(3): 362-364, 445. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202103007.htm
    [4]
    RAHHAB Z, EL FAQUIR N, TCHETCHE D, et al. Expanding the indications for transcatheter aortic valve implantation[J]. Nat Rev Cardiol, 2020, 17(2): 75-84. doi: 10.1038/s41569-019-0254-6
    [5]
    BARBANTI M, BUCCHERI S, CAPODANNO D, et al. Transcatheter or surgical treatment of severe aortic stenosis and coronary artery disease: A comparative analysis from the Italian OBSERVANT study[J]. Int J Cardiol, 2018, 270: 102-106. doi: 10.1016/j.ijcard.2018.06.011
    [6]
    THALJI N M, SURI R M, DALY R C, et al. The prognostic impact of concomitant coronary artery bypass grafting during aortic valve surgery: Implications for revascularization in the transcatheter era[J]. J Thorac Cardiovasc Surg, 2015, 149(2): 451-460. doi: 10.1016/j.jtcvs.2014.08.073
    [7]
    ZHANG Y, WANG D, LIU Y, et al. Surgical management of severe ischaemic mitral regurgitation[J]. Heart Lung Circ, 2018, 27(4): 517-523. doi: 10.1016/j.hlc.2017.04.005
    [8]
    ROGERS C A, CAPOUN R, SCOTT L J, et al. Shortening cardioplegic arrest time in patients undergoing combined coronary and valve surgery: Results from a multicentre randomized controlled trial: the SCAT trial[J]. Eur J Cardiothorac Surg, 2017, 52(2): 288-296. doi: 10.1093/ejcts/ezx087
    [9]
    DAVARPASAND T, HOSSEINSABET A, JALALI A. Concomitant coronary artery bypass graft and aortic and mitral valve replacement for rheumatic heart disease: Short- and mid-term outcomes[J]. Interact Cardiovasc Thorac Surg, 2015, 21(3): 322-328. doi: 10.1093/icvts/ivv132
    [10]
    张金辉, 蔡淑女. 右美托咪定全程泵注对体外循环下心脏瓣膜置换术患者的心肌保护作用[J]. 中华全科医学, 2020, 18(5): 752-756. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202005014.htm
    [11]
    孟金金, 刁文杰, 刘学刚, 等. 70岁以上高龄冠心病患者27例外科手术临床分析[J]. 中华全科医学, 2019, 17(11): 1818-1820. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201911008.htm
    [12]
    MONGERO L B, TESDAHL E A, STAMMERS A H, et al. A BMI >35 does not protect patients undergoing cardiac bypass surgery from red blood cell transfusion[J]. Perfusion, 2017, 32(1): 20-26. doi: 10.1177/0267659116652213
    [13]
    RANUCCI M, DE VINCENTⅡS C, MENICANTI L, et al. A gender-based analysis of the obesity paradox in cardiac surgery: Height for women, weight for men?[J]. Eur J Cardiothorac Surg, 2019, 56(1): 72-78. doi: 10.1093/ejcts/ezy454
    [14]
    DIELEMAN J M, PEELEN L M, COULSON T G, et al. Age and other perioperative risk factors for postoperative systemic inflammatory response syndrome after cardiac surgery[J]. Br J Anaesth, 2017, 119(4): 637-644. doi: 10.1093/bja/aex239
    [15]
    ARONEY N, PATTERSON T, ALLEN C, et al. Neurocognitive Status after aortic valve replacement: Differences between TAVI and surgery[J]. J Clin Med, 2021, 10(8): 1789. doi: 10.3390/jcm10081789
    [16]
    RANKIN J S, BADHWAR V, HE X, et al. The society of thoracic surgeons mitral valve repair/replacement plus coronary artery bypass grafting composite score: A report of the society of thoracic surgeons quality measurement task force[J]. Ann Thorac Surg, 2017, 103(5): 1475-1481. doi: 10.1016/j.athoracsur.2016.09.035
    [17]
    HARTRUMPF M, KUEHNEL R, ALBES J M. The obesity paradox is still there: A risk analysis of over 15 000 cardiosurgical patients based on body mass index[J]. Interact Cardiovasc Thorac Surg, 2017, 25(1): 18-24. doi: 10.1093/icvts/ivx058
    [18]
    SØNDERGAARD L, POPMA J J, REARDON M J, et al. Comparison of a complete percutaneous versus surgical approach to aortic valve replacement and revascularization in patients at intermediate surgical risk[J]. Circulation, 2019, 140(16): 1296-1305. doi: 10.1161/CIRCULATIONAHA.118.039564
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(2)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (231) PDF downloads(5) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return