[Myocardial revascularization surgery without extracorporeal circulation. (Preliminary experience)].

Revista medica de Panama Pub Date : 1998-01-01
C A Rodríguez Zambrano, J A Croston, L Tuñón
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Abstract

Two hundred and three (203) open heart surgical procedures have been performed at the Complejo Hospitalario Metropolitano, from January 1997 to august 1998; Hundred and twenty-three (123) were of myocardial revascularization and twenty-four (24) of these patients were selected for revascularization without the assistance of the extracorporeal circulation machine. They were patients with chronic stable angina and had lesions of more than 95% in the descending anterior artery, high ventriculo-lateral branch and right coronary artery up to the crux cordis. In nineteen (19) patients the surgical approach was though a medical sternotomy; in four (4) through a left anterolateral thoracostomy and in three (3) of these patients a transverse sternotomy was added. There were no deaths perioperatively and at thirty (30) days there were no evidences of new Q waves or residual angina. With this technique, the time in the Intensive Care Unit and in the hospital has diminished; the patients also required less time in mechanical ventilation; less vasoactive amines are needed. In the operating room less equipment is necessary and the costs are significantly lower.

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无体外循环心肌血运重建术。(初步经验)]。
1997年1月至1998年8月,在大都会综合医院进行了203例心脏直视手术;心肌血运重建术123例,其中24例不借助体外循环机进行心肌血运重建术。慢性稳定型心绞痛患者,95%以上病变部位为前降动脉、高心室外侧支及右冠状动脉至心梗部。19例患者手术入路为内科胸骨切开术;其中4例通过左前外侧开胸术,3例增加了横向胸骨切开术。围手术期无死亡病例,30天无新的Q波或残留心绞痛。有了这项技术,在重症监护病房和医院的时间减少了;患者需要机械通气的时间也更短;需要较少的血管活性胺。在手术室中,所需的设备更少,成本也大大降低。
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