[Myocardial revascularization of patients with diffuse coronary artery disease].
OBJECTIVE
Off-pump coronary artery bypass grafting (off-pump CABG) after off-pump coronary endarterectomy (CE) for myocardial revascularization is a way to rescue the patients with diffuse coronary artery disease (CAD). This study retrospectively analyzed its clinical outcomes and experiences, and explored the safety and effectiveness.


METHODS
From October 2003 to December 2008, 177 diffuse CAD patients with 229 vascular lesions received off-pump CABG plus CE. Incision was made at the hardest part of coronary artery and ≥ 2 cm from the distal intervention site. Then bypass graft was performed by internal mammary artery or saphenous vein.


RESULTS
The intra-operative blood tests showed that 215 (93.9%) bridges were satisfied with (27 ± 12) ml/min blood flow while 14 bridges were dissatisfied. The blood flow was (7 ± 4) ml/min. Six (3.4%) cases suffered peri-operative myocardial infarction. Among them, 3 patients had no significant cardiac hemodynamic changes. Three suffered a low cardiac output and improved by intra-aortic balloon counter pulsation support. And they were then discharged after treatment. After 3 - 40 months, 98 patients underwent coronary angiography to measure the graft latency. And the blood flow was excellent.


CONCLUSIONS
Off-pump CABG plus CE for diffuse coronary artery disease is both feasible and safe. And it is an effective treatment with a high degree of vascularization.
Fang
Ying
Y
Department of Heart Surgery, Anzhen Hospital Affiliated to Capital Medical University, Beijing 100029, China. dinghuixw@163.com
Gu
Cheng-xiong
CX
Wei
Hua
H
Chen
Chang-cheng
CC
D000368:Aged; D000369:Aged, 80 and over; D017225:Atherectomy, Coronary; D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D012189:Retrospective Studies