摘要
目的评价同期行颈动脉内膜剥脱术（CEA）联合冠状动脉搭桥术（CABG）治疗颈动脉与冠状动脉狭窄并存疾病的安全性和临床疗效。方法总结2000年1月至2013年8月我科收治的34例并存颈动脉与冠状动脉狭窄并均实施了同期CEA联合CABG手术患者的临床资料，其中男21例，女13例；年龄54～85岁，平均（70±6）岁。所有患者术前均行冠状动脉和颈动脉造影明确诊断，其中冠状动脉左主干病变6例，3支血管病变17例，2支血管病变11例。先行CEA再行CABG者33例，1例先行CABG再行CEA。Off-Pump CABG 26例，On-Pump 8例。 CEA全部为单侧，术中均使用颈动脉转流管，并采用人工血管补片加宽颈动脉切口。结果无手术死亡病例，无围术期心肌梗死、脑血管意外。1例于术后1个月因下肢动脉硬化闭塞症行右侧股-腘动脉人工血管搭桥术。术后随访6～84个月，无心脑血管事件发生。结论同期行CEA联合CABG处理颈动脉与冠状动脉狭窄并存疾病安全、有效，可有效预防围术期心脑血管并发症的发生，中期随访效果满意。
Objective To evaluate clinical safety and efficiency of simultaneous carotid endarterectomy ( CEA) and coronary artery bypass grafting ( CABG) on patients with combined carotid and coronary artery stenosis . Methods From January 2000 to August 2013,34 patients[21males,13 females,aged(70 ±6)years in average] underwent combined CEA and CABG in our department .Preoperative coronary and carotid artery angiography revealed that left main trunk stenosis occurred in 6 cases,triple-vessel disease in 17 cases,double-vessel disease in 11 cases.33 patients were given unilateral CEA firstly and then CABG .Only 1 case was given CABG firstly and then unilateral CEA .26 cases received Off-Pump CABG and 8 cases underwent CABG with cardiopulmonary bypass support .An intraluminal carotid shunt and patch repair were used in all CEA procedure .Results There were no operative mortality and perioperative cardio-cerebral vascular accidents in our study .1 case received right femo-popliteal artificial graft bypass for lower extremity atherosclerotic occlusive disease 1 month after the simultaneous CEA and CABG.No cardiovascular events were observed during the 6 to 84-month follow-up.Conclusions Simultaneous CEA and CABG is effective and safety for patients combined carotid and coronary artery severe stenosis .It can effectively prevent postoperative cardio-cerebral vascular complications with satisfactory mid-term result.
出处
《心血管外科杂志（电子版）》
2014年第2期66-69,共4页
Journal of Cardiovascular Surgery(Electronic Edition)
