OBJECTIVE:To retrospectively analyze the experiences, indications, technique, and results of coronary artery bypass grafting (CABG) in patients over 70 years old.METHODS:Ninety-one patients received coronary artery bypass grafting from March 2004 to March 2008. Ages ranged from 70 to 83 years old, 22 patients over 75 years old. Conventional CABG (CCABG) in 72 patients, off-pump CABG (OPCAB) in 19 patients. Clinical data has no significant differences in two groups. The rate of using left internal mammary artery was 96.7%. The number of grafts in CCABG and OPCAB group were 2 to 5 (3.5 +/- 0.8) and 1 to 4 (2.9 +/- 0.7) respectively.RESULTS:In-hospital death in 2 cases, both were from chronic obstructive pulmonary disease and pulmonary infection. Cerebral infarction in 1 case and pulmonary infection in 2 cases in CCABG group, but no significant difference between two groups, and no difference in intubation, ICU stay, respiratory failure, renal function failure. But number of grafts in CCABG was significantly more than that in OPCAB (P < 0.01). Postoperative follow-up was 3 to 36 months, 1 case with recurrent angina in OPCAB.CONCLUSIONS:According to the characteristic of coronary artery disease in elderly, fully revascularization and improving myocardial blood supply, patients over 70 years old with CABG can obtain the same efficacy as younger patients. There were not significant difference between CCABG and OPCAB.

Objective To summarize the experience of perioperative management of coronary artery bypass graft(CABG) in high-risk patients with coronary heart disease.Methods The clinical data of 164 patients underwent CABG from March 2004 to November 2005 were analyzed.Of 164 patients,151(92.05%) cases had severe coronary heart disease.Results Totally 144 artery-vessels and 353 venous-vessels were transplanted to patients.Combined operative procedures included 11 cases of ventricular aneurysm resect,5 cases of valve replacement,5 cases of valve repair,and 1 case of surgical repair of perforation of ventricular septum.Post-operative complications included 2 cases of low cardiac output,1 case of respiratory failure,1 case of renal failure,and 1 case of cerbral infarction.Two patients died and the operative mortality was 1.22%.Conclusion CABG procedure is safe in the treatment of high-risk patients with coronary heart disease.Proper preoperative and perioperative treatment can improve the curative effects significantly.

1 资料与方法 1.1 一般资料 2003年3月17日至2005年12月我院共行搭桥手术189例,其中糖尿病患者52例,占29.2%.52例糖尿病患者冠状动脉搭桥(CABG)术前口服降糖药物33例,皮下注射胰岛素控制血糖19例.

目的:经冠状动脉造影前后采用彩色多普勒超声诊断仪进行外周血管测量,对比外周血管异常与冠状动脉狭窄的相关性,以了解冠状动脉粥样硬化与颈、股动脉不同部位动脉粥样硬化的关系.方法:对我院350例患者进行了外周血管检查,检查如发现内中膜增厚,血管内斑块则提示动脉粥样硬化存在,在冠状动脉造影如发现冠状动脉狭窄则提示冠心病.颈动脉、股动脉内中膜厚度,血管内斑块与冠状动脉相关性通过统计学检验进行分析.结果:冠心病患者外周血管多有改变,表现为颈动脉、股动脉内中膜增厚和动脉粥样硬化斑块阳性率增高.而在颈动脉、股动脉间比较无显著性差异.结论:对于外周动脉粥样硬化的内中膜增厚、斑块检出率及积分可作为预测心血管病存在的指标.对于疑似冠心病患者,外周血管超声可作为常规检查,而颈动脉相对股动脉来说可作为一个更为良好、便捷的窗口.