空军军医大学学报2025，Vol.46Issue(9)：1127-1132,6.DOI:10.13276/j.issn.2097-1656.2025.09.002
高龄复杂冠心病合并射血分数降低心力衰竭患者接受微创多支冠脉搭桥的近期临床效果研究
Recent clinical effect of minimally invasive coronary artery bypass grafting in elderly patients with complex coronary heart disease and heart failure with reduced ejection fraction
摘要
Abstract
Objective To investigate the clinical safety and effectiveness of minimally invasive coronary artery bypass grafting(MICS-CABG)via the left intercostal approach in elderly patients(＞70 years old)with complex coronary heart disease and reduced ejection fraction(EF＜40％).Methods The clinical data of 60 patients＞70 years old with a preoperative left ventricular EF＜40％who underwent coronary artery bypass grafting in the Department of Cardiac Surgery,Xijing Hospital,Air Force Medical University from April 2022 to October 2024 were analyzed.These patients were divided into two groups:the median sternotomy group(OP-CABG group)with 30 patients and the MICS-CABG group with 30 patients.Based on matched baseline information,a retrospective analysis was conducted to compare the perioperative data and one-year follow-up results between the two groups.Results There was no significant difference in baseline levels between the MICS-CABG group and the OP-CABG group.The MICS-CABG group had shorter operative duration,less intraoperative blood loss,lower perioperative blood transfusion rate,shorter postoperative ventilator assistance time,less postoperative drainage volume,and lower incidence of postoperative pleural effusion and wound complications(all P＜0.05).One-year follow-up after surgery showed that there was no significant difference in the patency rate of bridge vessels,improvement of EF values,MACCE events,and incidence of chronic wound pain between the two groups of patients.However,the MICS-CABG group had lower incidence of complications of poor wound healing compared to the OP-CABG group(P＜0.05).Conclusion Although MICS-CABG technology is difficult and has a long learning curve,its application in elderly patients with complex coronary heart disease and heart failure with reduced EF values can effectively shorten the operative time,reduce intraoperative bleeding,postoperative drainage,and transfusion rate.Compared with conventional open chest surgery,it is more acceptable for patients.One-year follow-up after surgery shows that the improvement of EF values and patency rate of bridge vessels in the MICS-CABG group are similar to those in the OP-CABG group,and effectively avoid complications of poor wound healing.关键词
复杂冠心病/微创冠脉搭桥/高龄/EF降低心力衰竭/非体外循环冠状动脉旁路移植术/左乳内动脉/大隐静脉/主要不良心脑血管事件分类
医药卫生引用本文复制引用
赵乾聪,唐嘉佑,温常暖,李志航,刘金成..高龄复杂冠心病合并射血分数降低心力衰竭患者接受微创多支冠脉搭桥的近期临床效果研究[J].空军军医大学学报,2025,46(9):1127-1132,6.基金项目
国家自然科学基金面上项目(82270526) （82270526）
陕西省创新能力支撑计划项目(2024CX-GXPT-01) （2024CX-GXPT-01）
陕西省心血管外科疾病临床研究中心项目(2024SF-LCZX05) （2024SF-LCZX05）
空军军医大学西京医院助推项目(2024XJSZ03,XJZT24LY40) （2024XJSZ03,XJZT24LY40）
