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頁籤選單縮合
題名 | Results of Coronary Artery Endarterectomy and Reconstruction --3 Years' Experience=冠狀動脈內膜切除術及重建之結果--三年經驗 |
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作者 | 潘俊彥; 鄭伯智; 郭樹民; 鄭國琪; 呂俊忠; 康沛倫; 盧麗芬; |
期刊 | 中華民國外科醫學會雜誌 |
出版日期 | 19950700、19950800 |
卷期 | 28:4 民84.07-08 |
頁次 | 頁274-279 |
分類號 | 416.262 |
語文 | eng |
關鍵詞 | 冠狀動脈內膜切除術; 重建; Coronary endarterectomy; Coronary artery bypass grafting; Patency; |
中文摘要 | 自1991年1月至1994年2月,高雄榮民總醫院共進行31例冠狀動脈內膜切除術合併動脈繞道手術,每位病人平均接受3.7個繞道血管,共施行37次的冠狀動脈內膜切除術,右冠狀動脈20次,左前降動脈12次,左迴旋動脈5次。動脈內膜切除後使用大隱靜脈繞道31次,左內乳動脈6次,3位病人(9.7%)發生周手術期死亡,3位病人(9.7%)發生併發症,包括1例腦血管疾病,1例心律不整, 1 例胸骨裂開,術後25位病人(86.2%)無症狀,3 位病人(10.3%)有鬱血性心衰竭症狀,1位病人(3.4%)有第二級心絞痛,一年的存活率81.8%,14位病人於術後2個月至28個月再度接受心導管檢查。左心室射出率從術前平均52.8%上升至術後平均60.6%(P= 0.09),傳統繞道血管通暢率是94.6%(35/37)而經動脈內膜切除後繞道血管通暢率是94.4%(17/18)。結論是對於廣泛性冠狀動脈 狹窄疾病,動脈內膜切除術可以重建良好的末端血流,且有很好的早期血管通暢結果,長期的結果則需要更進一步的努力及追蹤。 |
英文摘要 | Between January 1991 and February 1994, a total of 31 patients underwent combined coronary endarterectomy and coronary artery bypass grafting. The average bypass graft number was 3.7 per patient, and a total of 37 endarterectomy procedures were performed (20 for right coronary artery, 12 for left anterior descending artery, and 5 for left circumflex artery). Thirtyone great saphenous veins and six left internal mammary arteries were grafted for revascularization after endarterectomy. There were three (9.7%) surgical mortalities and 3(9.7%) complications including one with a cerebral vascular accident, one with cardiac arrhythmia and one with sternal dehiscence. Postoperative follow-up in this series showed that 25 (86.2%) were asymptomatic, 3 (10.3%) had congestive heart failure, 1 (3.4%) had Canadian Cardiovascular Society Class II angina pectoris. The one-year survivall rate was 81.8%. There were 14 patients who had postoperative cardiac catheterization 2 to 28 months after the surgery. The mean left ventricular ejection fraction was 52.8% before, and 60.6% after, the operations (P=0.09). The patency rate for conventional bypass grafting was 94.6%, and for endarterectomy grafting was 94.4%. It was concluded that, for diffuse coronary stenosis, coronary artery endarterectomy can reestablish distal coronary blood flow and all.so shows a satisfactory patency rate. A longterm result is necessary to document the efficacy of the procedure. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。