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題 名 | Minimally-Invasive, Direct Coronary Artery Bypass Grafting=微創冠狀動脈繞道手術 |
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作 者 | 許傅智; 王志軒; 賴曉亭; 游堂振; 翁仁崇; 施俊哲; | 書刊名 | 中華醫學雜誌 |
卷 期 | 61:9 1998.09[民87.09] |
頁 次 | 頁507-512 |
分類號 | 416.262 |
關鍵詞 | 前外側胸廓切開術; 冠狀動脈繞道手術; 內乳動脈; 微創手術; Anterolateral thoracotomy; Coronary artery bypass grafting; Internal mammary artery; Minimally-invasive surgery; |
語 文 | 英文(English) |
中文摘要 | 背景 微創冠狀動脈繞道手術是一項新的外科技術。它採用小切口的胸廓切開術, 在無心肺機輔助及心跳不停止下,完成冠狀動脈繞道手術。 方法 自1996年6月至1996年12月,共有12位患者接受了此一手術。患者全部為男性, 平均年齡為65.9歲,其中有11位因冠狀動脈左前降枝阻塞接受手術。手術部位從左前第4 肋間進入,打開心包膜後,在冠狀動脈左前降枝確立要做的吻合處。然後剝離左側內乳動脈 約8公分,做內乳動脈及左前降枝吻合手術。1位患者合併左前降枝及右側冠狀動脈阻塞, 必須接受兩側胸廓切開手術。血管吻合手術在直接目挸下進行,無需停止心跳及使用人工心 肺機。 結果 l2例患者無早期罹病率,加護病房的平均住院天數為1.8天。無l例患者因早期心 臟問題而需再次接受手術或需接受氣球擴張術。術後患者無症狀且無心臟缺血事件發生。 結論 初步結果顯示:低侵襲性的冠狀動脈繞道手術,對治療單獨冠狀動脈左前降枝阻塞或 石側冠狀動脈阻塞患者的結果相當良好,可成為另一種可選擇的手術方法。 |
英文摘要 | Background. Minimally-Invasive, direct vision coronary artery bypass grafting (MIDCAB) is a new surgical technique performed via limited thoracotomy in a beating heart without cardiopulmonary bypass. Methods. From June 1996 to December 1996, MIDCAB was performed in 12 patients (all male; average age, 65.9 years). In 11 patients with left anterior descending coronary artery lesions, thoracotomy was performed via the left, fourth intercostal space and the pericardium was incised to identify the target site. About 8 cm of the left internal mammary artery was harvested. Bilateral anterolateral thoracotomy was performed in one patient with left anterior descending and right coronary artery lesions. Anastomosis was performed under direct vision in the beating heart without cardiopulmonary bypass. Results. MIDCAB was performed successfully without morbidity. The patients' average stay in the intensive care unit was 1.8 days. No patient had any early cardiac event requiring additional surgery or percutaneous transluminal coronary angioplasty. Postoperatively, all patients were asymptomatic and their recovery was uneventful. Conclusions. Our initial experience indicates that MIDCAB offers good results and is a treatment option for selected patients with left anterior descending and/or right Coronary artery lesions. |
本系統中英文摘要資訊取自各篇刊載內容。