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永不停止

在非体外循环冠状动脉搭桥术中,生命的节奏永不停止

研究表明,非体外循环冠状动脉搭桥术(OPCAB)可以改善诊疗效果并降低风险

大量的人口研究表明,非体外循环冠状动脉搭桥术(OPCAB)降低了患者发病率和死亡率,降低了急性肾功能衰竭的发生率,减少了输血,改善了术后神经系统的诊疗效果,降低了术后的中风风险,并缩短了手术后的恢复时间。[1] [2] [3] [4] [5] [6] [7] [8] [9]

阅读更多关于血流动力学稳定性的策略

OPCAB: 降低微栓塞引起的中风风险

与中风相关的一个主要原因是微栓塞的出现,微小的斑块颗粒从血管中脱落并进入血流,在那里它们可以滞留在大脑中。与心脏搏动手术相比,传统的心脏搭桥手术更容易发生中风和认知功能障碍。据记载,在手术期间使用夹子阻断主动脉的血流是导致这些颗粒释放到血液中的原因。[10] [11] [12]通过消除钳夹,外科医生可以极小化主动脉操作,从而减少神经并发症的风险。[13]

OPCAB采用ACROBAT系统,减少CABG手术中夹具的使用

在传统的CABG手术中,为了将患者安置于心肺机上,主要使用两种夹具:阻断钳和侧壁钳。

在OPCAB手术中,则不需要阻断钳。虽然一些医生可能会使用侧壁钳在主动脉上缝合移植物时造成一个不流血的地方,但是也有完全使用夹具的替代方法,能够很大限度地利用到OPCAB的优势。

了解 Getinge’s OPCAB 解决方案

消除主动脉钳夹,降低CABG手术的风险

HEARTSTRING III 近端吻合系统消除了冠状动脉旁路移植术中对主动脉钳夹的需要。降低了脑栓塞的风险,并潜在改善了患者的神经认知结果。

了解更多关于HEARTSTRING III 近端吻合系统的信息

所有参考

  1. 1. Sedrakyan A, et al. Off-pump surgery is associated with reduced occurrence of stroke and other morbidity as compared with traditional coronary artery bypass grafting: a meta-analysis of systematically reviewed trials. Stroke. 2006 Nov;37(11):2759-69.

  2. 2. Puskas JD, et al. Off-Pump coronary artery bypass grafting provides complete revascularization while reducing myocardial injury, transfusion requirements and length of stay: prospective randomized comparison of 200 unselected patients having OPCAB verses conventional CABG. J Thorac Cardiovasc Surg. 2003;125:797-808.

  3. 3. Stamou SC, et al. Stroke after conventional versus minimally invasive coronary artery bypass. Ann Thorac Surg. 2002;74:394-399.

  4. 4. Van Dijk D, et al. Early outcome after off-pump versus on-pump coronary bypass surgery: results from a randomized study. Circulation. 2001 Oct 9;104(15):1761-6.

  5. 5. Puskas J, Cheng D, Knight J, et al. Off-pump versus conventional coronary artery bypass grafting: a meta-analysis and consensus statement from the 2004 ISMICS Consensus Conference. Innovations. 2005;1:3-27.

  6. 6. Ascione R, Angelini GD. OPCAB surgery: a voyage of discovery back to the future. Eur Heart J. 2003;24:121-124.

  7. 7. Angelini GD, Taylor FC, Reeves BC, Ascione R. Early and midterm outcome after off-pump and on-pump surgery in Beating Heart Against Cardioplegic Arrest Studies (BHACAS 1 and 2): a pooled analysis of two randomised controlled trials. Lancet. 2002;359:1194-1199.

  8. 8. Demers P, et al. Multivessel Off-Pump Coronary Artery Bypass Surgery In The Elderly. Eur J Cardiothorac Surg. 2001 Nov;20(5):908-12.

  9. 9. Mack MJ, et al. On-Pump Versus Off-Pump Coronary Artery Bypass Surgery in a Matched Sample of Women: A Comparison of Outcomes. Circulation. 2004 Sep 14;110(11 Suppl 1):II1-6.

  10. 10. Barbut D. et al. Cerebral emboli detected during bypass surgery are associated with clamp removal. Stroke. 1994 Dec;25(12):2398-402.

  11. 11. Pugsley W, et al. The impact of microemboli during cardiopulmonary bypass on neuropsychological functioning. Stroke. 1994 Jul;25(7):1393-9.

  12. 12. Barbut D, et al. Impact of embolization during coronary artery bypass grafting on outcome and length of stay. Ann Thorac Surg. 1997 Apr;63(4):998-1002.

  13. 13. El Zayat H, et al. Avoiding the clamp during off-pump coronary artery bypass reduces cerebral embolic events: results of a prospective randomized trial. Interact Cardiovasc Thorac Surg. 2012 Jan;14(1):12-6.