| 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 perfo:rmed (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 survival 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. also shows a satisfactory patency rate. A longterm result is necessary to document the efficacy of the procedure. |
