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Objective: To summarize the clinical experience of the treatment of coronary artery disease in coronary artery bypass surgery, and to lay a foundation for the future extensive coronary artery bypass surgery. Methods: A retrospective analysis of our hospital from April 1997 to December 2003, 35 patients with coronary artery bypass grafting. 27 males (77.1%) and 8 females (22.9%), aged 48-78 years old, on average (62.3 ± 7.1) years, of which 22 cases of unstable angina (62.9%); myocardial infarction in 19 patients (54.3%) , LVEF average (55.3 ± 6.2)%, single vessel disease, 9 cases (25.7%), two lesions in 6 patients (22.9%), 3 lesions 20 cases. Elective surgery in 33 patients (94.3%), the Asian emergency surgery in 2 cases (5.7%). Cardiopulmonary bypass cardiac jumped out of a coronary artery bypass surgery, 28 patients (80%), myocardial protection with cold-blooded potassium cardioplegia are carried out under anesthesia during cardiopulmonary bypass under mild hypothermia, the general order of the bypass graft is the right coronary artery, circumflex support diagonal branch, left anterior descending artery, the distal anastomosis is completed, heart open loop line proximal anastomosis. -Pump beating heart coronary artery bypass surgery in seven cases (20%), anesthesia, sternotomy, applications CTS incision distraction distraction sternum, conventional free internal mammary artery and saphenous vein. Postural changes by adjusting the pericardial sutures and exposed the heart of the coronary artery, to use Octopus Ⅱ Plus cardiac holder, with coronary shunt and flushing, to create no blood surgical field. Anterior descending artery - posterior descending artery - obtuse marginal branch - on the order of the diagonal branch anastomosis, depending on the situation after the completion of the distal anastomosis proximal anastomosis can. Results: The overall number of cases bypass 1-4, an average of 2.7, which left internal mammary artery (LIMA) 33, 3 left radial artery, the rest were with the great saphenous vein. Line single vessel bypass in 8 cases (22.8%), the two bypass in 6 cases (17.1%), three or more bypass graft in 21 patients (60%). Concomitant valve replacement surgery in 6 cases (17.1%), including four cases of pure mitral valve replacement, mitral and aortic valve replacement in 2 cases (5.7%). Early postoperative death in three cases (8.8%), early cause of death, cardiac arrest cases of severe cardiac dysfunction two cases. Concomitant valve replacement surgery no death-pump beating heart coronary artery bypass surgery without death. Reoperation after surgery to stop bleeding in 2 cases (5.7%), 6 cases (17.1%) rapid atrial fibrillation, pulmonary insufficiency in 1 case (2.8%), the application of intra-aortic balloon counterpulsation support in 2 cases (5.7%). Conclusion: Coronary artery bypass surgery is the treatment of coronary artery disease is the most effective and the most important methods. Reasonable choice for patients, adequate preoperative preparation, skilled surgical technique, myocardial protection and reasonable perioperative management is the key to improve coronary artery bypass surgery efficacy.
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