首页|冠状动脉功能学指导下的全动脉化微创冠状动脉旁路移植术一例

冠状动脉功能学指导下的全动脉化微创冠状动脉旁路移植术一例

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本文报道1例59岁男性劳力性心绞痛患者,冠状动脉造影显示多支病变.最初的策略为冠状动脉旁路移植术(coronary artery bypass grafting,CABG).术前行定量血流分数(quantitative flow ration,QFR)测定提示后降支无需处理,回旋支细小,前降支和第一对角支的QFR＜0.8,故主要针对前降支和第一对角支进行再血管化,更改手术策略为小切口非体外循环心脏跳动下CABG,最终策略为左乳内动脉-第一对角支-前降支(序贯桥).术后采用计算机断层扫描血流储备分数(fractional flow reserve,FFR)评估CABG后前降支远段和第一对角支的FFR均＞0.8,同时行CABG术后SYNTAX评分为20分,功能学SYNTAX评分为3分,提示预后良好.
Totally arterialized minimally invasive coronary artery bypass grafting under the guidance of coronary artery function:A case report
We reported a 59-year-old male with exertional angina pectoris,and the coronary angiography showed multiple vessellesions.The initial strategy was coronary artery bypass grafting(CABG).The measurement of quantitative flow ration(QFR)before operation indicated that the posterior descending branch(PD)did not need to be treated.The left circumflex branch(LCX)was small,and the QFR of the left anterior descending branch(LAD)and the first diagonal branch(D1)was＜0.8.Therefore,the LAD and D1 were re-vascularized.The operation strategy was changed to on-pump CABG through a smallincision,and the final strategy was LIMA-D1-LAD(sequential),fractional flow reserve(FFR)of distal LAD and D1 after CABG were＞0.8 by computed tomography FFR.SYNTAX scores after CABG were 20 and the functional SYNTAX scores after CABG were 3,indicating a good prognosis.

Exertional angina pectoristotally arterialized minimally invasive coronary artery bypass graftingquantitative flow rationcomputed tomography fractional flow reservecase report

双东思、符竣、王江友、余春俊、华正东

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武汉亚心总医院心血管内外科(武汉 430022)

劳力性心绞痛 全动脉化微创冠状动脉旁路移植术 定量血流分数 计算机断层扫描血流储备分数 病例报告

武汉市卫生计生委项目武汉亚心总医院科研创新基金

WX14C792022KYCX1-B03

2024

10.7507/1007-4848.202208004

中国胸心血管外科临床杂志
四川大学华西医院

中国胸心血管外科临床杂志

CSTPCD北大核心
影响因子：0.846
ISSN：1007-4848
年,卷(期)：2024.31(4)
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