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山东大学学报 (医学版) ›› 2025, Vol. 63 ›› Issue (5): 1-5.doi: 10.6040/j.issn.1671-7554.0.2024.0230

• 重点专题——动脉桥在冠脉旁路移植中的应用 •    下一篇

着力进一步推进动脉桥在我国冠心病冠脉旁路移植术中的应用

陈绪军1,何国伟2   

  1. 1.华中科技大学同济医学院武汉市第一医院心外科, 湖北 武汉 430022;2.天津大学泰达国际心血管病医院心外科/天津市心血管病分子调控及转化医学重点实验室, 天津 300457
  • 出版日期:2025-05-10 发布日期:2025-05-07
  • 通讯作者: 何国伟. E-mail:gwhezj@163.com

Focus on further more use of arterial grafts in coronary artery bypass grafting in patients with coronary heart disease in China

CHEN Xujun1, HE Guowei2   

  1. 1. Department of Cardiac Surgery, Wuhan First Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei, China;
    2. Department of Cardiac Surgery, TEDA International Cardiovascular Hospital, Tianjin University/ Key Laboratory of Molecular Regulation of Cardiovascular Diseases and Translational Medicine, Tianjin 300457, China
  • Online:2025-05-10 Published:2025-05-07

摘要: 多支动脉桥在冠状动脉旁路移植术(coronary artery bypass grafting, CABG)中的应用已成为CABG的重要发展方向。本文重点介绍美国胸外科医生协会(Society of Thoracic Surgeons, STS)多支动脉桥应用现状、CABG解剖完全再血管化新理念及多中心应用效果、快速拔管的CABG在冠心病患者治疗效果、动脉桥在在我国儿童冠脉疾病应用以及糖尿病患者受益于动脉桥等,期望能着力进一步推进动脉桥在我国冠心病冠脉旁路移植术中的应用。

关键词: 动脉桥, 冠脉旁路移植术, 解剖完全再血管化, 儿童冠脉疾病, 快速拔管, 糖尿病

Abstract: Use of multiple arterial grafts in coronary artery bypass grafting(CABG)has become mainstream for the surgical treatment of coronary heart disease worldwide. This review focuses on the current application status of multiple arterial grafts of the Society of Thoracic Surgeons(STS)of USA, the new concept of anatomic complete revascularization in CABG and its multi-center clinical outcomes, the results of quick extubation of total arterial revascularization in patients with coronary heart disease, the application of arterial grafts in childrens coronary artery disease in China, and the benefits of arterial grafts for patients with diabetes in order to further promote the wide use of multiple arterial grafts in CABG in China.

Key words: Arterial grafts, Coronary artery bypass grafting, Anatomic complete revascularization, Coronary artery disease in children, Fast extubation, Diabetes mellitus

中图分类号: 

  • R654
[1] Gaudino M, Sandner S, An KR, et al. Graft failure after coronary artery bypass grafting and its association with patient characteristics and clinical events: a pooled individual patient data analysis of clinical trials with imaging follow-up[J]. Circulation, 2023, 148(17): 1305-1315.
[2] Schwann TA, Habib RH, Wallace A, et al. Operative outcomes of multiple-arterial versus single-arterial coronary bypass grafting[J]. Ann Thorac Surg, 2018, 105(4): 1109-1119.
[3] Gaudino M, Benedetto U, Fremes S, et al. Radial-artery or saphenous-vein grafts in coronary-artery bypass surgery[J]. N Engl J Med, 2018, 378(22): 2069-2077.
[4] Rocha RV, Tam DY, Karkhanis R, et al. Long-term outcomes associated with total arterial revascularization vs non-total arterial revascularization[J]. JAMA Cardiol, 2020, 5(5): 507-514.
[5] Ren J, Tian DH, Gaudino M, et al. Survival benefit of multiple arterial revascularization with and without supplementary saphenous vein graft[J]. J Am Heart Assoc, 2023, 12(22): e031986. doi:10.1161/JAHA.123.031986
[6] Shapira OM. Radial artery as the preferred second conduit for coronary bypass[J]. N Engl J Med, 2018, 378(22): 2134-2135.
[7] Sabik JF, Mehaffey JH, Badhwar V, et al. Multiarterial vs single-arterial coronary surgery: 10-year follow-up of 1 million patients[J]. Ann Thorac Surg, 2024, 117(4): 780-788.
[8] 中国生物医学工程学会体外循环分会. 2022年中国心血管外科手术和体外循环数据白皮书[J]. 中国体外循环杂志, 2023, 21(4): 197-200.
[9] 中国动脉化冠状动脉旁路移植术专家共识组. 中国动脉化冠状动脉旁路移植术专家共识2019版[J]. 中华胸心血管外科杂志, 2019, 35(4): 193-200. Working Group of Chinese Expert Consensus on Arterial Coronary Artery Bypass Grafting. 2019 Chinese expert consensus on arterial coronary artery bypass grafting[J]. Chinese Journal of Thoracic and Cardiovascular Surgery, 2019, 35(4): 193-200.
[10] 肖飞, 王联群, 季强. STS多支动脉冠脉搭桥应用解读[J/OL]. 山东大学学报(医学版),2025-03-11. http://kns.cnki.net/kcms/detail/37.1390.r.20250310.1538.004.html
[11] Saadat S, Habib R, Engoren M, et al. Multiarterial coronary artery bypass grafting practice patterns in the United States: analysis of the Society of Thoracic Surgeons Adult Cardiac Surgery Database[J]. Ann Thorac Surg, 2023, 115(6): 1411-1419.
[12] Iribarne A, Zwischenberger B, Mehaffey J, et al. The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2024 update on national trends and outcomes[J]. Ann Thorac Surg, 2025: S0003-4975(25)00221-8. doi: 10.1016/j.athoracsur.2025.03.011
[13] Bianco V, Kilic A, Aranda-Michel E, et al. Complete revascularization during coronary artery bypass grafting is associated with reduced major adverse events[J]. J Thorac Cardiovasc Surg, 2023, 166(1): 104-113.
[14] 陈绪军, 申林, 陈军, 等. 解剖完全再血管化是冠心病外科治疗的新策略[J/OL]. 山东大学学报(医学版),2025-03-11. http://kns.cnki.net/kcms/detail/37.1390.R.20250310.1739.008.html
[15] 国科, 陈绪军, 刘达兴, 等. 解剖完全再血管化全动脉冠脉旁路移植术多中心应用的中期结果[J]. 山东大学学报(医学版),2025-04-08. http://kns.cnki.net/kcms/detail/37.1390.R.20250407.1726.006.html
[16] Mondal S, Bergbower EAS, Cheung E, et al. Role of cardiac anesthesiologists in intraoperative enhanced recovery after cardiac surgery(ERACS)protocol: a retrospective single-center study analyzing preliminary results of a yearlong ERACS protocol implementation[J]. J Cardiothorac Vasc Anesth, 2023, 37(12): 2450-2460.
[17] Teman NR, Strobel RJ, Bonnell LN, et al. Operating room extubation for patients undergoing cardiac surgery: a national society of thoracic surgeons database analysis[J]. Ann Thorac Surg, 2024, 118(3): 692-699.
[18] 国科, 陈绪军, 郑宝石, 等. 快通道拔管在全动脉冠脉旁路移植术多中心临床效果[J/OL]. 山东大学学报(医学版),2025-03-26. http://kns.cnki.net/kcms/detail/37.1390.r.20250325.1316.002.html
[19] 卢圣勋, 邢亚闯, 罗俊辉, 等. 糖尿病患者冠脉搭桥手术中动脉桥的研究现状[J/OL]. 山东大学学报(医学版),2025-02-26. http://kns.cnki.net/kcms/detail/37.1390.R.20250226.1324.002.html
[20] 莫绪明, 王庆峰. 冠状动脉旁路移植术在儿童心血管疾病中的应用[J/OL]. 山东大学学报(医学版),2024-12-13. http://kns.cnki.net/kcms/detail/37.1390.R.20241213.0918.002.html
[21] 陈绪军, 张建, 李伟栋, 等. 2023 年欧洲心胸外科协会和美国胸外科医师协会《冠状动脉旁路移植术旁路血管选择专家共识》解读[J]. 中华外科杂志, 2024, 62(1): 44-48.
[22] Berger A, MacCarthy PA, Siebert U, et al. Long-term patency of internal mammary artery bypass grafts: relationship with preoperative severity of the native coronary artery stenosis[J]. Circulation, 2004, 110(11 Suppl 1): II36-II40.
[23] 王智琪, 戚继荣, 扈元利, 等. 全动脉冠状动脉旁路移植术治疗儿童川崎病后冠状动脉瘤1例并文献复习[J/OL]. 山东大学学报(医学版),2025-03-20. http://kns.cnki.net/kcms/detail/37.1390.R.20250319.1656.004.html
[24] Xue HM, Hou HT, Sun WT, et al. Del Nido cardioplegia better preserves cardiac diastolic function but histidine-tryptophan-ketoglutarate is better for endothelial function[J]. Eur J Cardiothorac Surg, 2022, 61(6): 1368-1378.
[25] 赵志敏, 王春, 李白翎. del Nido停搏液在心脏外科的应用: 过去、现在与未来[J/OL]. 山东大学学报(医学版),2025-03-11. http://kns.cnki.net/kcms/detail/37.1390.R.20250310.1501.002.html
[26] 温学龙,刘安慧,陈经纬,等.急性非ST抬高型心肌梗死行CABG手术时机的系统评价和Meta分析[J/OL]. 山东大学学报(医学版),2025-03-21. http://kns.cnki.net/kcms/detail/37.1390.R.20250320.2254.002.html
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