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首页> 外文期刊>Journal of cardiac surgery. >Endarterectomy and surgical angioplasty without cardiopulmonary bypass.
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Endarterectomy and surgical angioplasty without cardiopulmonary bypass.

机译：内膜切除术和外科血管成形术无需体外循环。

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摘要

Surgical angioplasty for ostial stenosis of the major coronary arteries is a well-established treatment modality. Management of discrete stenoses of distal coronary arteries in the presence of mild proximal disease is a challenging task. Percutaneous intervention or grafting beyond the diseased segment may be limited by size of the target vessel, whereas endarterectomy followed by graft placement may result in graft occlusion due to competitive native flow. Patch angioplasty with or without endarterectomy is an effective option in this setting, which can be performed without cardiopulmonary bypass in the appropriate group of patients. A patient with triple vessel coronary artery disease and a discrete lesion in the posterior descending artery underwent off-pump endarterectomy with vein patch angioplasty in combination with bypass grafting to left anterior descending and obtuse marginal arteries. Operative technique and intraoperative strategies are discussed.
机译：主要冠状动脉口狭窄的外科血管成形术是一种行之有效的治疗方式。在轻度近端疾病的存在下，远端冠状动脉离散性狭窄的处理是一项艰巨的任务。经皮介入或移植到患病部位之外可能会受到靶血管大小的限制，而内膜切除术继之以移植物放置可能会由于竞争性天然血流而导致移植物闭塞。在这种情况下，伴或不伴动脉内膜切除术的修补血管成形术是一种有效的选择，在适当的患者组中，无需进行心肺旁路手术即可进行。一名患有三支冠状动脉疾病并在后降动脉中有离散病变的患者接受了非体外循环内膜切除术，并进行了静脉贴片血管成形术，并搭桥了左前降支和钝性边缘动脉。讨论了手术技术和术中策略。

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