尹朝华, 李巅远, 闫 军, 李守军, 胡盛寿. 川崎病致冠状动脉病变外科治疗的效果分析[J]. 心脏杂志, 2014, 26(6): 717-719.
    引用本文: 尹朝华, 李巅远, 闫 军, 李守军, 胡盛寿. 川崎病致冠状动脉病变外科治疗的效果分析[J]. 心脏杂志, 2014, 26(6): 717-719.
    Effect analysis of surgical treatment of Kawasaki coronary artery disease[J]. Chinese Heart Journal, 2014, 26(6): 717-719.
    Citation: Effect analysis of surgical treatment of Kawasaki coronary artery disease[J]. Chinese Heart Journal, 2014, 26(6): 717-719.

    川崎病致冠状动脉病变外科治疗的效果分析

    Effect analysis of surgical treatment of Kawasaki coronary artery disease

    • 摘要: 目的:分析和讨论川崎病致冠状动脉病变外科治疗的临床效果和经验。方法: 回顾分析2004年1月~2012年12月对13例川崎病致冠状动脉病变患者的临床资料。本组患者均行冠状动脉旁路移植术。所有患者均使用乳内动脉。8例体外循环手术,5例常温手术。2例行冠状动脉瘤成形术,1例行血栓清除术。1例行二尖瓣置换术。结果: 手术死亡1例。体外循环时间41~455(137±136) min,心肌阻断时间18~117(50±37) min,桥血管数量1~3(2.1±0.8)条。随诊3个月~6年,患者症状减轻或消失。动脉瘤直径减小。结论: 冠状动脉旁路移植是治疗川崎病致冠状动脉病变的有效方法,无需同期处理冠状动脉瘤。

       

      Abstract: AIM:To analyze and discuss of the clinical effect and experience of surgical treatment for Kawasaki coronary disease. METHODS: Clinical data of 13 patients with Kawasaki coronary artery disease from January 2004 to December 2012 were analyzed retrospectively. All patients underwent coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) in eight patients and off-pump technique in five patients. Left internal mammary artery was used in all cases. The combined procedures included coronary aneurysmectomy in two patients, coronary artery thrombus removal in one case, and mitral valve replacement in one case. RESULTS: One 4-year-old patient died of low cardiac output syndrome and acute renal failure 19 days after operation and who underwent CABG, coronary aneurysmectomy and coronary artery thrombus removal. The age of surgical operation was 3-49(18.5±13.5) years old. All patients had serious coronary stenosis or occlusion or reversible ischemia. Cardiopulmonary bypass and aortic clamp were 41-455(137±136) min and 18-117(50±37) min, respectively. The mean number of grafts was 1-3(2.1±0.8) and all patients except one<18 years old used artery graft. During the follow-up ranging from 3 months to 6 years, clinical symptoms were alleviated or disappeared. The diameter of the coronary aneurysm decreased. CONCLUSION: CABG is an effective procedure for Kawasaki CAD, which requires no treatment of coronary aneurysm at the same time.

       

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