ABSTRACT
Objective@#To evaluate the mid- and long-term efficacy of Hybrid coronary revascularization (HCR) in the treatment of multi-vessel coronary artery disease for 5 years after operation, and to compare the operative effect with those of off-pump coronary artery bypass grafting (OPCABG) for the same period.@*Methods@#From March 2010 to June 2013, 37 patients underwent selective staging HCR surgery (HCR group) due to multi-vessel coronary artery disease in our hospital. All patients were treated by PCI and MIDCAB subsequently. 148 patients with OPCABG completed by the same group of doctors at the same time were served as control group (OPCABG group), and the follow-up period was up to June 2018. The end point of the study was the incidence of major adverse cardiac or cerebrovascular events (MACCE) events in both groups, including cardiac death, new myocardial infarction, secondary coronary revascularization and cerebrovascular accident.@*Results@#The clinical baseline data of the two groups were basically matched. 37 patients in HCR group were successfully operated on, and each patient was completed with LIMA-LAD bypass, 72 drug-eluting stents were implanted. 504 stents were bridged in 148 patients in OPCABG group, each patient was completed with LIMA-LAD bypass, the other target vessels were performed by sequential anastomosis with great saphenous vein as graft. The average follow-up time was 6.3 years (5.1-8.2 years). In HCR group, 33 patients(89%)completed the follow-up, of which 6 (18%) had MACCE events. In OPCABG group, 130 patients(88%)successfully completed the follow-up, of which 19 (15%) had MACCE events. There was no significant difference in MACCE-free survival rate between the two groups (HCR 81.8% vs. OPCABG 73.8%, P>0.05).@*Conclusion@#The mid- and long-term effect of HCR is similar to that of OPCABG in the treatment of multi-vessel coronary artery disease, but it has the advantages of less traumatic, faster recovery and less use of blood products. It can be widely used in patients with selective multi-vessel coronary artery disease.
ABSTRACT
Objective To evaluate the mid-and long-term efficacy of Hybrid coronary revascularization (HCR) in the treatment of multi-vessel coronary artery disease for 5 years after operation,and to compare the operative effect with those of offpump coronary artery bypass grafting (OPCABG) for the same period.Methods From March 2010 to June 2013,37 patients underwent selective staging HCR surgery (HCR group) due to multi-vessel coronary artery disease in our hospital.All patients were treated by PCI and MIDCAB subsequently.148 patients with OPCABG completed by the same group of doctors at the same time were served as control group (OPCABG group),and the follow-up period was up to June 2018.The end point of the study was the incidence of major adverse cardiac or cerebrovascular events (MACCE) events in both groups,including cardiac death,new myocardial infarction,secondary coronary revascularization and cerebrovascular accident.Results The clinical baseline data of the two groups were basically matched.37 patients in HCR group were successfully operated on,and each patient was completed with LIMA-LAD bypass,72 drug-eluting stents were implanted.504 stents were bridged in 148 patients in OPCABG group,each patient was completed with LIMA-LAD bypass,the other target vessels were performed by sequential anastomosis with great saphenous vein as graft.The average follow-up time was 6.3 years (5.1-8.2 years).In HCR group,33 patients(89％)completed the follow-up,of which 6 (18％) had MACCE events.In OPCABG group,130 patients(88％)successfully completed the follow-up,of which 19 (15％) had MACCE events.There was no significant difference in MACCE-free survival rate between the two groups (HCR 81.8％ vs.OPCABG 73.8％,P ＞ 0.05).Conclusion The mid-and long-term effect of HCR is similar to that of OPCABG in the treatment of multi-vessel coronary artery disease,but it has the advantages of less traumatic,faster recovery and less use of blood products.It can be widely used in patients with selective multi-vessel coronary artery disease.
ABSTRACT
BACKGROUND@#Pulmonary thrombosis embolism (PTE) is one of the most severe complications of perioperative radical mastectomy. Massive PTE is often accompanied by shock and hypotension which is characterized by rapid progression and high mortality. There is no standard for the treatment of these patients, which is thoracic surgery, and it is a critical issue in the thoracic surgeons. This article summarizes and analyzes the treatment of two patients with high-risk PTE at the early stage of postoperative lung cancer in our hospital. In addition, we discusses the diagnosis and treatment strategies of these cases to provide a reference for the thoracic surgeons.@*METHODS@#We presented two patients with high-risk PTE at the early stage after thoracic surgery for radical surgery in our hospital back in 2017. One case was treated with intravenous venous interventional thrombolysis, and the other was treated with thrombolysis alone. The treatment effect of two patients and the complications during the treatment has been recorded to detail and summarized.@*RESULTS@#Both patients were female who aged 66 and 61 years old. The time point of pulmonary embolism was 48 h and 45 h after operation, and the time of interventional thrombolysis was 70 minutes and 50 minutes after onset respectively. After 120 minutes and 100 minutes, the drainage after interventional thrombolysis was 4,690 mL and 520 mL respectively. The hospitalization time after thrombolysis was 21 days and 14 days respectively. There was no obvious complication through a follow-up of 6 months.@*CONCLUSIONS@#Early postoperative acute massive pulmonary embolism in lung cancer should be treated with pulmonary interventional thrombolysis as soon as possible. Compared with intravenous thrombolysis, pulmonary interventional thrombolysis shows accuracy, easy controlling of dosage, fast curative effect and low bleeding risk.