《冠状动脉搭桥术CABG课件.ppt》由会员分享，可在线阅读，更多相关《冠状动脉搭桥术CABG课件.ppt（18页珍藏版）》请在三一办公上搜索。
1、Coronary Artery Bypass Grafting,1,2,What is CABG?,Coronary artery bypass graft surgery (CABG) is a procedure that uses patients own veins (usually from the legs) or arteries to bypass narrowed areas and restore blood flow to heart muscle. Bypass surgery can markedly reduce or relieve chest pain for
2、most patients, and improve survival and minimize complications of cardiac ischemiaMore than 300,000 patients undergo CABG surgery annually in the US,3,Coronary Arteries,4,AHA Guideline for CABG Surgery,CABG is superior to PCI for some patients with multivessel CAD,CABG Contraindication,Types of CABG
3、,Off Pump Coronary Artery Bypass Grafting,Off Pump Coronary Artery Bypass Grafting,Advantages:A decreased need for blood transfusionLess myocardial enzyme releaseLess renal dysfunctionLess early neurological dysfunctionDisadvantage:Decreased graft patency due to problems with anastomoses,9,Choice of
4、 Graft,Internal thoracic arteries (also called internal mammary arteries)Radial arteriesSaphenous veins Right gastroepiploic artery,Saphenous vein graft patency declines significantly starting at the time of surgery. Rates below 90 percent are common at one year. Long-term graft patency is excellent
5、 with internal thoracic artery and radial artery bypass grafts. Rates exceeding 90 percent at 5 to 10 years are common.Graft patency is dependent on a number of factors, including the type of graft used, the size of the coronary artery that the graft is anastomosed with, and the skill of the surgeon
6、(s) performing the procedure.,Blood flow begins to diminish with around a 70 percent stenosis in the graft.,Bypass Surgery Complications,Bypass Complications: Cardiac complications,Bypass Surgery Complications: Bleeding,Bypass Complications: Neurologic complications,The incidence of neurologic problems following CABG :2 to 4%Older patients and women are affected more frequently.,Bypass Complications: Infection,Other complications,
