冠状动脉搭桥术CABG.pptVIP

Coronary Artery Bypass Grafting Definition Indication Contraindication CABG Types Graft choose Complications 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 most patients, and improve survival and minimize complications of cardiac ischemia ? More than 300,000 patients undergo CABG surgery annually in the US 医者仁心 一路相随 With You All The Way Coronary Arteries 医者仁心 一路相随 With You All The Way AHA Guideline for CABG Surgery Left main coronary artery disease (LMCA) or significant disease of the LAD with another vessel involved or all three coronary arteries (LAD, LCX and RCA). Diffuse disease not suitable to treatment with a PCI or stent placement is not successful in opening the blocked blood vessels Survivors of sudden death who have coronary artery disease Other high-risk patients such as those with severe ventricular dysfunction (i.e. low ejection fraction), or diabetes mellitus. CABG is superior to PCI for some patients with multivessel CAD 医者仁心 一路相随 With You All The Way CABG Contraindication CABG is not recommended for patients who do not have adequate native vessels to use as graft. Patients with very small coronary arteries ( 1 mm or 1.5 mm ) and atherosclerosis of the aorta, heavily calcified, or located within the heart muscle rather than on the surface are challenges in CABG. 医者仁心 一路相随 With You All The Way Types of CABG Traditional CABG CABG Nontraditional CABG Minimally Invasive Direct Coronary Artery Bypass Grafting Off Pump Coronary Artery Bypass Grafting 医者仁心 一路相随 With You All The Way Off Pump Coronary Artery Bypass Grafting 医者仁心 一路相随 With You All The Way Off Pump Coronary Artery Bypass Grafting Advantages: ① ② ③ ④ A decreased need for blood transfusion Less myocardial enzyme release Less