Vascular Flow And Short-term Curative Effect Of Off-pump Coronary Artery Bypass Grafting

Objective:This topic selects patients undergoing off-pump coronary artery bypass grafting,sums up the general information and statistics the graft type,number,graft flow,heart chamber data for preoperative,postoperative(before discharge)and 1 year after surgery,aims to explore:(1)if there are differences in the flow rate between arterial graft and vein graft.(2)if there is a correlation between the number of graft and the total blood flow.(3)if there is a correlation between the total flow of the graft and the improvement of the left ventricular ejection fraction in early postoperative and 1 year after surgery.(4)The coronary artery CTA is reviewed in 1 year after surgery to analyze the patency of the graft and evaluate the surgical efficacy.Methods:Retrospectively analyze clinical data of patients who meet the criteria for inclusion and undergoing off-pump coronary artery bypass grafting in Shanghai 10 th people’s hospital cardiac surgery from February 2013 to October 2016.All patients are diagnosed by coronary angiography before surgery and are eligible for surgical indications.Preoperative echocardiography show no structural abnormalities in the heart.The arterial trunk flow is measured after blood pressure is stabilized.We compare the average flow rate of arterial graft and venous graft,compare with the preoperative,postoperative(before discharge)and 1 year after surgery of the heart chamber data and left ventricular ejection fraction change.Explore the relationship between the improvement of left ventricular ejection fraction and the total blood flow in the graft.The coronary artery CTA is reviewed to check the vessel patency 1 year after surgery.Results:The average flow rate of arterial graft is lower than that of the venous graft(36.7±23.0ml/min vs 42.9±25.2ml/min,P<0.05).There is a significant difference in the total flow rate between different grafts(P<0.05).In early postoperative,left atrial diameter and left ventricular diastolic diameter decreased(P<0.05),there was no significant improvement in left ventricular ejection fraction(P=0.276).In the first year after surgery,the left ventricular ejection fraction is statistically improved compared with the preoperative improvement,the degree of improvement is related to the flow of graft(Spearman correlation analysis r=0.381,P<0.05).The results of coronary CTA examination 1 year after surgery suggested that the graft are unobstructed.Conclusion:In the surgery of off-pump coronary artery bypass grafting,the average flow of venous graft is higher than that of arterial graft.There is a significant difference of graft flow in different numbers of graft.There is no significant improvement in early left ventricular ejection fraction.However,the left ventricular ejection fraction is improved 1 year after surgery and the degree of improvement is related to the flow of graft.In a word,better revascularization can increase coronary blood flow and improve cardiac systolic function after surgery.