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No-touch saphenous vein graft harvesting technique for coronary artery bypass grafting.

冠状动脉旁路移植术的无接触隐静脉移植物获取技术。

  • 影响因子:1.21
  • DOI:10.1007/s11748-019-01186-4
  • 作者列表:"Inaba Y","Yamazaki M","Ohono M","Yamashita K","Izumida H","Hayashi K","Takahashi T","Kimura N","Ito T","Shimizu H
  • 发表时间:2020-03-01
Abstract

OBJECTIVES:Although the patency of internal artery grafts in coronary artery bypass grafting (CABG) is superior to that of saphenous vein grafts (SVGs), good long-term patency rates have been reported with SVGs harvested using the no-touch technique. Here, we report the early results of CABG with no-touch SVGs (NT-SVGs) along with the precautions required while handling these grafts. METHODS:This retrospective study included 41 patients who underwent CABG with NT-SVGs between May 2016 and March 2018. NT-SVGs were harvested with minimal electric scalpel use, and post-harvesting vascular overdilation with a syringe was not performed. Blood with heparinized saline was used to prevent vascular endothelial damage. A drain was inserted into the SVG harvest site, which was closed with a single interrupted suture, and elasticated bandage and compression stockings were used to prevent fluid retention and avoid delayed wound healing. RESULTS:There was no case of postoperative thoracotomy due to bleeding or myocardial infarction, and postoperative graft assessment confirmed graft patency in all patients, with a little mismatch between the diameters of SVG and the anastomotic vessel. Delayed wound healing at the graft harvest site seemed to improve after introducing the above procedures. CONCLUSIONS:Early results of CABG with NT-SVGs were good. Some precautions must be taken during harvesting and anastomosis. Taking precautions described in this study may help reduce the risk of perioperative complications and make the no-touch technique the standard procedure for harvesting SVGs for CABG.

摘要

目的: 虽然在冠状动脉旁路移植术 (CABG) 中,内动脉移植物的通畅性优于隐静脉移植物 (SVGs),但据报道,使用无接触技术获得SVGs的长期通畅率良好。在此,我们报告了使用无接触SVGs (nt-svgs) 的CABG的早期结果,以及处理这些移植物时所需的预防措施。 方法: 本回顾性研究包括2016年5月至2018年3月间接受CABG伴nt-svgs的41例患者。用最少的电刀使用收获NT-SVGs,并且不进行用注射器的收获后血管过度扩张。使用含有肝素化盐水的血液来预防血管内皮损伤。将引流管插入SVG收获部位,用单个中断的缝线将其封闭,并使用弹性绷带和加压长袜来防止液体潴留并避免伤口愈合延迟。 结果: 术后无一例因出血或心肌梗死而开胸,术后移植物评估证实所有患者移植物通畅,SVG直径与吻合血管略有不匹配。在引入上述程序后,移植物收获部位的延迟伤口愈合似乎有所改善。 结论: nt-svgs的CABG早期结果良好。在收获和吻合期间必须采取一些预防措施。采取本研究中描述的预防措施可能有助于降低围手术期并发症的风险,并使无接触技术成为CABG获取SVGs的标准程序。

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影响因子:1.67
发表时间:2020-01-01
DOI:10.2174/1573403X15666190513105231
作者列表:["Dev M","Sharma M","Rana N"]

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心脏影像技术方向

心脏结构和心脏血流的可视化,用于诊断评估或通过内窥镜、放射性核素成像等技术来指导心脏手术。

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