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Coronary Artery Bypass Grafting on the Beating Heart Using the Octopus Method —A Case Report

使用Octopus方法於跳動心臟做冠狀動脈繞道手術之病例報告

摘要


一位74歲男性由於胸悶持續一個月而住院,這位病人於一年前因單條冠狀動脈疾病做經皮冠狀動脈整形術,這次住院經由心導管檢查發現左前降冠狀動脈及左旋枝狹窄,因再做經皮冠狀動脈整形術的效果被認為不良,因此被轉介做冠狀動脈導道手主,在合乎病人選擇條件,使用Octopus組織固定器為這位病人做輕微侵犯直接冠狀動脈繞道手術,我們在本文中報告手術及麻醉過程并詳細討論侵犯直接冠狀動脈繞道手術。

並列摘要


A 74-year-old male was admitted due to chest lightness for one month. He had received percutaneous transilluminal coronary angioplasty (PTCA) because of single-vessel disease one year ago. Cardiac catheterization examination carried out during this admission revealed 90% stenosis of the left anterior descending coronary artery (LAD) and circumflex branch (CX). Because another attempt of PTCA was considered not optimal, the patient was advised to undergo surgical grafting to which he consented. After expediently balancing the merits and demerits of every practicable surgical procedure-the essential determinant in selection of which was that the patient's condition and criteria of indication of that procedure were in perfect harmony - we decided to carry out minimally invasive direct coronary artery bypass (MIDCAB) with the application of Octopus tissue stabilizei We report the surgical course and anesthetic management of the patient and discourse some detail in MIDCAB.

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