Enclose无阻断近端吻合系统在老年患者OPCAB术中的应用

目的 应用主动脉近端吻合器（Enclose）对比冠状动脉旁路移植术（OPCAB）后脑保护的效果.方法 前瞻性选取我院2006年1月至2010年6月心脏外科单一手术组行OPCAB手术应用Enclose主动脉近端吻合器的150例65岁以上老年患者作为试验组;同期相同手术应用侧壁钳钳夹主动脉侧壁手术的200例65岁以上老年患者作为对照组,比较脑保护的效果.结果 试验组患者脑梗塞发生率、一过性脑缺血发作（TIA）发生率、死亡率和呼吸机使用时间均优于对照组.结论 Enclose无阻断近端吻合系统为升主动脉存在钙化和斑块者提供了一个相对安全的手术机会.使用中收到了良好的效果,近期随访较满意,远期疗效还有待进一步观察.

Enclose-without blocking the proximal anastomosis system in the application of OPCAB in elder patients

Objective To study the effect of brain protection after OPCAB by aortic proximal anastomosis device （Enclose）. Medthods 150 elderly patients over 65 years underwent cardiac surgery OPCAB and enclose proximal anastomosis device in our hospital from January 2006 to June 2010 were selected as experimental group, another 200 elderly patients aged over 65 earlier application of the same wall clamp surgical clamp Folder aortic wall surgery as control group. The brain protective effect was compared. Results The incidence of cerebral infarction patients, TIA incidence, mortality and ventilator use of time in experimental group were lower than the control group. Conclusion The method of enclose proximal anastomosis system for non-blocking presence calcification and plaque in the ascending aorta provide a relatively safe procedure opportunities. The early results are satisfactory, but the long-term efficacy remains more observation.