Objective: To evaluated early clinical outcomes of saphenous vein grafts harvested with a No-touch technique in off-pump coronary artery bypass graft (OPCABG) surgery. Methods: A total of 124 patients with three-vessel disease undergoing OPCABG by No-touch technique between June and November 2017 in Beijing An Zhen Hospital were respectively reviewed. Results: The average age of patients was (60.7±10.3) years, and 80 cases (64.5%) were male, with the average body mass index (BMI)of (25.4±2.5) kg/m(2,) the mean preoperative left ventricular ejection fraction (LVEF) of (58.0±7.0%). The operative time was (4.0±0.4) hours, and 16 cases (12.9%) were harvested for whole vein grafts. The number of vein grafts and venous anastomoses was 144 and 284, respectively. There were 16 cases of single bridge NTSVG-LAD, 4 cases of single bridge NTSVG-D, 99 cases of sequential bridge NTSVG-OM-PDA, 5 cases of sequential bridge NTSVG-OM-PLV, 4 cases of sequential bridge NTSVG-OM-RCA, 16 cases of sequential bridge NTSVG-D-OM-PDA. The mean flow volume of No-touch vein grafts was (51.9±2.4) ml/min. There was no death case in hospital. Postoperative re-exploration for hemorrhage of anastomosis happened in 1 case (0.8%), which was caused by pericardial tamponade due to insufficiency of hemostasis in internal mammary bed. There were 1 case of bad wound healing of lower extremity incision (0.8%). A total of 124 cases were followed up after operation, and the follow-up rate was 100%. There was one all-cause death (0.8%) 27 days after the operation. Conclusion: The short-term clinical observation of the application of No-touch great saphenous vein harvesting technique for OPCABG is safe and effective.
目的： 评价不接触(No-touch)大隐静脉获取技术在非体外循环冠状动脉旁路移植(OPCABG)术中应用的短期临床疗效。 方法： 回顾性分析北京安贞医院2017年6至11月应用No-touch技术获取大隐静脉，同时行单纯OPCABG术治疗的冠心病三支病变患者124例临床资料和出院后3个月随访资料，评价临床疗效。 结果： 124例患者年龄(60.7±10.3)岁，男80例(64.5%)，体质指数(25.4±2.5)kg/m(2)，术前左心室射血分数(58.0±7.0)%，肌钙蛋白(0.24± 0.02)μg/L。手术时间(4.0±0.4)h，16例(12.9%)患者使用No-touch技术获取全静脉桥完成手术。静脉桥血管数目144根，静脉吻合口数284个。单根桥静脉-前降支(NTSVG-LAD)16例，单根桥静脉-对角支(NTSVG-D)4例，序贯桥静脉-回旋支-后降支(NTSVG-OM-PDA)99例，序贯桥静脉-回旋支-左室后支(NTSVG-OM-PLV)5例，序贯桥静脉-回旋支-右冠主干(NTSVG-OM-RCA)4例，序贯桥静脉-对角支-回旋支-后降支(NTSVG-D-OM-PDA)16例。No-touch静脉桥流量(51.9±2.4)ml/min。无院内死亡患者，术后因乳内床止血不充分心包填塞，二次开胸止血1例(0.8%)，下肢切口不良1例(0.8%)，术后随访124例，随访率100%。术后27 d死亡1例(0.8%)，死因为不明原因的全身血运感染。 结论： No-touch大隐静脉获取技术在OPCABG术中应用短期临床疗效和安全性较好。.
Keywords: Coronary artery bypass, off-pump; Great saphenous vein; No-touch technique.