Objective: To introduce our experience with Coronary artery bypass.
Methods: From January 1996 to March 1999, coronary artery bypass was in 1110 patients at our hospital. They were 985 men and 125 women, aged 27 - 78 years (57 +/- 9). 500 patients were aged over 60 years. 670 patients had a history of myocardial infarction. 450 patients suffered from instable, and 460 from stable angina. 169 patients had stenosis of the left main trunk (>or= 50%). The heart function of 240 patients was over NYHA class III, the EF of 123 patients was less than 40%. 454 patients were associated with hypertension, 133 with diabetes, 131 with ventricular aneurysm, 48 with valvular disease, and 5 with rupture of ventricular septal. 1048 procedures were performed on hypothermia cardiopulmonary bypass (CPB) and 60 on beating heart. Myocardial preservation was carried out by cold blood cardioplegia with potassium. The average time of CPB was 115 +/- 35 minutes, and that of aortic cross clamp was 72 +/- 24 minutes 110 cases received one graft, 145 cases two grafts, 415 cases three grafts, and 439 cases four and more than four grafts. Left internal mammary artery, great saphenous vein, and radial artery were used as coronary artery bypass conduits on 751, 877 and 101 patients, respectively. Total arterial myocardial revascularization was performed on 72 patients. Concomitant operation included ventricular aneurysmetomy (112 cases), plication (14), left ventriculoplasty (5), valvular procedures (48), repair ventricular septal rupture (5).
Results: 1 101 patients were discharged uneventfully. Early death occurred in 9 patients, (0.81%). Complication included low cardiac output (11 cases), introaortic balloon pump (7), perioperative myocardial infarction (2), complication of brain (3), and rethoractomy for bleeding (4).
Conclusions: To identify adequate target vessel and completely revascularize ischemic myocardium are the key of coronary artery bypass. Perioperative treatment is important.