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Development of SIMS (Simple Indigenous Metallic Stabilizer) for opcab

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World Journal of Cardiovascular Diseases 2019年第5期9卷 324-330页

作者： Murali P. Vettath Kannan Arunachalam Venkatachalam Nitin Gangadharan Madhu Ravisankar Smera Koroth Gopalakrishnan Raman Meitra Hospital Kozhikode India

Development of a simple, reusable stabilizer for beating heart surgery has been long overdue. Every time a disposable stabilizer is used and discarded, we add to the carbon footprint we leave behind. We had been working on developing such a stabilizer, and had finally come up with a simple indigenous (reusable) metallic stabilizer (SIMS). We have used it for over 600 consecutive off pump coronary artery bypass (opcab) with excellent results. The anatomy of the stabilizer is described here along with a comparison of this stabilizer with the commercially available one.

关键词： SIMS opcab

Mini opcab Mammary to Left Anterior Descending Artery

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Surgical Science 2017年第9期8卷 407-413页

作者： Federico Benetti Natalia Scialacomo Cardiac Surgery Benetti Foundation Alem 1846 Rosario Argentine

Introduction: Here we will describe the actual surgical technique to perform the left mammary artery bypass to the left anterior descending artery, and the results of this operation in the Benetti Foundation in the last 20 years. Materials and Methods: The inclusion criteria for this operation were patients with a demonstrated predominant ischemia by functional test. In the patients with double, triple vessels disease or left main, the age was more than 65 years or and Euro score Risk of surgery of more than 4. The exclusion criteria were patients with more areas of ischemia and lesions that involved a considerable territory apart from the Lad and good candidates for surgery are younger than 65 years or the Euro score Risk of surgery were less than 4. Seventy patients were operated in the Foundation through LIMA to LAD Anastomosis with the MINI opcabG technique. The average Preoperative Risk Euroscore was 3,5. Surgical Technique after open the lower part of the sternum, the left mammary artery is dissected around 8 cm. The pericardium is open and the mammary is connected to the left anterior descending. Results: Operative mortality in this series was 0%. One patient was converted to sternotomy Off Pump (1, 4%). None of the grafts were revised after the measure with the Medistim System. 55 (79%) were extubated in the operating room. The average Hospitalization stay were 60 hours (D +_17 ci 95%), 16 patients with Lima to LAD were restudied in the initially experience with 100% patency, at 144 months, 82% of the patients were alive and 68% asymptomatic. Conclusion: More clinical experience is important to find the definitive indications of this technique;and better technologies are required to be able to standardize this operation in definitive form.

关键词： Mini opcab Minimally Invasive Coronary Surgery Off Pump Coronary Coronary Off Pump Lima to Lad

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opcab术后精神障碍的临床分析

江苏医药 2010年第16期36卷 1976-1978页

作者：张亚军宋建祥王进施展尹琴张国培东南大学医学院附属盐城医院心胸外科盐城224001

体外循环心内直视术后出现精神障碍在临床中日益受到重视,成人体外循环(CPB)下冠脉搭桥手术发生率可达30%~50%,以往认为CPB是术后出现精神障碍的重要因素,近年,我们在临床中发现,非体外循环心脏不停跳冠脉搭桥术(opcab)未经历CPB,却仍... 详细信息

体外循环心内直视术后出现精神障碍在临床中日益受到重视,成人体外循环(CPB)下冠脉搭桥手术发生率可达30%~50%,以往认为CPB是术后出现精神障碍的重要因素,近年,我们在临床中发现,非体外循环心脏不停跳冠脉搭桥术(opcab)未经历CPB,却仍有较高的精神障碍发生率.2004年2月~2009年10月我院行opcab136例,其中32例术后出现精神障碍,发生率为23·5%,现报道如下

关键词：术后精神障碍临床分析 opcab 不停跳冠脉搭桥术非体外循环心内直视术后冠脉搭桥手术发生率

Re-engineering in opcab—A Vettath’s perspective

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World Journal of Cardiovascular Diseases 2013年第4期3卷 33-44页

作者： Murali P. Vettath Et Ismail Av Kannan Department of Cardiothoracic and Vascular Surgery International Center of Excellence in OPCAB Surgery Malabar Institute of Medical Sciences Kozhikode India

opcab (off pump coronary artery bypass) has become a preferred technique of coronary revascularization in India, and more so in the East. This technique was restarted by Buffalo and Bennetti who had published their results in 1985. Since then, there has been a great enthusiasm among coronary surgeons to develop and standardize this technique of CABG (coronary artery bypass grafting). In the late nineties, nearly all the coronary centers in India started performing this technique. But, by the early 2000, only a few surgeons continued this practice. Only those who could perform this opcab technique in nearly 100% of their patients continued this and the rest of them returned back to the conventional on pump CABG. To attain this result, we had to re-engineer our technique of anesthesia, surgical technique, stabilization, and positioning of the heart to enable us to perform opcab in all patients who needed CABG. We have analyzed our last 3000 patients operated by the same surgeon (Dr MPV), in the same center with the same team. As opcab was the only procedure performed for coronary revascularization, we have compared our first 1000 patients, with the second 2000 patients that underwent the procedure. Our technique and our results are presented.

关键词： CABG (Coronary Artery Bypass Grafting) opcab (Off Pump Coronary Artery Bypass) ONCAB (On Pump Coronary Artery Disease) Diffuse Coronary Artery Disease IABP (Intra-Aortic Balloon Pump) CPB (Cardiopulmonary Bypass)

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opcab术后发生精神障碍的相关因素

中华胸心血管外科杂志 2014年第6期30卷 370-371页

作者：张亚军宋建祥袁从虎施展常绘文赵强东南大学医学院附属盐城医院心胸外科 224002 上海交通大学附属瑞金医院心外科

精神障碍已成为心脏手术后主要的并发症之一，发生比例高达30%～50％，非体外循环心脏不停跳下冠状动脉旁路移植（opcab）术后精神障碍的发生比例为23．5％。精神障碍可能与多种因素影响下引发的中枢神经系统功能紊乱有关。现回顾性分... 详细信息

精神障碍已成为心脏手术后主要的并发症之一，发生比例高达30%～50％，非体外循环心脏不停跳下冠状动脉旁路移植（opcab）术后精神障碍的发生比例为23．5％。精神障碍可能与多种因素影响下引发的中枢神经系统功能紊乱有关。现回顾性分析我科行opcab的患者临床资料，探讨并总结患者术后发生精神障碍原因及防治措施。

关键词：术后精神障碍心脏手术后 opcab 相关因素非体外循环心脏不停跳冠状动脉旁路移植神经系统功能紊乱临床资料

Guillaine Barre Syndrome after opcab Surgery

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Surgical Science 2014年第12期5卷 540-541页

作者： Murali Vettath A. V. Kannan Malabar Institute of Medical Sciences Kozhikode India

We report a successful treatment of the first reported case of Guillaine-Barre Syndrome (GBS) detected post Off Pump Coronary Artery Bypass Surgery (opcab). A 70-year-old man underwent opcab surgery for Triple Vessel Disease. In the post-operative period he developed respiratory distress with unexplained weakness in the limbs. CSF study confirmed Guillaine-Barre Syndrome. He was administered immunoglobulin therapy. The patient fully recovered and was discharged in good health.

关键词： GBS opcab Immunoglobulin

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opcab围手术期护理的联合教学查房

护士进修杂志 2004年第2期19卷 191-192页

作者：张丽红雷荣兰郭宇河北省唐山工人医院护理教研室河北唐山063000

护理教学查房是临床护理教学很重要的一环,它不仅能巩固和加强学生在校所学的理论知识,同时还能检验临床教学水平和学生临床护理综合能力的掌握情况.

关键词： opcab 联合教学查房

合并缺血性左心室功能不全的冠心病患者的opcab治疗

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中华胸心血管外科杂志 2014年第2期30卷 96-97页

作者：夏利民刘欢宋凯魏来沈金强黄奔王春生 200032上海复旦大学附属中山医院心外科

目前，冠状动脉旁路移植（CABG）是大多数缺血性左心室功能不全患者的主要治疗手段。虽然体外循环和心肌保护技术日趋完善，其引起的全身炎性反应和心肌缺血再灌注损伤是否影响患者预后仍存争议，非体外循环冠状动脉旁路移植（off—pump... 详细信息

目前，冠状动脉旁路移植（CABG）是大多数缺血性左心室功能不全患者的主要治疗手段。虽然体外循环和心肌保护技术日趋完善，其引起的全身炎性反应和心肌缺血再灌注损伤是否影响患者预后仍存争议，非体外循环冠状动脉旁路移植（off—pump coronau artery bypass，opcab）作为此类患者的首选治疗方法仍不确定。现回顾性分析我科近年来opcab治疗缺血性左心室功能不全病例，总结经验报道如下。

关键词：左心室功能不全冠心病患者 opcab 治疗方法非体外循环冠状动脉旁路移植缺血性心肌缺血再灌注损伤心肌保护技术

Comparative study of on-pump and off-pump coronary bypass surgery for patients with triple coronary artery disease

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介入放射学杂志 2004年第S2期13卷 96-100页

作者： CHEN Xin, XU Ming, SHI Hong-wei, MU Xin-wei, CHEN Zhen-qiang, QIU Zhi-bing Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing Heart Institute, Nanjing, 210006 P.R.China

Objective To compare the clinical results of on-pump and off-pump coronary bypass surgery in patients with triple-vessel disease. Methods A total of 300 consecutive isolated multiple CABG patients entered into off-pump coronary artery bypass (opcab group, n=150) or CABG with cardiopulmonary bypass (CPB) (CCABG group, n=150). There were no significant difference regarding the degree of angina, history of myocardial infarction, diabetes and left main disease between two groups. The ejection fraction in opcab before surgery was lower than CCABG (Popcab pre-operatively( Popcab, along with a stabilizer and a coronary shunt. Medi-Stim Butterfly Flowmeter was used to measure the flow of grafts in both groups. Results No one in opcab needed to convert to CCABG. The number of the distal anastomosis and the index of completeness of revisualization (ICR) were similar in both groups. The respiratory support time, the volume of chest tube drainage and blood transfusion were less in opcab than in CCABG post-operatively (both Popcab than in CCABG post-operatively ( both Popcab can be applied to patients with triple vessels disease and achieved similar completeness of revascularization, similar early surgical results with shorter respiratory support, reduced transfusion requirement, less pulmonary dysfunction and abnormal renal function.

关键词： opcab lrmltiple vessels disease complete revascularization