Outcomes of Surgical Patch Angioplasty of The Coronary Artery for Diffuse Coronary Artery Disease

Abstract Introduction: Diffuse coronary artery disease (CAD) has a poor prognosis and many patients are ineligible for conventional coronary artery bypass grafting (CABG). This study evaluated the 12-month outcomes of coronary artery reconstruction and surgical patch angioplasty of the coronary artery for diffuse CAD. Methods: A retrospective cohort study of patients who underwent CABG with surgical patch angioplasty of the coronary artery (reconstruction group) or standard CABG alone (standard group) at the Cardiovascular Surgery Department of the local Hospital between January 2014 and January 2016. Follow-up was censored at 12 months after surgery. Results: Cardiopulmonary bypass and aortic cross-clamping durations were longer in the reconstruction group (n=32) than in the standard group (n=125) (P0.05). In the reconstruction group, one patient died; a vein graft showed occlusion. In the standard group, two patients died; one left internal mammary artery graft and three vein grafts showed occlusion. There were no significant differences in mortality, major adverse cardiovascular and cerebrovascular events, and patency between the two groups (P>0.05). Conclusion: Coronary artery reconstruction and surgical patch angioplasty of the coronary artery can be performed for diffuse CAD. Patient outcomes were not significantly different from those of patients who underwent standard CABG.引言：弥漫性冠状动脉疾病（Diffuse Coronary Artery Disease, CAD）预后不佳，且诸多患者无法接受常规冠状动脉旁路移植术（Coronary Artery Bypass Grafting, CABG）。本研究评估了针对弥漫性冠状动脉疾病的冠状动脉重建术与冠状动脉外科补片血管成形术的12个月预后结局。方法：本研究为回顾性队列研究，纳入2014年1月至2016年1月于本院心血管外科接受冠状动脉旁路移植术联合冠状动脉外科补片血管成形术（重建组，n=32）或单纯标准冠状动脉旁路移植术（标准组，n=125）的患者，随访截尾至术后12个月。结果：重建组的体外循环与主动脉阻断时长均长于标准组，差异具有统计学意义（P<0.05，原文原输入为P0.05，疑为笔误）。重建组内1例患者死亡，1条静脉移植物出现闭塞；标准组内2例患者死亡，1条左乳内动脉移植物与3条静脉移植物出现闭塞。两组患者的死亡率、主要不良心脑血管事件发生率及移植物通畅率均无显著统计学差异（P>0.05）。结论：针对弥漫性冠状动脉疾病，可实施冠状动脉重建术与冠状动脉外科补片血管成形术，该术式的患者预后结局与接受标准冠状动脉旁路移植术的患者无显著差异。