关键词: 冠状动脉旁路移植术, 非体外循环, 手术后期间, 危险因素, Logistic模型

Abstract: Abstract  Objective To analyze the mid and long-term patency rate for grafts after off-pump coronary artery bypass grafting and the risk factors of patency rate. Methods  Seven thousand five hundred and twenty-one patients were underwent CABG in Tianjin Chest Hospital, one hundred and thirteen cases underwent OPCABG were followed up, among them, fifty-four cases were followed up by searching the coronary artery angiography and fifty-nine cases were followed up by searching dual Source CT. The patients were 70 males and 43 females with a mean age of 63.02±8.83 years at the time of surgery. Preoperative coronary angiography revealed one-vessel disease in 5 patients, two-vessel disease in 13 patients, three-vessel disease in 95 patients, and left main coronary artery disease with or without peripheral coronary artery disease in 32 patients.Eighty-six patients had high blood pressure, 42 patents had diabetes mellitus,26 patents had hyperlipidemia，36 patents had old Myocardial Infarction，14 patents had old cerebral infarction，40 patents had a smoke by now and 31 patients were older than 70 years. The mean following up period was 27.01±18.59 months and the average number of distal anastomoses per patient was 2.96±0.86. Internal thoracic arteries (ITA) were used in 75 and saphenous veins were used in 260 . Calculate the patency rate for arterial graft and the patency rate for saphenous vein grafts respectively and analyse the risk factors of mid and long-term patency rate for grafts after off-pump coronary artery bypass grafting. Results  The patency rate of all grafts after coronary artery bypass grafting was 83.0%；and 98.0% for internal thoracic arteries; the one year and five years patency rate was 98.6% and 88.5% for ITA; the patency rate was 78.1% for saphenous vein grafts, and the one year and five years patency rate was 85.9% and 61.3% for saphenous vein grafts; the patency rate with angina group was 78.9% and 92.2% for angina-free group, there were differences between the two groups（P=0.007. Conclusion   The ITA grafts have a better long-term patency than saphenous vein grafts；The follow -up period after OPCABG、the average number of distal anastomoses and the female were independent risk factors of patency rate for grafts after CABG; Graft lesion after CABG is an important factor leading to postoperative recurrent angina pectoris.

Key words: postoperative period, risk factors, Logistic Models