Louagie Y A, Jamart J, Buche M, Eucher P, van San P, Theys S, Schoevaerdts J C
Division of Cardiovascular and Thoracic Surgery, Université Hospital of Mont-Yvoir, Belgium.
J Thorac Cardiovasc Surg. 1999 Aug;118(2):330-8. doi: 10.1016/S0022-5223(99)70224-2.
Blood flow characteristics of right gastroepiploic artery and saphenous vein conduits were compared during bypass surgery.
This study is based on a consecutive series of 97 patients undergoing a bypass graft to the right coronary artery, posterior descending artery, or posterolateral branch using either a pediculated right gastroepiploic artery (n = 52) or a saphenous vein (n = 45) bypass graft. Flows and velocity profiles were measured with an 8-MHz pulsed-wave Doppler ultrasound flowmeter. Thorough flow measurements were made (1) after cessation of cardiopulmonary bypass and (2) before chest closure.
At the end of cardiopulmonary bypass, flow in the right gastroepiploic artery (59. 0 +/- 6.7 mL/min) did not differ (P =.08) from flow in the saphenous vein (46.1 +/- 2.7 mL/min). Mean trace velocity was 11.9 +/- 0.7 cm/s in the right gastroepiploic artery and 11.6 +/- 0.8 cm/s in the saphenous vein (P =.80), but peak systolic velocity was 29.4 +/- 1.2 cm/s for the right gastroepiploic artery and 23.1 +/- 1.3 cm/s for the saphenous vein (P <.001). Likewise, before chest closure, flow was 57.1 +/- 4.7 mL/min in the right gastroepiploic artery and 46.5 +/- 4.0 mL/min in the saphenous vein (P =.10), mean velocity was 12. 9 +/- 0.7 and 11.6 +/- 0.8 cm/s, respectively (P = .22), and systolic peak velocity was 30.0 +/- 1.2 and 22.3 +/- 1.2 cm/s, respectively (P < .001).
There were no flow differences between right gastroepiploic artery and saphenous vein grafts implanted into the same coronary bed in comparable groups of patients. Waveform shape of the right gastroepiploic artery grafts was characterized by a wider spectral dispersion resulting in a higher maximal frequency.
比较在搭桥手术中胃网膜右动脉和大隐静脉血管桥的血流特征。
本研究基于连续97例行冠状动脉搭桥术的患者，这些患者使用带蒂胃网膜右动脉（n = 52）或大隐静脉（n = 45）血管桥，将其移植至右冠状动脉、后降支或后外侧分支。使用8兆赫脉冲波多普勒超声流量计测量血流和速度剖面。在（1）体外循环停止后和（2）关闭胸腔前进行全面的血流测量。
体外循环结束时，胃网膜右动脉的血流（59.0±6.7毫升/分钟）与大隐静脉的血流（46.1±2.7毫升/分钟）无差异（P = 0.08）。胃网膜右动脉的平均跟踪速度为11.9±0.7厘米/秒，大隐静脉为11.6±0.8厘米/秒（P = 0.80），但胃网膜右动脉的收缩期峰值速度为29.4±1.2厘米/秒，大隐静脉为23.1±1.3厘米/秒（P < 0.001）。同样，在关闭胸腔前，胃网膜右动脉的血流为57.1±4.7毫升/分钟，大隐静脉为46.5±4.0毫升/分钟（P = 0.10），平均速度分别为12.9±0.7和11.6±0.8厘米/秒（P = 0.22），收缩期峰值速度分别为30.0±1.2和22.3±1.2厘米/秒（P < 0.001）。
在可比的患者组中，植入同一冠状动脉床的胃网膜右动脉血管桥和大隐静脉血管桥之间没有血流差异。胃网膜右动脉血管桥的波形形状特点是频谱离散度更宽，导致最大频率更高。
