Hetzer R, Heim K, Borst H G, Amende I, Sigwart U
Thoraxchir Vask Chir. 1976 Aug;24(4):296-302. doi: 10.1055/s-0028-1095932.
The purpose of this study was to observe the effect of surgical revascularization on the motility of the left ventricular segment distal to a high grade coronary stenosis. In 17 patients with LAD bypass local relative segment shortening lambda (lambda = diastolic length - systolic length/diastolic length X 100) was determined measuring the distances of coronary bifurcations and surgically implanted myocardial metal markers frame by frame in high speed cineradiography. A group of 14 patients whose angina pectoris was abolished after operation and where bypass proved to be patent showed significant increase of lambda within the first postoperative days (lambda preop. = 3,4 +/- 18,3 SD, lambda postop. = 18,9 +/- 8,0 SD, p less than 0.05). Paradoxical movement had disappeared in 4 cases. In the following two-monthly controls up to one year no significant further alterations of local motility were seen. Three patients with persisting angina did not show any increase of segment shortening. It is concluded that aorto-coronary bypass surgery can restore impaired local motility in the majority of patients. The method described is useful for repeated non-invasive controls of the success of operation.
本研究的目的是观察外科血管重建术对重度冠状动脉狭窄远端左心室节段运动的影响。在17例行左前降支搭桥术的患者中，通过在高速电影血管造影术中逐帧测量冠状动脉分叉处和手术植入的心肌金属标记物的距离，确定局部相对节段缩短率λ（λ=舒张期长度-收缩期长度/舒张期长度×100）。一组14例术后心绞痛消失且搭桥血管通畅的患者在术后第一天内λ显著增加（术前λ=3.4±18.3标准差，术后λ=18.9±8.0标准差，p<0.05）。4例患者的矛盾运动消失。在接下来长达一年的每两个月一次的随访中，未观察到局部运动有进一步的显著变化。3例持续心绞痛患者的节段缩短未增加。结论是，主动脉-冠状动脉搭桥手术可使大多数患者受损的局部运动恢复。所描述的方法有助于对手术成功进行反复无创性监测。
