Siegel W, Loop F D
Circulation. 1976 Dec;54(6 Suppl):III1-3.
The effectiveness of myocardial perfusion with internal mammary artery (IMA) bypass revascularization has been questioned. We compared 37 patients with single patent IMA bypass grafts with 26 patients who had single patent saphenous vein graft (SVG) bypass. Serial computer assisted graded maximal stress testing was used for quantitation of palliation. Patients were classified and compared according to the completeness of revascularization by postoperative catheterization. All patient subgroups, had statistically significant improvements in work capacity, maximal heart rate, maximal rate-pressure products, abnormal exercise electrocardiograms, and exercise-induced angina pectoris. The quantitative improvements in these measurements of patient palliation were the same during postoperative stress tests after either SVG or IMA revascularization. Considering the overall higher patency rate of the IMA bypass, the data indicate that this procedure, when surgically applicable, is preferable to SVG bypass.
乳内动脉（IMA）搭桥血管重建术的心肌灌注效果受到质疑。我们将37例单支IMA搭桥血管通畅的患者与26例单支大隐静脉移植血管（SVG）搭桥的患者进行了比较。采用连续计算机辅助分级最大负荷试验对缓解情况进行定量分析。根据术后心导管检查的血管重建完整性对患者进行分类和比较。所有患者亚组在工作能力、最大心率、最大速率压力乘积、异常运动心电图以及运动诱发心绞痛方面均有统计学意义的改善。在SVG或IMA血管重建术后的负荷试验中，这些患者缓解指标的定量改善情况相同。考虑到IMA搭桥总体上较高的通畅率，数据表明该手术在手术可行时比SVG搭桥更可取。
