Weinschelbaum E E, Macchia A, Caramutti V M, Machain H A, Raffaelli H A, Favaloro M R, Favaloro R R, Dulbecco E A, Abud J A, De Laurentiis M, Gabe E D
Department of Cardiovascular Surgery, Institute of Cardiology and Cardiovascular Surgery, Favaloro Foundation, Buenos Aires, Argentina.
Ann Thorac Surg. 2000 Oct;70(4):1378-83. doi: 10.1016/s0003-4975(00)01701-x.
The radial artery is being used with increasing frequency instead of the saphenous vein in coronary artery bypass grafts. We analyzed the in-hospital and midterm results in patients undergoing coronary artery bypass surgery in whom a combination of arterial grafts was used, including radial artery and one or both internal mammary arteries.
Between 1995 and 1998, 1,023 patients underwent coronary artery bypass surgery using arterial conduits. The left internal mammary artery and the right internal mammary artery were employed in combination with the radial artery.
An average of 3.2 grafts per patient were done. The left internal mammary artery and radial artery were used in 100% of patients, the right internal mammary artery in 21.7%, and a venous graft in 31%. The operative mortality rate was 2.5%. On repeat angiography performed in 62 patients before their discharge, the arterial conduits were patent in 98.4%. Mean follow-up was 25.0 +/- 9.6 months (1 to 48 months). The probability of survival was 92.8%.
Revascularization using mammary and radial artery grafts is safe. Complications are not higher than those observed with saphenous vein grafting. It was possible to use arterial conduits in all the patients, even in those with impaired left ventricular function.
在冠状动脉旁路移植术中，桡动脉的使用频率越来越高，取代了大隐静脉。我们分析了接受冠状动脉旁路手术患者的院内及中期结果，这些患者使用了包括桡动脉和一根或两根乳内动脉在内的动脉移植物组合。
1995年至1998年间，1023例患者接受了使用动脉管道的冠状动脉旁路手术。左乳内动脉和右乳内动脉与桡动脉联合使用。
每位患者平均进行3.2次移植。100%的患者使用了左乳内动脉和桡动脉，21.7%的患者使用了右乳内动脉，31%的患者使用了静脉移植物。手术死亡率为2.5%。62例患者出院前进行的再次血管造影显示，动脉管道通畅率为98.4%。平均随访时间为25.0±9.6个月（1至48个月）。生存率为92.8%。
使用乳内动脉和桡动脉移植物进行血运重建是安全的。并发症不高于大隐静脉移植术。即使是左心室功能受损的患者，也可以在所有患者中使用动脉管道。
