Endo M
Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 2000 Dec;101(12):827-32.
It is nearly 40 years since the introduction of coronary artery bypass grafting (CABG) in humans. A. Carrel (1910) attempted the first CABG in animals and G. Murray (1954) succeeded in performing experimental CABG using the internal mammary artery (IMA). The first reported CABG using the IMA in humans was performed by R. Goetz using the sutureless technique in 1960. V. Kolessov (1964) performed the first sutured bypass grafting using the IMA. From 1962 to 1967, human CABG using autogenous saphenous vein grafts was performed by D. Sabiston (1962). H. Garrett (1964), D. Kahn (1966), and R. Favaloro (1967). Saphenous vein grafting became the most common CABG technique for the next two decades. In Japan, Y. Sezai et al. performed CABG using the free femoral artery, we performed CABG using the IMA, and S. Asada et al. performed CABG using the saphenous vein in 1970. In 1986, F. Loop et al. reported that the long-term survival rate of CABG was significantly higher when the IMA rather than the saphenous vein was used. IMA grafting, supplemented by the gastroepiploic artery, inferior epigastric artery, and radial artery, has enabled complete arterial revascularization to be performed in almost all patients. In the graft selection for CABG, the first choice is the left IMA and the second choice is the right IMA. The third choice is the gastroepiploic artery and/or radial artery, depending on the target anastomotic site, degree of stenosis, size of the distal graft, and in situ or free use.
自冠状动脉旁路移植术（CABG）应用于人体以来已近40年。A. 卡雷尔（1910年）尝试了首例动物冠状动脉旁路移植术，G. 默里（1954年）成功地使用乳内动脉（IMA）进行了实验性冠状动脉旁路移植术。1960年，R. 戈茨首次报告在人体使用IMA进行冠状动脉旁路移植术，采用了无缝合技术。V. 科列索夫（1964年）进行了首例使用IMA的缝合旁路移植术。1962年至1967年期间，D. 萨比斯顿（1962年）、H. 加勒特（1964年）、D. 卡恩（1966年）以及R. 法瓦洛罗（1967年）开展了使用自体大隐静脉移植物的人体冠状动脉旁路移植术。在接下来的二十年里，大隐静脉移植术成为最常用的冠状动脉旁路移植术。在日本，Y. 濑泽等人使用游离股动脉进行冠状动脉旁路移植术，我们使用IMA进行冠状动脉旁路移植术，S. 浅田等人于1970年使用大隐静脉进行冠状动脉旁路移植术。1986年，F. 卢普等人报告称，使用IMA而非大隐静脉进行冠状动脉旁路移植术时，长期生存率显著更高。IMA移植术辅以胃网膜动脉、腹壁下动脉和桡动脉，使得几乎所有患者都能够进行完全动脉血运重建。在冠状动脉旁路移植术的移植物选择中，首选是左IMA，次选是右IMA。第三选择是胃网膜动脉和/或桡动脉，这取决于目标吻合部位、狭窄程度、远端移植物大小以及原位或游离使用情况。
