Kameda Y, Kitamura S, Taniguchi S, Kawata T, Mizuguchi K, Nishioka H, Sakaguchi H
Department of Surgery III, Nara Medical University, Kashihara, Nara, Japan.
J Cardiovasc Surg (Torino). 2001 Feb;42(1):9-16.
It is not known how the internal thoracic artery (ITA) and saphenous vein graft (SVG) adapts to somatic growth of pediatric patients who underwent coronary artery bypass grafting (CABG).
Twenty-two ITAs and 6 SVGs in 17 patients who underwent at least three postoperative catheterizations with biplanar cineangiography and followed for a minimum of 5 years were evaluated. We evaluated the length, diameter and curvature of the grafts by cineangiographies which were performed at 1 month, 1 year, 5 years and more than 5 years postoperatively.
The length of the ITA (1-month: 117+/-31 mm, 1-year: 134+/-32 mm, 5-years: 146+/-28 mm, and >5-years: 155+/-34 mm, p=0.032) and diameter of the ITA (1.4+/-0.4 mm, 2.0+/-0.7 mm, 2.3+/-0.6 mm and 2.6+/-0.6 mm, p<0.0001) significantly increased over time, but neither the length nor diameter of the SVG length: 121+/-33 mm, 119+/-29 mm, 119+/-25 mm and 126+/-1 mm, p=0.9907; diameter: 4.1+/-1.0 mm, 3.9+/-0.7 mm, 4.0+/-0.8 mm and 3.3+/-0.4 mm, p=0.5784) increased. Although the ITA exhibited no change in curvature over time (1 month: 1.15+/-0.07, late: 1.15+/-0.07, p=0.8490), the curvature of the SVG significantly decreased over time (1 month: 1.42+/-0.19 and late: 1.25+/-0.16, p=0.0277). The percent segmental length of ITAs were changed little from early to late after CABG (1 month: proximal: 33.7+/-7.0%, middle: 33.3+/-7.9% and distal: 32.9+/-7.9%, vs late: 34.3+/-7.2%, 33.2+/-7.9% and 32.5+/-7.9%, p=0.937).
ITAs grow in proportion to somatic growth, while SVGs course in a more linear fashion in adapting to patient growth.
对于接受冠状动脉旁路移植术（CABG）的儿科患者，其胸廓内动脉（ITA）和大隐静脉移植物（SVG）如何适应躯体生长尚不清楚。
对17例患者的22条ITA和6条SVG进行评估，这些患者术后至少接受了三次双平面血管造影导管检查，并至少随访了5年。我们通过术后1个月、1年、5年和5年以上进行的血管造影评估移植物的长度、直径和曲率。
ITA的长度（1个月：117±31mm，1年：134±32mm，5年：146±28mm，>5年：155±34mm，p=0.032）和直径（1.4±0.4mm，2.0±0.7mm，2.3±0.6mm和2.6±0.6mm，p<0.0001）随时间显著增加，但SVG的长度（121±33mm，119±29mm，119±25mm和126±1mm，p=0.9907）和直径（4.1±1.0mm，3.9±0.7mm，4.0±0.8mm和3.3±0.4mm，p=0.5784）均未增加。尽管ITA的曲率随时间无变化（1个月：1.15±0.07，后期：1.15±0.07，p=0.8490），但SVG的曲率随时间显著降低（1个月：1.42±0.19，后期：1.25±0.16，p=0.0277）。CABG术后早期至晚期ITA各节段长度百分比变化不大（1个月：近端：33.7±7.0%，中间：33.3±7.9%，远端：32.9±7.9%，与后期：34.3±7.2%，33.2±7.9%和32.5±7.9%，p=0.937）。
ITA与躯体生长成比例生长，而SVG在适应患者生长时呈更线性的走行。
