Geha A S
Arch Surg. 1976 Mar;111(3):289-92. doi: 10.1001/archsurg.1976.01360210083017.
Crossed double internal mammary (IMA)-coronary artery grafts (the left to the left anterior descending artery [LAD], the right to a diagonal or marginal coronary branch) were used without mortality and with excellent functional results in 36 patients requiring separate grafts to these vessels (22% of patients undergoing coronary revascularization). Flows were 70 +/- 9 ml/min in the left and 50 +/- 7 ml/min in the right IMA, respectively. All revisualized grafts remained patient. The location and direction of the LAD and of diagonal and marginal branches allow excellent alignment of these shorter and wider double IMA grafts. The left IMA is the graft of choice for the LAD, and the right IMA is the choice for a high diagonal or early arising marginal branch that requires an additional separate graft. The right IMA is not satisfactory for right coronary or LAD bypass.
采用交叉双侧乳内动脉（IMA）-冠状动脉移植术（左侧连接左前降支动脉[LAD]，右侧连接对角支或边缘冠状动脉分支），36例需要对这些血管进行单独移植的患者（占接受冠状动脉血运重建患者的22%）手术无死亡，功能结果良好。左侧IMA血流量为70±9 ml/min，右侧IMA血流量为50±7 ml/min。所有复查的移植血管均通畅。LAD以及对角支和边缘支的位置和走行使得这些较短且较宽的双侧IMA移植血管能完美对齐。左侧IMA是LAD移植的首选血管，右侧IMA则是需要额外单独移植的高位对角支或早期发出的边缘支的首选血管。右侧IMA用于右冠状动脉或LAD搭桥并不理想。
