Kawachi K, Kitamura S, Morita R, Kondo Y, Taniguchi S, Seki T, Kawata T, Hasegawa J, Yoshida Y, Hagihara Y
Department of Surgery III, Nara Medical College.
Kyobu Geka. 1992 Jul;45(8 Suppl):665-70.
Between November 1981 and December 1991, 755 patients underwent isolated coronary artery bypass grafting. We compared postoperative events, graft patency and survival rates of the patients who received at least one internal thoracic artery graft (n = 517) with those of the patients who had only saphenous vein bypass grafts (n = 238). No significant difference was found between the 2 groups in patient's age at the operation, female ratio and the incidence of emergency operation. The operative mortality was not significantly different in either group. Graft patency was better for internal thoracic artery grafts than for SVG (ITA grafts 97.1%, SVG 85.6% p less than 0.0001). Graft-LAD patency rate was also better for ITA grafts than for SVG (ITA grafts 97.7%, SVG 86.8%, p less than 0.0001). The incidence of late cardiac events (late cardiac death, reoperation, myocardial infarction) is lower in patients with ITA. Furthermore, patients who received ITA grafts had a better survival rate at 8 years (91.1% versus 85.3%, p = 0.048) than those who had vein bypass grafts alone. We conclude that the use of ITA grafts enhances the long-term benefits including long-term survival rate. This is the first observation in Japanese population.
1981年11月至1991年12月期间，755例患者接受了单纯冠状动脉旁路移植术。我们比较了至少接受一根胸廓内动脉移植的患者（n = 517）与仅接受大隐静脉旁路移植的患者（n = 238）的术后事件、移植血管通畅率和生存率。两组患者的手术年龄、女性比例和急诊手术发生率无显著差异。两组的手术死亡率也无显著差异。胸廓内动脉移植的血管通畅率优于大隐静脉移植（胸廓内动脉移植97.1%，大隐静脉移植85.6%，p < 0.0001）。左前降支移植血管的通畅率胸廓内动脉移植也优于大隐静脉移植（胸廓内动脉移植97.7%，大隐静脉移植86.8%，p < 0.0001）。接受胸廓内动脉移植的患者晚期心脏事件（晚期心脏死亡、再次手术、心肌梗死）的发生率较低。此外，接受胸廓内动脉移植患者的8年生存率（91.1%对85.
