Tobe M, Ozaki T, Sakamoto A, Hamada T, Kubo N, Uchida K, Sato S, Toyama S
Division of Cardiovascular Surgery, Kanagawa Cardiovascular and Respiratory Center.
Kyobu Geka. 1992 Jul;45(8 Suppl):686-9.
The clinical characteristics of selection of graft materials were analysed for patients undergoing emergency coronary artery bypass surgery (CABG) following failed coronary angioplasty (PTCA). Ten emergency CABGs were performed from January 1983 to December 1991. Perioperative variables and follow-up were compared to 18 patients undergoing elective CABG after PTCA. The emergency group had shorter operative time (p less than 0.01) and shorter bypass time (p less than 0.05). Moreover the emergency group had decreased use of the internal thoracic artery (ITA) (40% vs 94.4%, p less than 0.01). There was no use of bilateral ITAs in the emergency group. There was not significant difference in hospital mortality and medium term follow-up between two groups. In conclusion, emergency CABG carries a significantly less use of ITA graft than elective CABG although ITAs are superior to SVGs about long term patency rate. So it is desirable that arterial graft should be used under an appropriate selection at emergency operation.
对冠状动脉血管成形术（PTCA）失败后接受急诊冠状动脉旁路移植术（CABG）的患者移植物材料选择的临床特征进行了分析。1983年1月至1991年12月期间进行了10例急诊CABG手术。将围手术期变量和随访情况与18例PTCA后接受择期CABG的患者进行了比较。急诊组的手术时间较短（p<0.01），旁路时间较短（p<0.05）。此外，急诊组胸廓内动脉（ITA）的使用率较低（40%对94.4%，p<0.01）。急诊组未使用双侧ITA。两组之间的医院死亡率和中期随访无显著差异。总之，尽管ITA在长期通畅率方面优于大隐静脉移植物（SVG），但急诊CABG中ITA移植物的使用明显少于择期CABG。因此，在急诊手术时，应在适当选择的情况下使用动脉移植物。
