Kondoh K, Takeuchi A, Sasaki S, Oku T, Minohara S, Nishimoto Y, Hasegawa S, Morita M, Okamoto J, Hikita Y
Department of Thoracic Surgery, Osaka Medical College.
Kyobu Geka. 1992 Jul;45(8 Suppl):694-8.
Internal thoracic artery (ITA) grafts for coronary artery bypass grafting (CABG) are superior to SVG in the long-term patency and survival. In spite of our effort to utilize ITA whenever possible, we still have some cases which have to receive only vein grafts. Among the consecutive 201 patients undergoing CABG in the past three years, 32 patients (16%) received only vein grafts. We compared these patients (SVG group) with those who received ITA grafts (ITA group). The SVG group consisted of all emergency cases and many cases with single and double vessel disease. In the SVG group, perioperative use of IABP was more frequent and operative mortality was higher, although the number of grafts was fewer (2.66 vs 3.61) and aortic cross clamping time was shorter in this group. Main reasons for selecting only vein grafts were emergency surgery, inadvertent injury of ITA, inadequate ITA free flow etc. Technical refinement in the preparation of ITA is important to make possible wider application of arterial grafts for CABG.
用于冠状动脉旁路移植术（CABG）的胸廓内动脉（ITA）移植物在长期通畅率和生存率方面优于大隐静脉移植物（SVG）。尽管我们尽可能努力使用ITA，但仍有一些病例只能接受静脉移植物。在过去三年中连续接受CABG的201例患者中，32例（16%）仅接受了静脉移植物。我们将这些患者（SVG组）与接受ITA移植物的患者（ITA组）进行了比较。SVG组包括所有急诊病例以及许多单支和双支血管病变的病例。在SVG组中，围手术期主动脉内球囊反搏（IABP）的使用更为频繁，手术死亡率更高，尽管该组的移植物数量较少（2.66对3.61）且主动脉阻断时间较短。仅选择静脉移植物的主要原因是急诊手术、ITA意外损伤、ITA血流不足等。ITA制备技术的改进对于更广泛地应用动脉移植物进行CABG至关重要。
