Go T, Toyama M, Yanagi K, Tanabe H, Ozaki S, Kawase I
Department of Cardiovascular Surgery, Kameda General Hospital.
Kyobu Geka. 1992 Jul;45(8 Suppl):715-9.
Increasing number of coronary artery bypass surgery has been performed utilizing more arterial grafts because of poor long term patency rate of saphenous vein grafts. The risk of bilateral internal mammary artery grafting was studied in two groups of patients who were matched for recognized risk factors such as year of operation, age, gender, extent of coronary artery disease, left ventricular function, completeness of myocardial revascularization, and history of congestive heart failure. The patient groups differed in the fact that they received on internal mammary artery graft or two internal mammary artery grafts. The operative mortality rate was zero in either group. Analysis of operative and postoperative morbidity demonstrated no significant differences except for a slight increase in transfusion requirement, rate of wound infection and use of catecholamine in the group receiving two internal mammary artery grafts (p = 0.1, 0.1 and 0.05, respectively). We conclude at this moment that bilateral internal mammary artery grafting does not increase surgical mortality but increases the use of catecholamine comparing with the ipsilateral internal mammary artery grafting. Since the cases analysed in this study are limited, definitive conclusion should be deferred.
由于大隐静脉移植血管的长期通畅率较低，越来越多的冠状动脉搭桥手术采用了更多的动脉移植血管。在两组患者中研究了双侧乳内动脉移植的风险，这两组患者在公认的风险因素方面相匹配，如手术年份、年龄、性别、冠状动脉疾病程度、左心室功能、心肌血运重建的完整性以及充血性心力衰竭病史。患者组的不同之处在于，一组接受单根乳内动脉移植，另一组接受两根乳内动脉移植。两组的手术死亡率均为零。手术和术后发病率分析显示，除了接受两根乳内动脉移植的组在输血需求、伤口感染率和儿茶酚胺使用方面略有增加外，没有显著差异（p值分别为0.1、0.1和0.05）。我们目前得出的结论是，与同侧乳内动脉移植相比，双侧乳内动脉移植不会增加手术死亡率，但会增加儿茶酚胺的使用。由于本研究分析的病例有限，最终结论应推迟得出。
