Gaudino Mario, Alessandrini Francesco, Pragliola Claudio, Luciani Nicola, Trani Carlo, Burzotta Francesco, Girola Fabiana, Nasso Giuseppe, Guarini Giovanni, Possati Gianfederico
Department of Cardiac Surgery, Catholic University, Rome, Italy.
J Thorac Cardiovasc Surg. 2004 Apr;127(4):1139-44. doi: 10.1016/j.jtcvs.2003.07.051.
The angiographic patency of composite Y internal thoracic artery-saphenous vein grafts has not been investigated in detail.
Twenty-five patients who received composite Y internal thoracic artery-saphenous vein grafts had control angiography and vasoactive challenges with serotonin, acetylcholine, and isosorbide dinitrate at a mean of 2.5 +/- 1.2 years after surgery.
The perfect patency rate of composite Y internal thoracic artery-saphenous vein grafts was 72% (18/25). The distal portion of the internal thoracic artery was stringed in 4 patients and occluded in 2. The saphenous branch of the composite Y internal thoracic artery-saphenous vein grafts was found patent in all patients except 1. No failures were reported in the proximal tract of the internal thoracic artery. The distal tract of the internal thoracic artery showed reduced capacity of endothelium-mediated relaxation.
The short-term patency of composite Y internal thoracic artery-saphenous vein grafts is suboptimal and markedly influenced by distal runoff and native flow competition.
复合Y型胸廓内动脉-大隐静脉移植物的血管造影通畅情况尚未得到详细研究。
25例接受复合Y型胸廓内动脉-大隐静脉移植物的患者在术后平均2.5±1.2年时接受了对照血管造影以及血清素、乙酰胆碱和硝酸异山梨酯的血管活性激发试验。
复合Y型胸廓内动脉-大隐静脉移植物的完美通畅率为72%（18/25）。4例患者胸廓内动脉远端呈条索状，2例闭塞。除1例患者外，复合Y型胸廓内动脉-大隐静脉移植物的大隐静脉分支在所有患者中均通畅。胸廓内动脉近端未报告失败病例。胸廓内动脉远端显示内皮介导的舒张功能降低。
复合Y型胸廓内动脉-大隐静脉移植物的短期通畅情况欠佳，且明显受远端血流和自身血流竞争的影响。
