Esmore Donald S, Markman Phuong L, Agrawal Sunil, Burton Paul R, Rosenfeldt Franklin L
Department of Cardiothoracic Surgery, Alfred Hospital and Cardiac Surgical Research Unit-Alfred Hospital and Baker Medical Research Institute, The Alfred, Commercial Road, Melbourne, Vic. 3004, Australia.
Heart Lung Circ. 2005 Mar;14(1):32-5. doi: 10.1016/j.hlc.2004.11.007.
There is evidence that the use of Y-grafts attached to the left internal mammary artery - to - left anterior descending artery graft may compromise the patency of the distal limb of the left internal mammary artery. We describe a technique (split radial technique) that avoids the use of Y-grafts by constructing two aorto-coronary grafts from a single radial artery. The split radial technique requires the harvesting of the radial artery in its entirety from the brachial bifurcation to the radial styloid. The first radial artery distal anastomosis is performed and the required length of conduit is determined. The conduit is transected, leaving a sufficiently long radial segment for a second aorto-coronary graft. A clinical follow-up 41 weeks after surgery of the first 37 patients in whom the split radial technique was used showed no deaths or major complications. This suggests that the split radial technique is a useful and safe way to maximise the use of radial artery conduit and to avoid the potential risk of compromising internal mammary artery patency with Y-grafts. There is evidence that the use of Y-grafts attached to the left internal mammary artery may compromise the patency of the distal limb of the left internal mammary artery. We describe the split radial technique of constructing two aorto-coronary graft segments from a single radial artery that can be used to avoid the use of Y-grafts.
有证据表明，将Y形移植物连接到左乳内动脉至左前降支动脉移植物上，可能会损害左乳内动脉远端的通畅性。我们描述了一种技术（桡动脉劈开技术），通过从单一桡动脉构建两个主动脉-冠状动脉移植物来避免使用Y形移植物。桡动脉劈开技术需要完整地获取从肱动脉分叉处至桡骨茎突的桡动脉。进行第一次桡动脉远端吻合，并确定所需的移植物长度。将移植物横断，留下足够长的桡动脉段用于第二个主动脉-冠状动脉移植物。对使用桡动脉劈开技术的首批37例患者术后41周的临床随访显示，无死亡或重大并发症发生。这表明桡动脉劈开技术是一种有用且安全的方法，可最大限度地利用桡动脉移植物，并避免Y形移植物损害乳内动脉通畅性的潜在风险。有证据表明，将Y形移植物连接到左乳内动脉可能会损害左乳内动脉远端的通畅性。我们描述了一种从单一桡动脉构建两个主动脉-冠状动脉移植物段的桡动脉劈开技术，该技术可用于避免使用Y形移植物。
