在非体外循环冠状动脉旁路移植术后，交感神经刺激可增加原位右胃网膜动脉移植物的血流量。

Sympathetic stimulation increases the blood flow through the in situ right gastroepiploic artery graft after off-pump coronary artery bypass graft surgery.

作者信息

Ryu Ho-Geol, Bahk Jae-Hyon, Kim Ki-Bong

机构信息

Department of Anesthesiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong Chongno-gu, Seoul 110-744, Republic of Korea.

出版信息

Eur J Cardiothorac Surg. 2006 Jun;29(6):948-51. doi: 10.1016/j.ejcts.2006.03.017. Epub 2006 May 3.

DOI:10.1016/j.ejcts.2006.03.017

PMID:16675234

Abstract

OBJECTIVE

The right gastroepiploic artery is gaining popularity as an in situ arterial graft for coronary artery bypass surgery. Unlike the internal thoracic artery, the right gastroepiploic artery is a visceral artery and has a vasoconstrictive tendency in response to sympathetic stimulation. We hypothesized that blood flow through the in situ right gastroepiploic arterial graft might be compromised after sympathetic stimulation.

METHODS

Thirty patients scheduled for off-pump coronary artery bypass surgery using the left internal thoracic artery and the right gastroepiploic artery as in situ arterial grafts were enrolled. Blood flow through both arteries was measured by transit time flow before (T1), during (T2), and after noradrenalinee infusion (T3).

RESULTS

After sympathetic stimulation, blood flow of both the right gastroepiploic artery (30.1+/-13.9 mL/min at T1 vs 36.2+/-17.5 mL/min at T2; P = 0.001) and left internal thoracic artery grafts (37.3+/-19.1 mL/min at T1 vs 41.8+/-18.2 mL/min at T2; P = 0.01) was increased significantly. However, blood flow in proportion to cardiac output increased only in the right gastroepiploic artery graft (P = 0.01).

CONCLUSIONS

Sympathetic stimulation increases, rather than compromises, blood flow through the right gastroepiploic artery graft after coronary revascularization.

摘要

目的

胃网膜右动脉作为冠状动脉旁路移植术中的原位动脉移植物正越来越受到欢迎。与胸廓内动脉不同，胃网膜右动脉是一条内脏动脉，对交感神经刺激有血管收缩倾向。我们假设交感神经刺激后，通过原位胃网膜右动脉移植物的血流可能会受到影响。

方法

纳入30例计划行非体外循环冠状动脉旁路移植术的患者，使用左胸廓内动脉和胃网膜右动脉作为原位动脉移植物。在去甲肾上腺素输注前（T1）、输注期间（T2）和输注后（T3），通过渡越时间血流测量两条动脉的血流。

结果

交感神经刺激后，胃网膜右动脉（T1时为30.1±13.9 mL/min，T2时为36.2±17.5 mL/min；P = 0.001）和左胸廓内动脉移植物（T1时为37.3±19.1 mL/min，T2时为41.8±18.2 mL/min；P = 0.01）的血流均显著增加。然而，仅胃网膜右动脉移植物中与心输出量成比例的血流增加（P = 0.01）。