Deng Yongzhi, Sun Zongquan, Paterson Hugh S
Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
J Huazhong Univ Sci Technolog Med Sci. 2006;26(1):82-5. doi: 10.1007/BF02828045.
The feasibility and safety of total arterial coronary revascularization with 2 arterial conduits in patients with impaired left ventricular function was evaluated. Data were prospectively collected on all patients with multiple vessel discase and moderately or severely impaired left ventricular function, who underwent coronary surgery with the intention of total arterial revascularization with 2 conduits between March 1995 and August 2002. One hundred and seventy-nine patients were included in the study. Acute coronary insufficiency was present in 3 patients and 43 had unstable angina. Severe left ventricular impairment was present in 29 patients. There were 17 redo operations including 3 redo-redo procedures. Eighty-two percent of patients had a Y graft configuration from the left internal mammary artery (right internal mammary artery 40.8%, radial artery 33.5%, other 7.8%). The perioperative mortality was 2.2%, myocardial infarction 1.7% and stroke 0.6%. Total arterial revascularization in patients with ischaemic left ventricular dysfunction can be safely performed with 2 arterial conduits. The radial artery provides conduit length greater than the right internal mammary artery and allows full revascularization despite left ventricular dilatation.
评估了在左心室功能受损患者中使用2条动脉血管进行全动脉冠状动脉血运重建的可行性和安全性。前瞻性收集了1995年3月至2002年8月期间所有患有多支血管病变且左心室功能中度或重度受损、接受冠状动脉手术旨在使用2条血管进行全动脉血运重建的患者的数据。179例患者纳入研究。3例患者出现急性冠状动脉供血不足，43例有不稳定型心绞痛。29例患者存在严重左心室损害。有17例再次手术，包括3例再次-再次手术。82%的患者采用了来自左乳内动脉的Y型移植物构型（右乳内动脉40.8%，桡动脉33.5%，其他7.8%）。围手术期死亡率为2.2%，心肌梗死为1.7%，中风为0.6%。缺血性左心室功能障碍患者使用2条动脉血管可安全地进行全动脉血运重建。桡动脉提供的血管长度大于右乳内动脉，即使左心室扩张也能实现完全血运重建。
