Barra J A, Mondine P, Bezon E, Mahlab A, Rukbi I, Braesco J
Service de Chirurgie Thoracique, cardiaque et vasculaire, CHRU, Brest.
Presse Med. 1991 Mar 9;20(9):423-5.
The distal latero-circumflex arteries and the posterior descending artery are located so far from the mammary arteries that they cannot be revascularized by the conventional procedure. Reimplantation of the right internal mammary artery (RIMA) used as a free graft into the left internal mammary artery (LIMA) in situ doubles the length of the RIMA, thus enabling the distal coronary arteries (lower lateral or posterior interventricular arteries) to be bypassed. The Y-shaped reimplantation anastomosis technique is described, and the immediate results obtained in 25 patients are reported. Seven angiographic controls were performed after 6 months to 1 year, and 6 anastomoses were perfectly patent. One RIMA is occluded (major competitive flow).
远侧外侧回旋动脉和后降支动脉距离乳内动脉很远，以至于无法通过传统手术实现血管再通。将作为游离移植物的右乳内动脉（RIMA）原位再植入左乳内动脉（LIMA）可使RIMA的长度增加一倍，从而能够绕过远端冠状动脉（下外侧或后室间动脉）。本文描述了Y形再植入吻合技术，并报告了25例患者的即时结果。6个月至1年后进行了7次血管造影对照，6处吻合口完全通畅。1处RIMA闭塞（主要为竞争性血流）。
