Chung Cheol Hyun, Lee Jae Won, Kang Joon Kyu, Song Hyun, Choo Suk Jung, Song Meong Gun
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
J Korean Med Sci. 2006 Oct;21(5):849-53. doi: 10.3346/jkms.2006.21.5.849.
The aortic connector system may reduce stroke during proximal venous anastomosis. However, the overall anastomotic patency rate has been generally reported to be low. From October 2002 to March 2004, 68 patients who received proximal anastomosis using the St. Jude Aortic Connector System were included in the study. There were 47 men and 21 women and their mean age was 65.68+/-6.68 yr old (52 to 85 yr). Grafts were evaluated by coronary angiography or multi-slice 16 channel 3-D CT at 6 days and at 6 months postoperatively. In the immediate postoperative period, no stenosis was observed by either angiography (n=22) or 3D CT (n=46). At 6-month postoperatively, we performed either angiography (n=7) or 3-D CT (n=52). Of these patients, 5 patients showed graft stenosis in the midportion, and 3 in the ostium. There were no stroke. Simple, and effective proximal anastomosis with good protection from cerebrovascular accident was achieved especially when calcification or atheromatous plaque was observed at the ascending aorta in the operation room. However, our mid term patency results raise concerns related to venous graft stenosis in the midportion. Therefore, longer follow up is recommended.
主动脉连接系统可能会降低近端静脉吻合术中的中风发生率。然而,总体吻合通畅率普遍报道较低。2002年10月至2004年3月,本研究纳入了68例使用圣犹达主动脉连接系统进行近端吻合的患者。其中男性47例,女性21例,平均年龄为65.68±6.68岁(52至85岁)。术后6天和6个月通过冠状动脉造影或16层3D CT对移植物进行评估。术后即刻,血管造影(n = 22)或3D CT(n = 46)均未观察到狭窄。术后6个月,我们进行了血管造影(n = 7)或3D CT(n = 52)。在这些患者中,5例患者的移植物在中段出现狭窄,3例在开口处出现狭窄。未发生中风。尤其是在手术室中发现升主动脉有钙化或动脉粥样斑块时,可实现简单有效的近端吻合,并能很好地预防脑血管意外。然而,我们的中期通畅结果引发了对中段静脉移植物狭窄的担忧。因此,建议进行更长时间的随访。