Suma H, Wanibuchi Y, Furuta S, Isshiki T, Yamaguchi T, Takanashi R
Department of Cardiovascular Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
Eur J Cardiothorac Surg. 1991;5(5):244-7. doi: 10.1016/1010-7940(91)90171-f.
Ninety-two gastroepiploic artery (GEA) and 322 internal thoracic artery (ITA) grafts which underwent postoperative angiography (0.5-24 postoperative months, mean 2.0 months) were compared. The sites of GEA anastomosis were 5 left anterior descending, 3 diagonal, 16 circumflex and 68 right coronary arteries and for ITA grafts, 241 left anterior descending, 40 diagonal, 36 circumflex and 5 right coronary arteries. Patency rates were 96% (88/92) of GEA and 98% (314/322) of ITA, respectively. No focal stenosis in the graft trunk was found in both GEA and ITA except occasional spasm in GEA. Six (6%) GEAs were opacified via the superior mesenteric artery. Mean diameter of grafts just proximal to the anastomosis measured by angiogram was 2.3 mm in GEA and 1.9 mm in ITA (P less than 0.01). Free flow after intraluminal papaverine injection was 90.6 ml/min (50-300 ml/min) in 48 GEAs and 81.3 ml/min (50-150 ml/min) in 98 ITAs. Histology showed normal to mild intimal sclerotic changes in 58 of 63 (92%) GEAs and in 94 of 95 (99%) ITAs. From these results, we concluded that GEA is a suitable conduit and good long term patency similar to ITA grafting can be expected in coronary artery bypass grafting.
对92例胃网膜动脉（GEA）移植物和322例胸廓内动脉（ITA）移植物进行了比较，这些移植物均在术后（术后0.5 - 24个月，平均2.0个月）进行了血管造影。GEA吻合的部位为5支左前降支、3支对角支、16支回旋支和68支右冠状动脉；而ITA移植物吻合的部位为241支左前降支、40支对角支、36支回旋支和5支右冠状动脉。GEA和ITA的通畅率分别为96%（88/92）和98%（314/322）。除GEA偶尔出现痉挛外，GEA和ITA的移植物主干均未发现局灶性狭窄。6例（6%）GEA通过肠系膜上动脉显影。血管造影测量显示，GEA吻合口近端移植物的平均直径为2.3 mm，ITA为1.9 mm（P<0.01）。48例GEA在腔内注射罂粟碱后的自由血流为90.6 ml/min（50 - 300 ml/min），98例ITA为81.3 ml/min（50 - 150 ml/min）。组织学检查显示，63例GEA中有58例（92%）及95例ITA中有94例（99%）有正常至轻度的内膜硬化改变。根据这些结果，我们得出结论，在冠状动脉旁路移植术中，GEA是一种合适的血管 conduit，并且可以预期其长期通畅率与ITA移植相似。
