Chen Xu-jun, Zhang Yong, Li Hong-wei, Feng Wen-hui, Wang Lei, Li Da-lian, Shen Lu-hua, Gu Fu-sheng, Chen Xin
Department of Cardiac Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Zhonghua Wai Ke Za Zhi. 2008 Feb 15;46(4):248-51.
To investigate the effect of autologous radial artery (RA) on coronary artery bypass grafting (CABG) in the elderly aged 65 years and older.
Three hundreds and twenty-two patients aged 65 years and older underwent CABG with autologous RA from January 2000 to March 2007. Peri-operative complication and mortality were observed and follow-up was performed.
Three hundreds and forty-four RA grafts including 300 cases of single and 22 cases of bilateral RA were collected. The total number of distal anastomosis was 974, with the mean of (3.0 +/- 0.4). The mean of RA distal anastomosis was (1.1 +/- 0.4). There were 321 single, 16 Y or T composite and 7 sequential grafts of RA constructed. The distal end of RA was anastomosed to right coronary artery system for 234 times, to obtuse marginal for 95 times, to diagonal or intermediate ramous artery for 22 times. The proximal end of RA was anastomosed to aorta for 328 times, to left internal mammary artery for 9 times and to saphenous vein for 7 times. Only 13 patients manifested transient paresthesia in the area of radial aspect of thumb and no other complication occurred in the forearm. During hospitalization, 7 patients died. No patient died after the follow-up of (46.5 +/- 6.7) months. Seventy-three patients were performed with coronary angiography postoperatively. It was showed by coronary angiography that all RA conduits were patent after the duration of (47.5 +/- 11.2) months after CABG.
Utilization of RA to CABG in the elderly is safe and effective.
探讨自体桡动脉（RA）在65岁及以上老年人冠状动脉旁路移植术（CABG）中的应用效果。
2000年1月至2007年3月，322例65岁及以上患者接受了自体桡动脉CABG。观察围手术期并发症和死亡率，并进行随访。
共采集344根桡动脉移植物，其中单根桡动脉300例，双侧桡动脉22例。远端吻合总数为974个，平均（3.0±0.4）个。桡动脉远端吻合平均为（1.1±0.4）个。构建了321个单根、16个Y形或T形复合及7个序贯桡动脉移植物。桡动脉远端与右冠状动脉系统吻合234次，与钝缘支吻合95次，与对角支或中间支动脉吻合22次。桡动脉近端与主动脉吻合328次，与左乳内动脉吻合9次，与大隐静脉吻合7次。仅13例患者拇指桡侧区域出现短暂感觉异常，前臂未发生其他并发症。住院期间，7例患者死亡。随访（46.5±6.7）个月后无患者死亡。73例患者术后行冠状动脉造影。冠状动脉造影显示，CABG术后（47.5±11.2）个月时所有桡动脉血管均通畅。
在老年人中应用桡动脉进行CABG是安全有效的。
