双侧胸廓内动脉蒂取材会增加纵隔炎的风险吗？
Does bilateral pedicle internal thoracic artery harvest increase the risk of mediastinitis?
作者信息
Choo Suk-Jung, Lee Sang-Kwon, Chung Sung-Woon, Kim Jong-Won, Sung Si-Chan, Kim Young-Dae, Bae Mi-Ju, Kim June-Hong, Chon Kook-Jin, Lee Han-Cheol
机构信息
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, Seoul, Korea.
出版信息
Yonsei Med J. 2009 Feb 28;50(1):78-82. doi: 10.3349/ymj.2009.50.1.78. Epub 2009 Feb 24.
PURPOSE
Bilateral in situ internal thoracic artery (ITA) bypassing may result in excellent myocardial revascularization without increasing the risk of deep sternal wound infection. Although there have been concerns with the use of pedicled bilateral ITA, the risk of infection may not be greater than the use of skeletonized ITA.
MATERIALS AND METHODS
The present study was retrospectively undertaken to determine if pedicled BITA grafts are associated with a higher risk of sternal wound complications. A total of 207 patients who underwent bilateral ITA bypasses with or without existing diabetes mellitus, and 162 patients of those received bilateral pedicled ITA and 98 patients received unilateral ITA bypass grafts.
RESULTS
No sternal wound complications were noted in either the bilateral ITA or unilateral left ITA groups.
CONCLUSION
Bilateral pedicled ITA harvesting was not associated with a greater incidence of infectious sternal complications compared to patients receiving unilateral ITA bypass grafts.
目的
双侧原位胸廓内动脉（ITA）搭桥术可实现良好的心肌血运重建，且不会增加深部胸骨伤口感染的风险。尽管使用带蒂双侧ITA存在一些担忧，但感染风险可能并不高于使用骨骼化ITA。
材料与方法
本研究为回顾性研究，旨在确定带蒂双侧ITA移植是否与胸骨伤口并发症的较高风险相关。共有207例接受双侧ITA搭桥术的患者，其中有或无糖尿病，162例接受双侧带蒂ITA，98例接受单侧ITA搭桥移植。
结果
双侧ITA组和单侧左ITA组均未发现胸骨伤口并发症。
结论
与接受单侧ITA搭桥移植的患者相比，双侧带蒂ITA采集与感染性胸骨并发症的发生率较高无关。
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