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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.

DOI:10.3349/ymj.2009.50.1.78
PMID:19259352
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2649852/
Abstract

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.

摘要

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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引用本文的文献

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Ann Cardiothorac Surg. 2018 Sep;7(5):663-672. doi: 10.21037/acs.2018.06.11.

本文引用的文献

1
Does bilateral ITA grafting increase perioperative complications? Outcome of 4462 patients with bilateral versus 4204 patients with single ITA bypass.双侧胸廓内动脉移植是否会增加围手术期并发症?4462例双侧胸廓内动脉搭桥患者与4204例单侧胸廓内动脉搭桥患者的结果对比。
Eur J Cardiothorac Surg. 2006 Aug;30(2):318-23. doi: 10.1016/j.ejcts.2006.05.017. Epub 2006 Jul 7.
2
The effect of bilateral internal thoracic artery harvesting on superficial and deep sternal infection: The role of skeletonization.双侧胸廓内动脉获取对胸骨浅表及深部感染的影响:骨骼化的作用。
J Thorac Cardiovasc Surg. 2005 Mar;129(3):536-43. doi: 10.1016/j.jtcvs.2004.07.059.
3
Single versus multiple internal mammary artery grafting for coronary artery bypass: 15-year follow-up of a clinical practice trial.冠状动脉搭桥术中单支与多支乳内动脉移植:一项临床实践试验的15年随访
Circulation. 2004 Sep 14;110(11 Suppl 1):II27-35. doi: 10.1161/01.CIR.0000138193.51635.6f.
4
Should the internal thoracic artery be skeletonized?
Ann Thorac Surg. 2004 Jun;77(6):2238-46. doi: 10.1016/j.athoracsur.2003.10.041.
5
Single versus bilateral internal thoracic artery grafts with concomitant saphenous vein grafts for multivessel coronary artery bypass grafting: effects on mortality and event-free survival.单支与双支胸廓内动脉移植物联合大隐静脉移植物用于多支冠状动脉旁路移植术:对死亡率和无事件生存率的影响。
J Thorac Cardiovasc Surg. 2004 May;127(5):1408-15. doi: 10.1016/j.jtcvs.2003.10.006.
6
Long-term follow-up of coronary artery bypass grafting in three-vessel disease using exclusively pedicled bilateral internal thoracic and right gastroepiploic arteries.仅使用带蒂双侧胸廓内动脉和右胃网膜动脉进行三支血管病变冠状动脉旁路移植术的长期随访
Ann Thorac Surg. 2004 Mar;77(3):794-9; discussion 799. doi: 10.1016/S0003-4975(03)01659-X.
7
Skeletonization of bilateral internal thoracic artery grafts lowers the risk of sternal infection in patients with diabetes.双侧胸廓内动脉移植物骨骼化可降低糖尿病患者的胸骨感染风险。
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Internal thoracic artery vs. vein grafts--postoperative angiographic findings in symptomatic patients after 1000 days.胸廓内动脉与静脉移植物——有症状患者术后1000天的血管造影结果
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Bilateral pedicled internal thoracic artery grafting.
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