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术后12年对单支左乳内动脉与动脉T型移植物的解剖学和功能评估。

Anatomical and functional assessment of single left internal mammary artery versus arterial T-grafts 12 years after surgery.

作者信息

Hartman Joost M, Meijboom Bob W, Galema Tjebbe W, Takkenberg Johanna J M, Schets Anne-Maria, de Feyter Pim J, Bogers Ad J J C

机构信息

Department of Cardiothoracic Surgery, Thoraxcentre, Bd 575, Erasmus Medical Center Rotterdam, 3000 CA, Rotterdam, The Netherlands.

出版信息

Interact Cardiovasc Thorac Surg. 2009 Sep;9(3):416-20. doi: 10.1510/icvts.2008.199828. Epub 2009 Jun 2.

Abstract

We determined whether ultrasonographic left internal mammary artery (LIMA) findings correspond with 64 multislice computed tomography (MSCT) in patients 12 years after coronary artery bypass grafting. We included 34 patients (63.2+/-9.2 years), 16 with conventional single LIMA (group I) and 18 arterial T-grafts (group II), in a cross-sectional study. Patients underwent transthoracic proximal LIMA ultrasonography at rest and during the Azoulay maneuver, transthoracic echocardiography of the left ventricle and 64-MSCT, 11.5+/-1.4 years postoperatively. MSCT scans showed three string sign LIMA grafts (19%) in group I and three distal string sign LIMA grafts (17%) and 16 occluded T-graft anastomoses (22%) in group II. LIMA diameters and areas are significantly larger in group II in the origin, 3.5+/-0.7 vs. 2.5+/-0.5 mm, P=0.00007 and 0.09+/-0.04 vs. 0.05+/-0.02 cm(2), P=0.00019 and in the third intercostal space, 3.4+/-0.7 vs. 2.5+/-0.5 mm, P=0.00009 and 0.09+/-0.03 vs. 0.05+/-0.02 cm(2), P=0.000047. Most ultrasonographic LIMA findings do not differ between the groups. Thus, proximal LIMA diameters and areas are significantly larger in T-grafts and ultrasonographic variables equalize between the groups at rest and during the Azoulay maneuver 12 years after surgery.

摘要

我们对冠状动脉搭桥术后12年的患者进行研究,以确定超声检查的左乳内动脉(LIMA)结果与64层螺旋计算机断层扫描(MSCT)结果是否相符。在一项横断面研究中,我们纳入了34例患者(63.2±9.2岁),其中16例采用传统单支LIMA(I组),18例采用动脉T型移植物(II组)。患者在术后11.5±1.4年时接受了静息状态及阿祖莱动作时的经胸LIMA近端超声检查、左心室经胸超声心动图检查以及64层MSCT检查。MSCT扫描显示,I组中有3例LIMA移植物出现三线征(19%),II组中有3例LIMA移植物出现远端三线征(17%),16例T型移植物吻合口闭塞(22%)。II组LIMA在起始处的直径和面积显著更大,直径分别为3.5±0.7 vs. 2.5±0.5 mm,P = 0.00007,面积分别为0.09±0.04 vs. 0.05±0.02 cm²,P = 0.00019;在第三肋间,直径分别为3.4±0.7 vs. 2.5±0.5 mm,P = 0.00009,面积分别为0.09±0.03 vs. 0.05±0.02 cm²,P = 0.000047。两组间大多数LIMA超声检查结果无差异。因此,T型移植物中LIMA近端直径和面积显著更大,且术后12年时,静息状态及阿祖莱动作时两组间超声检查变量趋于一致。

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