Masuda T, Tanimoto Y, Kobayashi Y, Sakata K, Misumi H, Hayashi K
Department of Cardiovascular Surgery, Saiseikai Shimonoseki General Hospital, Yamaguchi, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Oct;39(10):1888-93.
In the two year period from 1989 to 1990, 22 patients (18 men, 4 women; age range from 40 to 59 years) underwent coronary artery bypass grafting (CABG) using in situ and free internal thoracic arteries (ITAs). 23 of total 38 ITA grafts were free grafts in the aorta-coronary position, mainly to provide sufficient graft length. All of 34 ITA grafts were patent in 20 patients with coronary arteriography about one month after operation. There were no early and late death, and all patients were free from angina after a 9.4 month mean follow-up. Perioperative complications included reoperation for the bleeding in one case and the elevation of left diaphragm in one case, but there was no other major complication such as perioperative myocardial infarction, cerebral infarction or mediastinitis. These results indicated that the free ITA could be applied as well as the in situ ITA in multiple CABG of the Japanese with good patency rate and low operative risk.
在1989年至1990年的两年期间,22例患者(18例男性,4例女性;年龄范围为40至59岁)接受了使用原位和游离胸廓内动脉(ITA)的冠状动脉旁路移植术(CABG)。38根ITA移植物中有23根为主动脉-冠状动脉位置的游离移植物,主要是为了提供足够的移植物长度。术后约1个月,20例接受冠状动脉造影的患者中,34根ITA移植物全部通畅。无早期和晚期死亡病例,平均随访9.4个月后,所有患者均无心绞痛发作。围手术期并发症包括1例因出血而再次手术和1例左膈肌抬高,但无其他主要并发症,如围手术期心肌梗死、脑梗死或纵隔炎。这些结果表明,游离ITA在日本患者的多次CABG中与原位ITA一样适用,通畅率高且手术风险低。